曲马多与阿米替林治疗带状疱疹后遗神经痛的疗效比较

Comparison of Therapeutic Effect between Tramadol and Amitriptyle in Postherpetic Neuraglia

目的:研究曲马多对带状疱疹后遗神经痛的临床疗效、剂量控制以及主要的不良反应。方法:将50例带状疱疹后遗痛患者分为曲马多组(n=30)和阿米替林组(n=20),对患者的疼痛程度(visual analog scale,VAS)、疼痛缓解程度、不良反应、日常生活等进行8周的随访。结果:曲马多治疗后8周VAS较治疗前显著下降(P<0.01)。第1～3周曲马多较阿米替林能够更好的减轻患者的疼痛程度(P<0.05)。第4～8周两者疗效无显著差异(P>0.05)。曲马多最常见的不良反应为便秘、乏力、恶心及嗜睡;80%的患者用曲马多后生活质量得到改善。结论:曲马多或阿米替林都能够减轻带状疱疹后遗神经痛。曲马多能够快速的缓解患者疼痛,疗效稳定。大部分患者可以耐受曲马多的不良反应且生活质量得到了改善。曲马多可以作为带状疱疹后遗神经痛的主要镇痛药物。

Objective：To compare the efficiency between tramadol and amitriptyle,and analyze the dose of the tramadol and main side effects.Methods：A total of 50 patients with postherpetic neuralgia（PHN） were included.All the patients were devided into two groups who were given tramadol,and amitriptyle respectively.Then each of them was followed up by pain score（visual analog scale,VAS）,pain relieve rate（PRR）,side effects and quality of life.Results：Both tramadol and amitriptyle reduced pain score（P0.01）.Tramadol made a greater pain reduction than amitriptyle during the first 3 weeks（P0.05）.There was no significant difference to the pain relieve rate（P0.05） between these two groups from 4th-8th week anymore.Fatigue and nausea were common side effect in tramadol groups.There were 80% patients in tramadol group got improvement of their quality of life,especially the sleep and the mood.Conclusions：Either the tramadol or amitriptyle could alleviate the PHN.Tramadol whose effectiveness was stable could make moderate pain relief rapidly without opioid-induced tolerance.Most of the patients could endure the side effect of tramadol and improve their life quality as well.As a kind of weak opioids,tramadol reveals its advantage and potential in the treatment of neurpathic pain and is a promising drug for neuropathic pain.