西酞普兰对2型糖尿病痛性神经病变的治疗效果观察  

Therapeutic effects of citalopram on alleviating pain of peripheral neuropathy in type 2 diabetic patients

作　　者：楚勤英[1] 唐志雄[1] 王进伟[1] 傅小玲[1] 蒋虹[1] 贾军宏[1] 

机构地区：[1]解放军总医院第一附属医院干二科,北京100037

出　　处：《解放军医学杂志》2008年第3期332-333,341,共3页Medical Journal of Chinese People's Liberation Army

摘　　要：目的考察西酞普兰对2型糖尿病痛性神经病变患者疼痛的治疗效果。方法将38例2型糖尿病痛性神经病变患者随机分为治疗组(20例)和对照组(18例)。收集患者的一般资料和糖尿病控制情况,对照组常规给予降糖药、神经营养药、止痛药、抗血小板药治疗,治疗组在此基础上加用抗抑郁药物西酞普兰20mg/d,疗程2周。以汉密尔顿抑郁量表(HAMD-17)评定抗抑郁疗效,用数字疼痛分级法(NPIS)评估疼痛的改善情况,同时记录镇痛药物的等级。结果治疗第7天和第14天,治疗组的HAMD评分(22.1±8.9、18.7±9.5)均显著低于对照组(26.81±9.79、25.71±9.92,P<0.05或P<0.01),抑郁症状明显改善,NPIS评分(5.1±1.1、2.9±1.3)显著低于对照组(5.5±1.2、5.1±1.1,P<0.05或P<0.01),同时镇痛药物的等级低于对照组(P<0.01)。结论西酞普兰治疗不仅可缓解患者的抑郁症状,还有助于促进疼痛的缓解。Objective To investigate the therapeutic effects of citalopram on alleviating painful symptoms in type 2 diabetes mellitus （DM） patients with complication of painful peripheral neuropathy. Methods Thirty-eight type 2 DM patients with painful peripheral neuropathy were randotrdy divided into control group （eighteen patients） and treatment group （twenty patients）. The diabetes control （including fasting blood glucose） and general health state （including body mass index, liver function, renal function） of patients were recorded. Patients in control group were given conventional drugs （including hypoglycemic drugs, anodyne, neurotrophy drugs, antiplatelet drugs）, and those in treatment group received conventional drugs plus antidepressant drugs （citalopram, 20mg, q. i.d. for 14 days）. Hamilton Depression Rating Scale for Depression （HAMD-17） was used to assess the depressive symptoms, and numeric pain intensity scale （NPIS） was used to assess the pain intensity on baseline and the 1st, 7th and 14th day. At the same time, the levels of analgesic agents were recorded. Results On the 7th and 14th day, the HAMD-17 scores in treatment group （22. 14±8. 92, 18. 69±9.4） were significantly lowered compared with that in control group （26. 81--±9. 79, 25. 71-±9. 92）, P〈0. 05 and P〈0. 01, respectively; the NPIS scores in treatment group （5. 1 -± 1.1, 2. 9 q- 1.3） were also significantly decreased than that in control group （5. 5± 1.2, 5. 1 ± 1.1）, P〈0. 05 and P〈0. 01, respectively. The results showed that the pain was relieved significantly in treatment group than that in control group （P〈0.01）, and the levels of analgesic agents used in treatment group were also lower than that in control group （P〈0. 01）. Concision Citalopram is effective on controlling depressive symptoms and relieving pain of type 2 DM patients with painful peripheral neuropathy as well as an antidepressant treatment when it is used for 14 days.

关 键 词：糖尿病 2型 糖尿病神经病变 疼痛 西酞普兰 

分 类 号：R587.15[医药卫生—内分泌]