普瑞巴林联合加巴喷丁或拉莫三嗪治疗脊髓损伤后神经病理性疼痛的临床效果

Clinical effect of Pregabalin combined with Gabapentin or Lamotrigine in the treatment of neuropathic pain after spinal cord injury

目的探讨普瑞巴林联合加巴喷丁或拉莫三嗪治疗脊髓损伤后神经病理性疼痛的临床效果。方法选取2015年11月~2018年11月我院收治的75例脊髓损伤后神经病理性疼痛患者作为研究对象,按照随机数字表法分为A、B与C组,每组各25例,C组出组1例,因此C组进入结果分析的为24例。A组给予普瑞巴林口服,B组给予普瑞巴林联合加巴喷丁口服,C组给予普瑞巴林联合拉莫三嗪口服。比较三组的疼痛数字分级量表(NRS)、汉密尔顿抑郁量表(HAMD)评分、NRS和HAMD评分差值及不良反应发生率。结果三组治疗后的NRS、HAMD评分低于治疗前,差异均有统计学意义(P<0.05);B、C组治疗后的NRS、HAMD评分低于A组,差异均有统计学意义(P<0.05)。B、C组的NRS评分差值高于A组,差异均有统计学意义(P<0.05);C组的HAMD评分差值高于A、B组,B组的HAMD评分差值高于A组,差异均有统计学意义(P<0.05)。三组的乏力、头晕、嗜睡、周围性水肿及皮疹等不良反应发生率比较,差异无统计学意义(P>0.05)。结论对脊髓损伤后神经病理性疼痛的治疗,普瑞巴林联合加巴喷丁或拉莫三嗪的治疗效果优于单药普瑞巴林,值得临床推广应用。

Objective To explore the clinical effect of Pregabalin combined with Gabapentin or Lamotrigine in the treatment of neuropathic pain after spinal cord injury.Methods A total of 75 patients with neuropathic pain after spinal cord injury admitted to our hospital from November 2015 to November 2018 were selected as the research objects,they were divided into group A,group B and group C,25 cases in each group,according to the random number table method,1 case in group C,so group C entered the result analysis for 24 cases.Group A was treated with Pregabalin,group B with Pregabalin and Gabapentin,and group C with Pregabalin and Lamotrigine.The scores of numerical rating scale(NRS),Hamilton depression scale(HAMD),difference value of NRS and HAMD scores,the incidence of adverse reactions were compared among the three groups.Results The scores of NRS and HAMD in the three groups were lower than those before treatment,the differences were statistically significant(P<0.05).The scores of NRS and HAMD in group B and C were lower than those in group A,the differences were statistically significant(P<0.05).The difference value of NRS scores in group B and C were higher than those in group A,the differences were statistically significant(P<0.05).The difference value of HAMD score in group C was higher than that in group A and B,the difference value of HAMD score in group B was higher than that in group A,the differences were statistically significant(P<0.05).There were no significant differences in the incidence of adverse reactions such as fatigue,dizziness,lethargy,peripheral edema and rash in the three groups(P>0.05).Conclusion For the treatment of neuropathic pain after spinal cord injury,Pregabalin combined with Gabapentin or Lamotrigine is superior to single-agent pregabalin,which is worthy of clinical application.