加巴喷丁与卡马西平治疗复发性三叉神经痛的临床随机对照研究  

Randomized Control Trial of Gabapentin and Carbamazepine in the Treatment of Recurrent Trigeminal Neuralgia

作　　者：曲丕盛[1] 万海方[1] 王振[1] 余建明[1] 陶凡[1] 

机构地区：[1]浙江省杭州市红十字会医院麻醉科,310003

出　　处：《中国全科医学》2013年第21期2444-2446,共3页Chinese General Practice

摘　　要：目的观察加巴喷丁与卡马西平治疗复发性三叉神经痛的临床疗效及安全性。方法选取2008年5月—2012年8月我院疼痛门诊收治的经微创及外科手术治疗后复发的三叉神经痛患者50例,将其随机分为卡马西平组和加巴喷丁组,各25例。两组患者分别服用卡马西平片和加巴喷丁治疗,观察患者治疗前及治疗1、2、4周后的疼痛缓解程度〔采用视觉模拟评分法(VAS)评分表示〕;药物用量;治疗前后患者的生活满意度〔采用生活满意度指数B(LSI-B)表示〕;疗效;不良反应发生情况。结果 48例患者完成本研究,其中卡马西平组23例,加巴喷丁组25例。经过4周药物治疗后,加巴喷丁组患者药物用量平均为(1 884±546)mg/d,卡马西平组药物用量平均为(652±121)mg/d,两组差异有统计学意义(P<0.01)。两组患者组内治疗前后不同时间VAS评分比较,差异均有统计学意义(P<0.01);与治疗前比较,两组患者治疗1、2、4周后VAS评分均下降,差异有统计学意义(P<0.01)。两组患者治疗前及治疗2、4周后VAS评分比较,差异均无统计学意义(P>0.05)。两组患者治疗4周后LSI-B均较本组治疗前增加,差异有统计学意义(P<0.05);且加巴喷丁组治疗后LSI-B高于卡马西平组,差异有统计学意义(P<0.01)。两组患者治疗1、2、4周后疗效比较,差异均无统计学意义(P>0.05)。治疗后加巴喷丁组不良反应发生率为28.0%(7/25),低于卡马西平组的56.5%(13/23),两组间差异有统计学意义(P<0.05)。结论加巴喷丁与卡马西平用于治疗复发性三叉神经痛均有效、安全,但加巴喷丁在用药安全性及患者生活质量改善方面优于卡马西平。Objective To study the efficacy and safety of Gabapentin and Carbamazepine in treatment of recurrent trigeminal neuralgia（RTN）.Methods Fifty RTN patients were divided randomly into groups C（taking Carbamzepine） and G（taking Gabapentin）,25 in each.Visual analog scale（VAS） was used to analyze pain relief before treatment and after 1,2,4 weeks of treatment,drug dosage,and life satisfaction index B（LSI-B） used to evaluate patients＇ life satisfaction,and efficacy,adverse events observed.Results A total of 48 patients finished this study,thereinto 23 in group C,25 in group G.The average drug dosage was（1 884 ± 546） mg / d in group G,（652 ± 121） mg / d in group C,the difference was significant（P《0.01）.There was difference in VAS at different time before and after treatment（P《0.01）;VAS after 1,2,4 weeks of treatment decreased as compared with that of pre-treatment（P《0.01）.There was no difference in VAS between the two groups before treatment and after 2,4 weeks of treatment（P《0.05）.LSI-B after 4 weeks of treatment was higher than that before treatment in 2 groups（P《0.05）,and that of group G higher than that of group C（P《0.01）.There was no difference in efficacy between 2 groups after 1,2,4 weeks of treatment（P《0.05）.The incidence of adverse reactions of group G was 28.0%（7 /25）,lower than that of group C 〔56.5%（13 /23） 〕,the difference was significant（P《0.05）.Conclusion Gabapentin and Carbamazepine are effective and safe in treatment of RTN,but Gabapentin is superior to Carbamazepine.

关 键 词：加巴喷丁 卡马西平 三叉神经痛 疼痛测定 生活满意度指数B 治疗结果 

分 类 号：R745.11[医药卫生—神经病学与精神病学]