药物治疗带状疱疹后遗神经痛并发抑郁34例临床观察

Curative Effects of Medication Treatment of 34 Cases with Postherpetic Neuralgia and Depression

目的观察氟哌噻吨美利曲辛片(黛力新)联合复方利多卡因乳膏治疗带状疱疹后遗神经痛(PHN)并发抑郁的临床疗效和安全性。方法将入选的67例带状疱疹后遗神经痛并发抑郁患者按照就诊顺序随机分为两组,治疗组(34例)予黛力新10.5mg口服(1次/d)和复方利多卡因乳膏外搽皮损(2次/d)。对照组(33例)仅予复方利多卡因乳膏外搽皮损(2次/d)。两组患者的疗程均为4周,分别于治疗前及治疗第7,14和28天用视觉模拟评分法(VAS)评定PHN患者疼痛改善情况,用汉密尔顿抑郁评分(HAMD)评价其抑郁状态改善情况。结果治疗前两组患者的VAS评分:治疗组为7.15±0.99,对照组为7.00±1.06;在治疗7,14和28d,:治疗组分别为4.85±0.86,3.18±0.72,2.21±0.59,对照组分别为5.55±0.75,4.06±0.90,3.15±0.71,两组患者的VAS评分均较治疗前明显下降;而且治疗组的VAS评分和HAMD均明显低于对照组,以上差异均有统计学意义(P均<0.01)。治疗组3例出现失眠,对照组未见明显不良反应。结论黛力新联合复方利多卡因乳膏治疗PHN并发抑郁患者时能明显改善抑郁状态和疼痛症状,安全有效,无严重不良反应。

Objective To observe the clinical effect of flupentixol-melitracen tablets （Deanxit） combined with compound lidocaine cream in treatment of patients with postherpetic neuralgia（PHN） and depression. Methods Total 67 patients of PHN with depressive state were divided into treatment group and control group randomly. The 34 patients in the treatment group were given Deanxit 10.5rag orally once a day for 4 weeks combined with compound lidocaine cream twice a day externally at the same time. The same dose of compound lidocaine cream was used in the 33 patients in the control group. Results VAS scores in the treatment group and control group were （7.15±0. 99） and （7.00±1.06） before receiving treatment, respectively. VAS scores in the treatment group were （4. 85± 0. 86）, （3.18±0. 72） and （2. 21±0. 59 ） on 7 , 14 and 28 days after the treatment respectively. At the same time, VAS scores in the control group were （5.55± 0. 75）, （4. 06 ± 0. 90） and （3. 15 ± 0. 71 ）. VAS scores decreased significantly in both two groups（P 〈 0. 01 ） ,and the VAS and HAMD scores in the treatment group were significantly lower than those in the control group. The difference was statistically significant（ P 〈 0. 01 ）. The 3 cases in the treatment group had insomnia and no patients had obvious adverse reactions in the control group. Conclusion Deanxit combined with compound lidocaine cream can obviously relieve body pain symptoms and depressive state in PHN. It is a safe and effective treatment with little side effect.