加巴喷丁治疗原发性三叉神经痛的对照研究

Contrust Study on Treatment of Primary Trigeminal Neuralgia with Gabapentin

目的探讨加巴喷丁治疗原发性三叉神经痛的疗效、安全性及耐受性。方法将68例原发性三叉神经痛患者随机分为加巴喷丁组和卡马西平组各34例,分别单用加巴喷丁和卡马西平治疗10周,观察并记录患者的疼痛程度(VAS)、用药剂量及不良反应等。结果加巴喷丁组治疗4周后原发性三叉神经痛显效率61.8%,总有效率88.2%,4周后疼痛程度较治疗前显著减轻;卡马西平组三叉神经痛显效率64.7%,总有效率为91.2%,2周后疼痛程度较治疗前显著减轻。2组疗效比较,差异无统计学意义(P>0.05),卡马西平组起效时间较加巴喷丁组短(P<0.01),但4周后疼痛程度无统计学意义(P>0.05)。而加巴喷丁组不良反应发生率低。结论加巴喷丁治疗原发性三叉神经痛与卡马西平的疗效相当,且无严重的不良反应,值得推广应用。

Objective A total of to investigate the effects,security and tolerance of gabapentin for primary trigeminal neuralgia. Method 68 patients with primary trigeminal neuralgia were divided randomly into two groups. These two groups were treated by gabapentin or carbamazepine respectively for 10 weeks. During this period, the degree of ache （ VAS score ）, the dosage and the side effects of patients were observed and recorded. Results After 4 weeks of gabapentin treatment, the obvious effective rate was 61.8 %, and the total effective rate was 88.2%, the VAS score reduced significantly. After 2 weeks of carbamazepine treatment, the obvious effective rate was 64.7% , and the total effective rate was 91.2%, the VAS score reduced significantly. There were no significant differences between two groups in the clinical efficacy（ P 〉 0.05 ） , while gabapentin group had lower adverse reaction rate. However, the onset time of carbamazepine group was significantly shorter than that of gabapentin group（P 〈0.01 ） ,but after 4 weeks,there was no significant differences in VAS score in two groups. Conclusions The efficacy of gabapentin and carbamazepine for primary trigeminal neuralgia is equivalent, and gabapentin has no serious adverse reactions, it is worthy spreading.