普瑞巴林联合曲马多治疗顽固性带状疱疹后遗神经痛的疗效和安全性

Safety and efficacy of pregabalin combined with tramadol in treatment of intractable postherpetic neuralgia

目的观察普瑞巴林联合曲马多治疗顽固性带状疱疹后遗神经痛(postherpetic neuralgia,PHN)(病程超过3个月)的疗效和安全性。方法将56例带状疱疹后神经痛患者随机分成试验组(30例)和对照组(26例)。试验组给予普瑞巴林75~150 mg,2次/d,联合曲马多100 mg 2次/d;对照组予曲马多100 mg,2次/d口服,观察时间为6周。采用视觉模拟评分(VAS)评估治疗前及治疗后疼痛程度,同时观察不良反应。结果经过6周的治疗,两组患者VAS评分均较治疗前降低,试验组较对照组VAS评分降低更明显,差异有统计学意义(P<0.05);试验组有效率为76.7%,对组照有效率为46.1%,两组间差异有统计学意义(P<0.01);治疗期间普瑞巴林联合曲马多存在不良反应,主要表现为头昏、嗜睡及外周水肿等,且与剂量相关。结论联合应用普瑞巴林和曲马多对于治疗顽固性带状疱疹后神经痛效果好,安全。

Objective To evaluate the clinical efficacy and safety of pregabalin combined with tramadol in the treatment of patients with postherpetic neuralgia （PHN） caused by refractory herpes zoster（ the pain lasted more than 3 months）. Methods Fifty-six patients with PHN caused by refractory herpes zoster were randomly divided into two groups： treatment group （30 patients） and control group （26 patients）. The treatment group was given pregabalin, 75-150 mg BID combined with tramadol 100 mg BID for six weeks. The control group received tramadol 100 mgBID for six weeks. The degree of pain before and after treatment was evaluated using the Visual analogue scale （VAS） , while the adverse effects were observed. Results After six weeks of treatment, the VAS scores of both groups were significantly deceased, especially in the treatment group （P 〈 0.05 ）. The efficacy in the treatment group （76.7%） was significantly different from that in the control group （46.1%） （P 〈 0.01 ）. In this study, adverse effects of pregabalin were mainly manifested as dizziness, drowsiness and peripheral edema, which were dose related. Conclusions It is safe and effective to treat PHN caused by refractory herpes zoster with pregabalin combined with tramadol.