加巴喷丁联合小剂量丁丙诺菲透皮贴治疗老年带状疱疹后神经痛的临床观察

Clinical effects of buprenorphine transdermal patch combined with gabapentin on gerontic postherpetic neuralgia

目的观察加巴喷丁联合小剂量丁丙诺菲透皮贴治疗老年带状疱疹后神经痛(PHN)的临床效果。方法 60例PHN患者随机分为对照组和试验组。对照组:单独应用加巴喷丁;试验组:加巴喷丁联合应用丁丙诺菲透皮贴5 mg,每7天贴敷1次。根据患者疼痛情况逐渐调整加巴喷丁剂量,直至患者疼痛评分<4分,两组患者加巴喷丁最大剂量为1 800 mg/d。治疗8周后,记录两组患者用药前及用药后2、4、8周的疼痛评分(VAS)、睡眠评分、加巴喷丁日剂量及不良反应发生率。结果治疗后,两组患者VAS评分明显降低(P<0.01);治疗后4、8周,试验组VAS评分明显低于对照组(P<0.05)。治疗后,两组患者睡眠质量明显改善(P<0.01);试验组加巴喷丁的用量较小(P<0.05);联合应用丁丙诺菲透皮贴可以显著降低加巴喷丁相关不良反应头晕、嗜睡的发生率(P<0.05)。结论加巴喷丁联合小剂量丁丙诺菲透皮贴对PHN患者的临床效果优于单独应用加巴喷丁,不良反应较小,可安全用于临床。

Objective To observe the effect of buprenorphine transdermal patches combined with gabapentin on gerontic patients with PHN. Methods Sixty patients were divided into experimental group and control group ran-domly. Patients in control group were orally administered gabapentin only,and patients of experimental group were ad-ministered gabapentin combined with buprenorphine transdermal patches 5 mg every 7 d. The doctor increased the do-ses of gabapentin according to the scores of pain （ VAS〉4 ） gradually. The maximum dose of gabapentin was 1 800 mg/d in both groups. The VAS scores,sleep scores,doses of gabapentin and adverse reactions at each time point were recorded. Results There was a significant decline in VAS scores and sleep scores after treatment in the two groups （ P〈0. 01）. Compared with control group,the VAS scores and the doses of gabapentin were significantly lower at 4,8 weeks after treatment （P〈0. 05）. The incidence of dizzy and drowsiness were higher in control group （P〈0. 05）,but there was no significant difference in the incidence of other side effects. Conclusion The combination of buprenor-phine transdermal patches with gabapentin is effective and safe for the gerontic patients with PHN.