芬太尼透皮贴联合普瑞巴林治疗带状疱疹后神经痛临床观察

Clinical observation of fentanyl transdermal patches combined with pregabalin in the treatment of postherpetic neuralgia

目的评价芬太尼透皮贴联合普瑞巴林治疗带状疱疹后神经痛的临床效果。方法 56例PHN患者随机分为实验组(A组)和对照组(B组)。A组:普瑞巴林150 mg,2次/d口服,联合应用芬太尼透皮贴4.2 mg,每72 h更换1次;B组:单独应用口服普瑞巴林150 mg,2次/d口服。两组分别治疗8周。记录两组患者用药前及用药后2、4、6、8周时的疼痛评分(VAS评分)、生活质量评分(SF-36评分)及不良反应。结果治疗前,A、B组的VAS评分为7.79±0.92、7.70±0.87,治疗2周后降至3.89±1.07、6.33±0.73(P<0.05),组间比较差异也有统计学意义(P<0.05),治疗后4、6、8周亦存在相似情况。治疗后8周,两组SF-36评分与治疗前比较,除一般健康状况和心理健康外,其余各项差异均有统计学意义;A组恶心呕吐和便秘发生率高于B组。结论芬太尼透皮贴联合普瑞巴林对PHN患者的临床效果优于单独应用普瑞巴林,不良反应较小。

Objective To observe the effect of fentanyl transdermal patches combined with pregabalin on PHN. Methods Fifty-six patients were divided into experimental group （ group A） and control group （ group B） ran-domly. Group A was treated with fentanyl transdermal patches 4. 2 mg per 72 h. Group A and group B were orally ad-ministered pregabalin 150 mg/d. The course of treatment were 8 weeks. The analgesic effect （VAS score）,quality of life （SF-36 score） and adverse reactions were recorded before treatment and at 2,4,6,8 weeks after treatment. Results After 2 weeks＇ treatment,the VAS scores of both group decreased （P〈0. 05）,there was significant difference be-tween the two groups （P〈0. 05）,and so as the situation at 4,6 and 8 weeks after treatment. Except the general health and mental health,there was significant difference in SF-36 score between the two groups （P〈0. 05）. The incidences of nausea and vomiting and constipation were higher in group A than those in group B （P〈0. 05）. Conclusion The combination of fentanyl transdermal patches and pregabalin is effective and safe for the patients with PHN.