加巴喷丁联合神经妥乐平治疗痛性糖尿病周围神经病变的临床观察

Effect of gabapendin combined with neurotropin for treatment of painful diabetic peripheral neuropathy

目的观察加巴喷丁(GBP)联合神经妥乐平治疗痛性糖尿病周围神经病变(PDPN)的临床疗效。方法选择确诊PDPN的患者60例,随机分成GBP组(对照组)和GBP联合神经妥乐平组(联合组),每组30例。对照组予以GBP及其他补救用药治疗;联合组在对照组基础上,予以神经妥乐平治疗,观察治疗前和治疗后第1、2、4、6和8周的视觉模拟评分(VAS)、生活质量评分(QOL)、治疗有效率、麻木及痛觉过敏改善状况、补救镇痛药剂量的使用量及不良反应。结果治疗后第1、2、4、6和8周,两组VAS、QOL评分较治疗前改善(P<0.05),联合组较对照组效果更显著(P<0.05)。联合组镇痛效率为90.0%,与对照组镇痛效率(56.7%)比较,差异有统计学意义(P<0.05)。随着治疗时间延长,两组的麻木和痛觉过敏明显改善(P<0.05),联合组较对照组改善更明显(P<0.05)。联合组较对照组使用补救辅助镇痛药的剂量明显减少,不良反应少。结论 GBP联合神经妥乐平治疗PDPN的疗效优于单用GBP,是一种安全有效方法。

[Objective] To observe the effect of gabapendin combined with neurotropin for the treatment of painful diabetic peripheral neuropathy. [Methods ] Sixty patients with painful diabetic peripheral neuropathy were selected, then randomly divided into 2 groups： the gabapendin group （control group, n = 30）, the neurotropin combined with gabapendin group （combination group, n = 30）. The control group received gabapendin and other remedy drugs. The combination group received neurotropin combined with the same administration of gabapentin as the control group. The visual analogue scale （VAS）, the quality of life （QOL）, the effective rate of pain relieving, the improvement of numb and hyperpathia, administration of remedy drug and side effects were evaluated before treatment and 1, 2, 4, 6 and 8 weeks after treatment. [Results] The VAS was significantly declined and the QOL was significantly improved in both groups after the treatment （P 〈 0.05）, which were more significant in the combination group than in the control group （P〈 0.05）. The effective rate was 90.0% in the combination group, while 56.7% in the control group （P〈0.05）. The numb and hyperpathia were significantly improved in both groups （P〈 0.05）, and the improvement was more significant in the combi- nation group than in the control group （P〈 0.05）. The administration dose of remedy drug was lower and side effects were fewer in the combination group. [Conclusion] Gabapendin combined with neurotropin is more effective than single administration of gabapendin for the treatment of painful diabetic peripheral neuropathy. It is a safe and effective treatment.