摘要
目的观察普瑞巴林和加巴喷丁治疗带状疱疹后神经痛(PHN)的安全性与疗效。方法 156例PHN患者随机、双盲均分为四组:A组给予安慰剂;B组普瑞巴林胶囊225mg/d;C组普瑞巴林胶囊375mg/d;D组加巴喷丁胶囊900mg/d,前5d剂量滴定,之后按照上述剂量维持,连续观察8周。于治疗前(T1)、治疗后第1天(T2)、第2天(T3)、第4天(T4)、第6天(T5)、第8天(T6)、第2周(T7)、第4周(T8)、第8周(T9)记录患者VAS评分;于T1时和治疗结束后(T10)记录睡眠障碍指数(SPI);评估终点睡眠干扰评分(EMSIS)、治疗效果和不良反应发生率。结果 T5～T9时B、C、D组VAS评分均明显低于A组,且C组明显低于D组(P<0.05);T7～T9时B、C组明显低于D组(P<0.05)。B、C、D组的EMSIS明显低于A组(P<0.05)。T10时四组SPI明显低于T1时,B、C、D组SPI明显低于A组(P<0.01或P<0.05),C组明显低于B、D组(P<0.05);治疗PHN的有效率和优良率B、C、D组均明显高于A组,B、C组均明显高于D组。头晕、嗜睡、周围水肿的不良反应发生率B、C组明显低于D组(P<0.05)。结论普瑞巴林与加巴喷丁、安慰剂比较,能更快、持久地缓解PHN,呈剂量依赖性,不良反应轻且呈一过性,患者耐受性较好。
Objective To assess the efficacy and adverse events of pregabalin and gabapentin in treating postherpetic neuralgia （PHN） patients. Methods A total of 156 hospitalized patients with PHN were dividied into four groups by using a randomized, double-blind method. All groups received a routine therapy of mecobalamin, neurotropin and tramadol, accompanied by different adjuvants regimen. Group A （n=39） received placebo. Group B and group C received oral 225 mg/d and 375 mg/d of pregabalin separately. Group D received oral gabapentin 900 mg/d. All patients received dose titration in the first 5 days, and then the maintenance dose in the following two months. We recorded VAS scores before treatment （T1. baseline）, at 1st day （T2）, the 2nd day （T3）, the 4th day （T4）, the 6th day （T5）, the 8th day （T6）, the 2nd week （T7）, the 4th week （T8）, the 8th week （T9）. And the SPI at T1 , EMSIS, treatment outcome and the incidence of adverse events were recorded and at the end of treatment （T10）. Results VAS scores of groups B, C, and D were significantly lower than group A （P〈0. 05）, group C was also significantly lower than group D at T5 T9 （P〈0. 05）. VAS scores of groups B and C was obviously lower than group D at T7 T9 （P〈0. 05）. Compared to group A, the scores of EMSIS of groups B, C, and D were statistically lower （P〈0. 05）. SPI of all the groups at T10 were lower than those at T1, and groups B, C, D were lower than group A while group C was lower than groups B and D. The effective and excellent rates of group A were significantly lower than the other groups and group C was lower than group B and D. Rates of dizziness, somnolence and edema of group B and C were lower than group D （P 〈0.05）. Conclusion Pregabalin could offer better adjuvant analgesic effect on treating neuropathic pain of PHN than gabapentin. Meanwhile, it could improve sleep disorders, life quality, and the PGIC with low incidence of adverse events.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2013年第2期117-120,共4页
Journal of Clinical Anesthesiology
