阿米替林联合卡马西平治疗带状疱疹后神经痛的疗效与安全性

Efficacy and Safety of Amitriptyline Combined with Carbamazepine in the Treatment of Postherpetic Neuralgia

目的：观察阿米替林联合卡马西平治疗带状疱疹后神经痛（PHN）的疗效与安全性。方法：将80例PHN患者随机均分为观察组和对照组。对照组患者口服卡马西平片100 mg,bid,3 d后剂量增加至100 mg,tid。观察组患者在对照组治疗的基础上加用阿米替林片12.5 mg,每晚睡前口服,d1~3;3 d后剂量增加至25 mg,每晚睡前口服,d4~5;第6天起每日晨起口服12.5 mg＋每晚睡前口服25 mg。两组患者用药期间均可根据患者的疼痛及药物不良反应调整用药剂量,疗程均为4周。观察两组患者治疗后的视觉模拟评分法（VAS）评分、睡眠时间、疼痛消失时间与总有效率,并记录不良反应发生情况。结果：观察组患者的总有效率显著高于对照组,VAS评分显著低于对照组,睡眠时间显著长于对照组,疼痛消失时间显著短于对照组,差异均有统计学意义（P〈0.05）。两组患者不良反应发生率比较,差异无统计学意义（P〉0.05）。结论：阿米替林联合卡马西平治疗PHN的疗效显著,安全性较好。

OBJECTIVE：To observe the efficacy and safety of amitriptyline combined with carbamazepine in the treatment of postherpetic neuralgia（PHN）. METHODS：80 patients with PHN were randomly divided into observation group and control group.Control group was orally given Carbamazepine tablets 100 mg,bid,then increased to 100 mg,tid after 3 d. Observation group was additionally given Amitriptyline tablets 12.5 mg every night before bed,d1~3;then increased to 25 mg after 3 d every night before bed,d4~5;and 12.5 mg every morning from 6th d＋25 mg every night before bed,and the dose could be adjusted based on the pain and adverse reactions of 2 groups. The treatment course for 2 groups was 4 weeks. Visual analogue scale score（VAS）,sleeping time,pain disappearing time and clinical efficacy in 2 groups were compared,and the incidence of adverse reactions were recorded. RESULTS：The total effective rate in observation group was higher than control group,VAS was lower than control group,sleeping time was longer than control group and pain disappearing time was shorter than control group,the differences were statistically significant（P〈0.05）. There was significant difference in the incidence of adverse reactions between 2 groups（P〉0.05）. CONCLUSIONS：Amitriptyline combined with carbamazepine has obvious efficacy in the treatment of PHN,with good safety.