摘要
目的 比较丁丙诺啡透皮贴剂与口服曲马多缓释片对普瑞巴林治疗老年带状疱疹后神经痛患者疗效的影响.方法 将2016年1月至2017年1月就诊于山东大学齐鲁医院的182例带状疱疹后神经痛患者,采用随机数字表法随机分为丁丙诺啡+普瑞巴林组和曲马多+普瑞巴林组,每组91例,两组患者分别口服普瑞巴林联合丁丙诺啡透皮贴剂或口服普瑞巴林联合曲马多缓释片,共接受4周的药物治疗,记录两种用药方案治疗前和治疗后3、7、14、21及28 d时NRS疼痛评分及生活质量评分(简明疼痛量表BPI).记录患者恶心呕吐、头晕、嗜睡及便秘等不良反应.结果 最终有154例患者进入有效分析,每组77例.与治疗前比较,两组患者治疗后各时点NRS评分降低,差异有统计学意义(P<0.05),但两组患者NRS评分比较差异无统计学意义(P>0.05).与治疗前比较,两组患者治疗后各时点BPI评分中的各项评分均降低,差异有统计学意义(P<0.05),但组间比较差异无统计学意义(P>0.05).丁丙诺啡+普瑞巴林组恶心呕吐及便秘的发生率分别为6%和12%,明显低于曲马多+普瑞巴林组的18%和29%,差异有统计学意义(P<0.05).结论 丁丙诺啡透皮贴剂联合普瑞巴林治疗老年带状疱疹后神经痛患者,可明显缓解疼痛并改善生活质量,且其效果与口服曲马多联合普瑞巴林相当,但不良反应较少.
Objective To compare the influences of transdermal buprenorphine with oral tramadol on the treatment of postherpetic neuralgia(PHN)with pregabalin in elderly patients.Methods One hundred and fifty-four PHN patients selected from January 2016 to January 2017 in Qilu Hospital of Shandong University were randomly divided into buprenorphine+pregabalin group and tramadol+pregabalin group,77 patients in each group.Pregabalin combined with transdermal buprenorphine or oral tramadol treatment were accepted respectively in each group for 4 weeks.NRS and BPI score were assessed at baseline and 3,7,14,21 and 28 days follow-up.Adverse reactions such as nausea,vomiting,drowsiness and constipation were also recorded.Results Compared with the baseline,NRS and all components of BPI score were significantly decreased at each time point in the two groups(P<0.05),but there was no statistical difference between the two groups(P>0.05).The rates of nausea and vomiting,constipation in the buprenorphine+pregabalin group were higher than those in the tramadol+pregabalin group respectively(6%vs.18%,12%vs.29%,P<0.05).Conclusion Buprenorphine can efficiently alleviate pain and improve the quality of life as same as tramadol,when combined with pregabalin in the treatment of PHN,but with lower adverse effects.
作者
王宇飞
梁立双
Wang Yufei;Liang Lishuang(Department of Pain Treatment,Qilu Hospital of Shandong University,Jinan City 250012,China)
出处
《实用疼痛学杂志》
2018年第5期350-355,共6页
Pain Clinic Journal
