抗癫痫药物治疗神经病理性疼痛的对照研究  

CLINICAL USE OF ANTIEPILEPTIC DRUGS IN THE MANAGEMENT OF CHRONIC PAIN

作　　者：赵序利[1,2] 许永广[3] 宋文阁[1] 傅志俭[1,2] 

机构地区：[1]山东大学附属省立医院疼痛科,济南250021 [2]新疆医科大学第一附属医院疼痛科,乌鲁木齐830054 [3]山东大学附属省立医院麻醉科,济南250021

出　　处：《中国疼痛医学杂志》2012年第2期73-77,共5页Chinese Journal of Pain Medicine

基　　金：山东省自然科学基金项目资助(ZR2009CQ016)

摘　　要：目的:回顾性分析卡马西平和加巴喷丁治疗原发性三叉神经痛、带状疱疹以及带状疱疹后遗神经痛的疗效、安全性和不良反应。方法:102位患者进入本研究,比较卡马西平或加巴喷丁治疗前后患者疼痛强度的改变和对睡眠影响的改善;依据药物分类,比较两种药物的副作用和不良反应。结果:卡马西平治疗原发性三叉神经痛起效较加巴喷丁快,二者长期疗效相当;加巴喷丁治疗带状疱疹和带状疱疹后神经痛的疗效优于卡马西平;疗效随治疗时间的延长而增加。卡马西平的副作用和不良反应事件发生率较加巴喷丁高。结论:抗癫痫药物卡马西平和加巴喷丁是治疗神经病理性疼痛的有效药物,可以改善患者的睡眠,但副作用和不良反应发生率高。Objective：To evaluate the effects,safety and adverse effects of carbamazepine and gabapentin in the treatment of primary trigeminal neuralgia,herpes zoster neuralgia and postherpetic neuralgia.Methods： A total of 102 patients who suffered from primary trigeminal neuralgia,herpes zoster neuralgia and postherpetic neuralgia were assessed with changes in pain and sleep interference improvement after treatment with carbamazepine or gabapentin.The adverse events were evaluated and calculated between the carbamazepine and gabapentin.Results： Both carbamazepine and gabapentin had the same long term effects on trigeminal neuralgia,but carbamazepine got a rapid analgesia and sleep improvement effect than gabapentin.Gabapentin was more effective than carbamazepine in controlling pain and in improving sleep interference caused by herpes zoster and postherpetic neuralgia.The therapeutic effects was continually improved over time.Carbamazepine caused more adverse events than gabapentin.Conclusion： Antiepileptic drugs were effective in controlling neuropathic pain,and improved patient’s sleep interference caused by pain.But they had a high risk in causing adverse events.

关 键 词：抗癫痫药 慢性疼痛 三叉神经痛 带状疱疹 带状疱疹后神经痛 

分 类 号：R741[医药卫生—神经病学与精神病学]