普瑞巴林、加巴喷丁、卡马西平治疗带状疱疹后神经痛的疗效比较

Comparing the effects of pregabalin, gabapentin and carbamazepine in the treatment of patients withpostherpetic neuralgia

目的观察普瑞巴林、加巴喷丁、卡马西平在治疗带状疱疹后神经痛的临床疗效与安全性。方法带状疱疹后神经痛患者120例，随机分为3组，每组40例。A组患者予以普瑞巴林口服（150mg，2次，d），B组患者予以加巴喷丁口服（300mg，3次，d），c组患者予以卡马西平（0.1g，3次，d）。治疗2周病情稳定后可予出院，并由专职护士通过门诊或电话随访至第8周。疗程结束后比较3组患者的临床效果及不良反应。结果治疗2周后，与C组患者相比，A、B组患者疼痛程度明显减轻（P〈0.05）；与B组患者相比，A组患者疼痛程度减轻明显（P〈0.05）。与B、C两组患者比较，A组患者睡眠状态明显改善（P〈0.05）。治疗4周后，与c组相比，A、B两组睡眠均明显改善（P〈0.05）；与B组相比，A组患者睡眠改善更明显（P〈0.05）。同时A组患者不良反应较少（P〈O.05）。结论卡马西平、加巴喷丁及普瑞巴林治疗带状疱疹后神经痛均能在一定程度上达到治疗效果，但普瑞巴林改善症状的速度及效果明显优于前两者；在安全性方面，普瑞巴林不良反应也较前两者少。

Objective To compare the clinical effects of pregabalin,gabapentin and carbamazepine in the treatment of patients with postherpetic neuralgia （PHN）. Methods One hundred and twenty patients with PHN were randomly divided into three groups. The patients in group A were treated with oral pregabalin （ 150 rag, 2 times/d）, group B with oral gabapentin （300 mg, 3 times/d）, group C with oral carbamazepine （0.1 g, 3 times/d）. The patients can be discharged and followed up to 8 weeks after 2 weeks of treatment. The clinical effects and adverse reactions in the 3 groups were compared after the treatment. Results Visual analogue scale （VAS） of patients in group A and B reduced significantly after 2 weeks compared with the patients in group C （P〈 0.05）; VAS in group A were lower significantly compared with group B and C （P〈 0.05）. After 4 weeks, sleep quality score （SQS） in group A and B significantly improved compared with group C （P〈 0.05）; SQS in group A improved more significantly compared with group B （P 〈 0.05）. Adverse reactions were less in group A compareed with other two groups. Conclusions The effects of carbamazepine, gabapentine and pregabalin are similar in the treatment of postherpetic neuralgia, but the clinical effect of pregabalin is obvisouly better than that of carhamazepine and gabapentin, with quick onset, safe efficacy and less adverse reactions.