度洛西汀添加治疗亚急性带状疱疹神经痛的疗效和安全性观察

Efficacy and safety of doloxetine in the treatment of subacute herpes zoster neuralgia

目的探索度洛西汀治疗亚急性带状疱疹神经痛(subacute herpes zoster neuralgia)的临床疗效及安全性。方法43例病程1个月以上的亚急性带状疱疹神经痛患者,随机分为度洛西汀组(doloxitine group)及对照组(control Group),对照组口服加巴喷丁、普瑞巴林治疗,度洛西汀组在对照组用药的基础上加用度洛西汀治疗;比较治疗前、治疗后1个月及3个月2组疼痛视觉模拟评分法(VAS)、抑郁自评量表(SDS)及焦虑自评量表评分(SAS)、普瑞巴林和加巴喷丁剂量及不良反应。结果度洛西汀组VAS评分较对照组显著降低(P<0.01);2组普瑞巴林剂量无明显变化,而度洛西汀组加巴喷丁剂量较对照组减少(P<0.05);3个月后,加巴喷丁的剂量无显着差异,而普瑞巴林的剂量则显著降低(P<0.05)。抑郁自评量表评分(SDS)、焦虑自评量表评分(SAS)2组无显著性差异;2组不良反应发生率差异无统计学意义(P>0.05)。结论度洛西汀可显著改善带状疱疹后遗神经痛的疗效及生活质量,且临床安全性较好。

Objective To evaluate the clinical efficacy and safety of doloxetine in the treatment of subacute herpes zoster neuralgia.Methods Forty-three patients with subacute herpes zoster neuralgia for more than 1 month were randomly divided into doloxetine group and control group.The control group was treated with gabapentin,pregabalin and methycobal and the duloxetine group was treated with duloxetine in addition to the drugs used in control group.Visual analogue scale(VAS),self-rating depression scale(SDS)and self-rating anxiety scale(SAS),pregabalin and gabapentin doses and related adverse reactions were observed in the two groups before treatment,1 month and 3 months after treatment.Results Compared with those of control group,the VAS score(P<0.01)of duloxetine group was significantly lower after 3 months treatment.There was no significant change in Pregabalin dose in the two groups,while the dose of gabapentin in the duloxetine group was lower than that in the control group after one month treatment(P<0.05),after 3 months,there was no significant differencein the dose of gabapentin,while the dose of pregabalin was significantly lower(P<0.05).There was no significant difference of SDS,SAS and the incidence of adverse reactions between the two groups(P>0.05).Conclusion Doloxetine can significantly improve the curative effect and quality of life in the patients with subacute herpes zoster neuralgia,and it is safe in clinical application.