加巴喷丁联合泼尼松治疗带状疱疹性疼痛疗效观察

Efficacy of gabapentin combined with prednisone on patients with herpetic neuralgia

目的观察加巴喷丁联合泼尼松治疗带状疱疹性疼痛的疗效。方法将2012年2月至2015年2月在我院皮肤科门诊及住院部带状疱疹疼痛视觉模拟评分(VAS)>5分的患者120例按随机数表法分为对照组和观察组各60例。两组均给予常规抗病毒、营养神经治疗,对照组给予小剂量泼尼松口服,观察组在对照组的基础上加用加巴喷丁口服。分别记录两组患者治疗前及治疗后1周、2周VAS评分。2周后对治疗的有效率进行比较,3个月后统计后遗神经痛的发生率及VAS评分并做比较。结果治疗后1周、2周,观察组患者的VAS评分分别为(3.36±1.27)分、(2.38±1.15)分,均明显低于对照组的(4.55±1.36)分、(3.48±1.35)分,两组比较差异均有统计学意义(P<0.05);2周后观察组的治疗有效率为86.67%(52/60),明显高于对照组的70.00%(42/60),差异有统计学意义(P<0.05);治疗后3个月,观察组的后遗神经痛发生率为15.00%(9/60),明显低于对照组的26.67%(16/60),差异有统计学意义(P<0.05)。结论加巴喷丁联合小剂量泼尼松治疗带状疱疹性疼痛效果好,后遗神经痛发生率低,值得临床推荐使用。

Objective To observe the clinical effect of gabapentin combined with prednisone in the treatment of patients with herpetic neuralgia.Methods A total of 120 cases of patients with herpes zoster [visual analogue scale(VAS) >5],who admitted to our hospital dermatology outpatient and inpatient from February 2012 to February 2015,were randomly divided into two groups.All patients in the two groups were treated with conventional therapies,such as antivirus,nutrition nerve agents.In addition to the above treatments,the control group(n=60) was treated with prednisone,while the treatment group(n=60) was treated with gabapentin and prednisone.The VAS scores of two groups were recorded before treatment and 1,2 weeks after treatment;the efficacy of the two groups were compared after 2 weeks;the incidence rate of post-herpetic neuralgia(PHN) and VAS scores were compared after 3 months.Results 1 and 2weeks after treatment,the VAS scores in treatment group [(3.36±1.27),(2.38±1.15)] were significantly lower than before treatment [(4.55±1.36),(3.48±1.35)](P<0.05);the effective rate in treatment group [86.67%(52/60)] was significantly higher than that in control group [70.00%(42/60)](P<0.05);the incidence rate of PHN in treatment group[15.00%(9/60)] was significantly lower that in control group [26.67%(16/60)](P<0.05).Conclusion The results suggest that the treatment of herpetic neuralgia using gabapentin combined with prednisone is an effective method,and it could decrease the incidence rate of PNH and is worthy of clinical application.