普瑞巴林联合加巴喷丁治疗脑梗死后中枢性疼痛的临床观察  

Clinical Observation of Pregabalin Combined with Gabapentin in the Treatment of Central Pain after Cerebral Infarction

作　　者：顾翠[1] 胡嘉云[1] 杨美丽[1] 冯磊[1] 张平[1] 师梦[1] 

机构地区：[1]玉溪市人民医院神内一科,云南玉溪653100

出　　处：《中国药房》2017年第8期1117-1120,共4页China Pharmacy

摘　　要：目的:探讨普瑞巴林联合加巴喷丁治疗脑梗死后中枢性疼痛的临床疗效及安全性。方法:选取我院2010年1月-2015年12月诊治脑梗死后中枢性疼痛患者共150例,采用随机数字表法分为A、B、C组,每组50例。A组患者采用普瑞巴林胶囊75mg,po,bid联合加巴喷丁胶囊0.1 g,po,tid;B组患者采用普瑞巴林胶囊75 mg,po,bid;C组患者采用加巴喷丁胶囊0.1 g,po,tid。3组患者治疗时间均为4周。观察3组患者治疗前后视觉模拟评分(VAS)、疼痛数字评分(NRS)、匹兹堡睡眠质量指数量表(PSQI)和健康调查简表(SF-36)评分,并据此评价3组患者的临床疗效;同时,记录3组患者不良反应发生情况。结果:A、B、C组患者临床治疗总有效率分别为94.00%、74.00%、70.00%;A组患者临床治疗总有效率显著优于B组和C组,差异有统计学意义(P<0.05)。治疗后,A、B、C组患者VAS评分分别为(3.87±0.74)、(5.10±1.26)和(5.03±1.23)分,NRS评分分别为(3.91±0.88)、(5.29±1.25)和(5.37±1.30)分,A组患者VAS评分和NRS评分均显著低于B、C组及治疗前,差异均有统计学意义(P<0.05);A、B、C组患者PSQI评分分别为(4.03±0.85)、(5.92±1.16)和(5.83±1.11)分,SF-36评分分别为(372.84±73.25)、(348.07±60.54)和(345.67±59.72)分;A组患者PSQI和SF-36评分均显著优于B、C组及治疗前,差异均有统计学意义(P<0.05);3组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论:相较于普瑞巴林与加巴喷丁单用,二者联用治疗脑梗死后中枢性疼痛可更显著地减轻患者自感疼痛水平,改善睡眠和日常生活工作质量,且未增加不良反应发生风险,故针对脑梗死后中枢性疼痛特别是两者单药应用效果不佳患者可考虑联合用药方案。OBJECTIVE： To investigate the clinical effect and safety of pregabalin combined with gabapentin in the treatment of central pain after cerebral infarction. METHODS： One hundred and fifty patients with central pain after cerebral infarction in our hospital from Jan. 2010 to Dec. 2015 in our department were randomly divided into group A, B, C , with 50 cases in each group. Group A was given Pregabalin capsule 75 mg, bid combined with Gabapentin capsule 0.1 g, tid; group B was given Pregabalin capsule 75 mg, bid; group C was given Gabapentin capsule 0.1 g, tid; 3 groups were treated for 4 weeks. VAS score, NRS score, PSQI and SF-36 score were observed among 3 groups before and after treatment to evaluate clinical efficacies of 3 groups; the occurrence of ADR were recorded in 3 groups. RESULTS： The clinical total response rate of group A, B, C were separately 94.00 %, 74.00 %, 70.00 %. The clinical total response rate of group A was significantly better than that of group B and C, with statistical significance （P〈0.05）. After treatment, VAS score of group A, B, C were separately（3.87± 0.74）, （5.10 ± 1.26）, （5.03 ± 1.23） ; NRS score were separately （3.91 ± 0.88）, （5.29 ± 1.25）, （5.37 ± 1.30） ; VAS score and NRS score of group A were significantly lower than group B, C and before treatment, with statistical significance （P〈0.05） ; PSQI score of group A, B, C were separately（4.03 ±0.85）, （5.92± 1.16）, （5.83± 1.11） ; SF-36 score were separately （372.84 ± 73.25）, （348.07 ±60.54）, （345.67± 59.72） ; PSQI score and SF-36 score of group A were significantly better than group B, C and before treatment, with statistical significance （P〈0.05）. There was no statistical significance in the incidence of ADR among 3 groups （P〉0.05）. CONCLUSIONS： Compared with pregabalin and gabapentin alone, pregabalin combined with gabapentin in the treatment of central pain after cerebral infarction can efficiently relieve the perceived pain, improve sleep

关 键 词：普瑞巴林 加巴喷丁 脑梗死 中枢性疼痛 临床疗效 

分 类 号：R971[医药卫生—药品] R969.3[医药卫生—药学]