氢吗啡酮静脉自控镇痛联合普瑞巴林治疗带状疱疹后神经痛临床研究  

Efficacy of hydromorphone by patient-controlled intravenous analgesia combined with pregabalin for postherpetic neuralgia

作　　者：李静[1] 黄莹[1] 陶高见[1] 黄泰源[1] 槐洪波[2] 宁本翔[1] 马超[1] 林建[1] LI Jing;HUANG Ying;TAO Gaojian;HUANG Taiyuan;HUAI Hongbo;NING Benxiang;MA Chao;LIN Jian(Department of Pain Medicine,Nanjing Drum Tower Hospital,The Affiliated Hospital of Nanjing University Medical School,Nanjing 210008,China;Department of Rehabilitation Medicine,Nanjing Drum Tower Hospital,The Affiliated Hospital of Nanjing University Medical School,Nanjing 210008,China)

机构地区：[1]南京大学医学院附属鼓楼医院疼痛医学科,南京210008 [2]南京大学医学院附属鼓楼医院康复医学科,南京210008

出　　处：《中国疼痛医学杂志》2022年第6期419-424,共6页Chinese Journal of Pain Medicine

基　　金：江苏省自然科学基金(BK20180130)。

摘　　要：目的:探讨氢吗啡酮静脉自控镇痛(patient-controlled intravenous analgesia,PCIA)联合普瑞巴林治疗带状疱疹后神经痛(postherpetic neuralgia,PHN)的有效性和安全性。方法:选择我院2018年12月5日至2019年12月4日确诊为PHN病人100例,按随机数字表法分为氢吗啡酮PCIA治疗组(H组)和用生理盐水替代氢吗啡酮对照组(C组),每组50例。两组均联合口服普瑞巴林及利多卡因凝胶贴膏外用。比较两组治疗前、治疗后1周、2周、4周的视觉模拟评分法(visual analogue scale,VAS)评分、简式版Mc Gill疼痛问卷(short-form McGill pain questionnaire,SF-MPQ)、匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)、不良反应及其他药物用量。结果:与治疗前相比,两组病人的各项评分均显著下降(P<0.01);治疗后各时间点,H组的VAS评分、SF-MPQ评分及其他药物用量均明显低于C组(P<0.01)。治疗后4周时,H组的PSQI评分明显低于C组(P<0.01)。两组不良反应发生率无明显差异。结论:普瑞巴林联合氢吗啡酮PCIA治疗PHN可显著减少病人疼痛,改善病人睡眠及生活质量,临床应用效果好且安全性较高。Objective:To evaluate the effectiveness and safety of intravenous hydromorphone by patient-controlled intravenous analgesia(PCIA)combined with pregabalin in the treatment of postherpetic neuralgia(PHN).Methods:One hundred PHN patients were randomly divided into group H(n=50)received hydromorphone by PCIA and group C(n=50)replaced hydromorphone with normal saline,all combined with pregabalin orally,and lidocaine patch was used externally if necessary.The visual analogue scale(VAS),the short-form McGill pain questionnaire(SF-MPQ),Pittsburgh sleep quality index(PSQI),and the adverse reactions were compared between the two groups before and 1 week,2 weeks,4 weeks after treatment,including other drug dosage.Results:Compared with pre-treatment,the scores of both groups were significantly decreased(P<0.01).At each time point after treatment,the VAS scores,SF-MPQ scores and the dosage of other drugs in group H were significantly reduced than those of group C(P<0.01).At 4 weeks after treatment,the PSQI scores in group H were significantly lower than group C(P<0.01).There was no significant difference in the incidence of adverse reactions between the two groups.Conclusion:Pregabalin combined with hydromorphone PCIA in the treatment of PHN can significantly reduce pain,improve the sleep and quality of life of patients,and has good clinical application effect and high safety.

关 键 词：带状疱疹后神经痛 氢吗啡酮 自控镇痛 普瑞巴林 

分 类 号：R752.12[医药卫生—皮肤病学与性病学]