摘要
目的探讨普瑞巴林治疗脑卒中后中枢性疼痛的疗效和安全性。方法65例脑卒中后中枢性疼痛（CPSP）患者采用随机数字表法分为普瑞巴林组（n=22）、加巴喷丁组（n=21）和阿米替林组（n=22）。普瑞巴林组予普瑞巴林150～300mg·d-1（分2～3次口服），加巴喷丁组予加巴喷丁300～1800mg.d-1（分1～3次口服），阿米替林组予阿米替林25～150mg·d-1（分2～3次口服）；三组均连服8周。所有患者于治疗前和治疗后3d、1周、2周、4周、8周行疼痛数字评分（NRS），同期比较三组疼痛缓解度（PAR）、显效率、总有效率及不良反应发生情况。结果普瑞巴林组在治疗后3dNRS评分比治疗前下降（P〈0．05），且在此后的各个时间点与治疗前相比NRS评分均显著下降（P〈0．01）；普瑞巴林组在治疗后各时间点的NRS评分均低于加巴喷丁、阿米替林组同期（P〈0．05）。普瑞巴林组在治疗后各时间点的PAR优于加巴喷丁组、阿米替林组同期，在治疗后各时间点的显效率及总有效率均显著高于加巴喷丁、阿米替林两组同期（P〈0．01）。普瑞巴林组不良反应以头晕、嗜睡为主，发生率分别为18％和14％，与加巴喷丁组比较无显著差异（P〉0．05），但显著低于阿米替林组（P〈0．05）。结论普瑞巴林可有效治疗脑卒中后中枢性疼痛，疗效优于加巴喷丁和阿米替林，且不良反应较少，药物耐受性良好。
AIM To investigate the efficacy and safety of pregabalin in the treatment of central poststroke pain. METHODS Sixty-five patients were randomly divided to pregabalin group （n = 22）, gahapentin group （n = 21） and amitriptyline group （n = 22） . The three groups were treated by pregabalin （150 - 300 mg- d-l, divided to 2 - 3 times, po）, gabapentin （300 - 1 800 mg.d-1, divided to 1 - 3 times, po） and amitriptyline （25 - 150 mg.d-l, divided to 2 - 3 times, po） respectively for 8 successive weeks. The numeric rating scale （NRS）, pain relief （PAR）, excellent rate, total effective rate and the adverse drug reactions were recorded pretherapy and in the third day, and the first, second, fourth, and eighth weeks after the therapy.RESULTS Compared with before the treatment, NRS score in the pregabalin group in the third day after the treatment was significantly lower （P 〈 0.05） , and remarkably decreased in the first, second, fourth, and eighth week after the treatment （P 〈 0.01）. NRS score in the pregabalin group was lower than that of the gabapentin group and the amitriptyline group at the same time points after the treatment （P 〈 0.05）. PAR in the pregabalin group was better than that of the gabapentin group and the amitriptyline group at the same time points after the treatment. The excellent rate and the total effective rate of the pregabalin group were higher than those of the gabapentin group and the amitriptyline group at the same time points after the treatment, showing statistical difference （P 〈 0.01 ）. The adverse drug reactions throughout 8 weeks in the pregabalin group were mainly dizziness （ 18% ） and somnolence （ 14% ）. There was no significant difference in the incidences of dizziness and somnolence between the pregabalin group and the gabapentin group （P 〉 0.05）, but the incidences of dizziness and somnolence in the pregabalin group were lower than those in the amitriptyline group, showing statistical difference （P 〈 0.05）. CONCLUSION Pregabalin is effective and safe for the treatment of central post-stroke pain. The clinical efficacy and tolerance of pregabalin are better than gabapentin or amitriptyline.
出处
《中国新药与临床杂志》
CAS
CSCD
北大核心
2013年第6期498-502,共5页
Chinese Journal of New Drugs and Clinical Remedies
