巴氯芬联合加巴喷丁对疱疹后神经痛的协同治疗作用研究

Clinical 0bservati0n 0f baclofen combined with gabapentin for treatment of postherpetic neuralgia

目的观察巴氯芬联合加巴喷丁治疗带状疱疹感染后神经痛的疗效。方法将2014年8月至2017年1O月武警重庆市总队医院收治的79例带状疱疹感染后神经痛患者随机分为治疗组(40例)和对照组(39例)。治疗组口服巴氯芬(每次5mg,每天3次)和加巴喷丁胶囊(每次0.3g,每天3次),对照组服用卡马西平(每次0.1~0.2,每天3次),28d为1个疗程。观察两组患者治疗前后[治疗前(T1),治疗后3d(T2)、7d(T3)、14d(T4)、21d(T5)、28d(T6)]疼痛改善情况及药物不良反应。结果两组患者年龄、性别、病程、治疗前神经痛分布区域比较,差异均无统计学意义(P>0.05),具有可比性。两组患者治疗后各时间点疼痛视觉模拟评分(VAS)明显低于治疗前,差异均有统计学意义(P<0.05);治疗组患者治疗后各时间点VAS明显低于对照组,差异均有统计学意义(P<0.05);两组患者未出现明显不良反应。结论巴氯芬联合加巴喷丁可作为治疗带状疱疹感染后神经痛的首选药物。

Objective To observe the curative effect of baclofen combined with gabapentin for postherpetic neuralgia. Methods Seventyeight patients with postherpetic neuralgia were divided randomly into baclofen combined with gabapentin therapy group( n =40)and carbamazapine control group(n=39).The therapy group were treated by baclofen 15 mg/d and gabapentin 900 mg/d for oral use while the group treated by carbamazapine 0.1-0.2 tid for oral use.The period of each were 28 days.Bafore and after treatment,symptoms and signs of neuropathy including pain and drug adverse reaction were observed. Results No significant diference in age,sex,course of disease,neuralgia distributed area of two groups.The Vas score of both groups in each times was lower than before treatment( P <0.05).The Vas score of therapy group in the T2,T3,T4,T5,T6 was lower than the comparison( P <0.05).There were no severe drug adverse reaction in both groups,and lower side efect was observed in therapy group. Conclusion Baclofen combined with gabapentin may be the first therapy to treat postherpetic neuralgia.