硬膜外自控镇痛治疗早期带状疱疹后神经痛的疗效分析

THE EFFECTIVENESS OF PATIENT-CONTROLLED EPIDURAL ANALGESIA IN TREATING POSTHERPETIC NEURALGIA

目的:本研究试图观察硬膜外自控镇痛联合普瑞巴林治疗早期带状疱疹后神经痛(postherpetic neuralgia,PHN)的临床疗效。方法:本研究选取了60例带状疱疹后神经痛的患者,随机分配成2组,口服普瑞巴林组(A组),硬膜外自控镇痛联合普瑞巴林组(B组),在治疗前,治疗后7天,治疗后1月,治疗后3月进行简式Mc Gill疼痛问卷(SF-MPQ)评定。在治疗前,治疗后6月进行简明疼痛评估量表(BPI)评定,并对药物的不良反应进行统计。结果:两组患者治疗后各时间点SF-MPQ评分和BPI评分均较治疗前显著下降(P<0.01)。B组SF-MPQ中各项评分较A组在术后7天,术后1月,术后3月显著下降(P<0.01),B组较A组术后6月的BPI评分显著下降(P<0.01)。结论:本研究结果表明硬膜外自控镇痛联合普瑞巴林是治疗早期带状疱疹后神经痛相对安全有效的方法。

Objective： This study sought to evaluate the clinical effectiveness and safety of patient-controlled epidural analgesia（PCEA） combined pregabalin in treating patients with early postherpetic neuralgia（PHN）. Methods：A total of 60 patients with PHN participated in the study. The patients were randomly divided into 2 groups： pregabalin group（group A）, PCEA combined pregabalin group（group B）. Pain intensity was rated on Short-form Mc Gill pain questionnaire（SF-MPQ） at pretreatment and 1 week, 1 month, and 3 months at post-treatment. Brief Pain Inventory（BPI） was applied at pretreatment and 6 months at posttreatment in evaluating quality of life. The adverse reactions were also recorded. Results： There were statistically significant decreases（P 〈0.01） in the SF-MPQ and BPI scores for all post-treatment time points when compared with the pretreatment values in the two groups. The group B produced a significantly greater reduction in the SF-MPQ score when compared with group A at 1 week, 1 month and 3 months after the treatment（P 〈0.01）. The BPI results for B group were significantly lower than those for group A at 6 months post-treatment（P 〈0.01）. Conclusions： The results of this study suggest that patient-controlled epidural analgesia combined pregabalin is relative effective and safe for treating early PHN.