不同离子通道调节剂治疗丘脑卒中后中枢神经病理性疼痛的疗效研究  

Therapeutic effect of different ion channel modulators on patients with central neuropathic pain after thalamic stroke

作　　者：张明 张兆波[1] 马丽丽 孙兴良 范文国 ZHANG Ming;ZHANG Zhao-bo;MA Li-li;SUN Xing-liang;FAN Wen-guo(Department of Physical Medicine and Rehabilitation,Zibo Central Hospital,Shangdong Zibo 255000,China;Department of Anesthesiology,Affiliated Oral Hospital,Sun Yat-sen University,Guangzhou 510055.China)

机构地区：[1]山东省淄博市中心医院康复医学科,山东淄博255000 [2]中山大学附属口腔医院麻醉科,广州510055

出　　处：《临床药物治疗杂志》2019年第10期61-65,共5页Clinical Medication Journal

基　　金：国家自然科学基金(81771098)

摘　　要：目的:比较不同离子通道调节剂治疗丘脑卒中后中枢神经病理性疼痛的疗效和安全性。方法:选择丘脑卒中后中枢神经病理性疼痛患者,随机分为A、B、C 3组,分别接受加巴喷丁、普瑞巴林、拉莫三嗪治疗。采用疼痛数字评分法(numerical rating scale,NRS)和汉密尔顿抑郁量表(Hamilton Depression Scale,HAMD) 17项版对患者进行疼痛和心理情况评定,比较各组患者不良反应的发生情况。结果:A、B、C 3组患者治疗后第1、2、4和6周的NRS评分和HAMD评分比治疗前均明显下降(P<0.01)。各时间点治疗前后NRS评分降低幅度:B组明显高于A组和C组,A组和C组之间比较差异无统计学意义(P>0.05)。3组患者的头晕、嗜睡、周围性水肿,以及皮疹等不良反应的发生率无明显差异(P>0.05)。结论:加巴喷丁、普瑞巴林和拉莫三嗪等治疗丘脑卒中后中枢神经病理性疼痛疗效确切,普瑞巴林在疗效上更具优势。Objective:To compare the effects and safety of ion channel modulators in patients with central neuropathic pain after thalamus stroke.Methods:Patients with central neuropathic pain after thalamus stroke were selected,and randomly divided into Group A,Group B and Group C.The patients in the 3 groups were treated with gabapentin,pregabalin and lamotrigine,respectively.Pain and psychological status was evaluated by the Numerical Rating Scale(NRS) and the Hamilton Depression Scale(HAMD),17 items,respectively.The adverse events were evaluated and compared among the three groups.Results:At the point of 1,2,4 and 6 weeks of post treatment,the NRS scores and the HAMD scores of the 3 group were significantly lower than pretreatment(P<0.01).The reduction degree of the NRS scores and the HAMD scores:group B was significantly higher than that in group A and group C,and there was no significant difference between group A and group C(P> 0.05).There was no significant difference in the incidence of dizziness,sleepiness,peripheral edema and rash among the 3 groups(P>0.05).Conclusion:Gabapentin,pregabalin and lamotrigine,are effective in the treatment of patients with central neuropathic pain with thalamus stroke.Pregabalin is superior among them in therapeutic effect.

关 键 词：神经病理性疼痛 脑卒中 疗效 

分 类 号：R971.1[医药卫生—药品]