CAJ | 학술논문

目的：评价普瑞巴林联合阿米替林治疗神经病理性疼痛的临床疗效。方法采用随机病例对照研究，将66例神经病理性疼痛患者随机分为治疗组和对照组。治疗组予以普瑞巴林75 mg ，2次/d＋阿米替林25 mg ；对照组予卡马西平0.1 g ，2次/d。疗程共2周。采用数字分级量表（N RS ）评价基线及第2周时疼痛强度并据此判定总体疗效，采用睡眠干扰评分评价疼痛对睡眠的干扰，应用汉密尔顿抑郁量表（17项）、汉密尔顿焦虑量表进行情绪评定，同时观察普瑞巴林的不良反应。结果66例患者均完成全程研究，经2周治疗后治疗组和对照组总有效率分别为87.9％、63.6％，2组相比较差异有统计学意义（P＜0.05）。治疗组疼痛评分由7.5±1.4下降至2周时的3.8±1.6，下降了49.3％；睡眠干扰评分、汉密尔顿抑郁评分和焦虑评分均明显改善（ P＜0.01）。66例患者中7例发生不良事件，症状的程度均较轻，且为一过性。无1例因严重并发症而退出本研究。结论普瑞巴林联合阿米替林能有效改善神经病理性疼痛以及相关的睡眠及情绪障碍，且耐受性良好。
목적：평개보서파림연합아미체림치료신경병이성동통적림상료효。방법채용수궤병례대조연구，장66례신경병이성동통환자수궤분위치료조화대조조。치료조여이보서파림75 mg ，2차/d＋아미체림25 mg ；대조조여잡마서평0.1 g ，2차/d。료정공2주。채용수자분급량표（N RS ）평개기선급제2주시동통강도병거차판정총체료효，채용수면간우평분평개동통대수면적간우，응용한밀이돈억욱량표（17항）、한밀이돈초필량표진행정서평정，동시관찰보서파림적불량반응。결과66례환자균완성전정연구，경2주치료후치료조화대조조총유효솔분별위87.9％、63.6％，2조상비교차이유통계학의의（P＜0.05）。치료조동통평분유7.5±1.4하강지2주시적3.8±1.6，하강료49.3％；수면간우평분、한밀이돈억욱평분화초필평분균명현개선（ P＜0.01）。66례환자중7례발생불량사건，증상적정도균교경，차위일과성。무1례인엄중병발증이퇴출본연구。결론보서파림연합아미체림능유효개선신경병이성동통이급상관적수면급정서장애，차내수성량호。
Objective To evaluate the clinical efficacy of pregabalin combined with amitriptyline on neuropathic pain.Methods A randomized case-control study of 66 patients with neuropathic pain were randomly divided into treatment group and control group.Treatment group received pregabalin 75 mg ,2 times/day + amitriptyline 25 mg ;the control group was given carbamazepine 0.1 g ,2 times/day.Each group received two weeks'treatment.Pain intensity was evaluated by numerical rating scales(NRS) at the baseline and 2 weeks after therapy and accordingly the overall efficacy was determined ,sleep interfered by pain was assessed by sleep disturbance score ,their emotion was assessed by the scores of 17-item Hamilton Depression Rating Scale (HAMD-17) and Hamilton Anxiety Rating Scale(HAMA) ,while the adverse reactions of pregabalin and amitriptyline were also observed.Results All of 66 patients completed the entire study ,after two weeks'treatment ,the total effective rate of the treatment group and the control group was 87.9 % and 63.6 % ,respectively. The difference between the two groups was statistically significant (P<0.05). Pain score of treatment group decreased from 7.5 ± 1.4 to 3.8 ± 1.6 after 2 weeks therapy , a reduction of 49.3% ;sleep disturbance score ,Hamilton depression scores and anxiety scores were significantly improved.in treatment group(P<0.01). Adverse events occurred in 7 of 66 patients ,the degree of the symptoms was mild ,and the symp-toms was transient. None of the serious complications was incurred and no patient withdrew from the study. Conclusion Pre-gabalin combined with amitriptyline can effectively improve neuropathic pain and associated sleep and mood disorders ,and is well tolerated.