普瑞巴林联合神经妥乐平治疗脊髓损伤患者神经病理性疼痛的疗效观察

关键词：神经病理性疼痛  脊髓损伤  普瑞巴林  神经妥乐平  焦虑  抑郁

Keywords:neuropathic pain  spinal cord injury  pregabalin  neurotropin  anxiety  depression

摘要：

      摘要 目的：探讨神经妥乐平对于脊髓损伤后神经病理性疼痛的临床疗效，同时比较单独使用神经妥乐平与联合使用普瑞巴林和神经妥乐平对神经病理性疼痛的缓解程度、对患者情绪以及睡眠状况的改善情况。 方法：选取符合入组标准的脊髓损伤伴神经病理性疼痛患者62例，电脑随机分2组，分别为神经妥乐平组、普瑞巴林联合神经妥乐平组，神经妥乐平组起始剂量为4U bid，普瑞巴林联合神经妥乐平组起始剂量为普瑞巴林75mg bid+神经妥乐平4U bid，间隔3d调整药物剂量，疗程为4周。采用视觉模拟评分量表（visual analogue scale，VAS）、医院焦虑抑郁量表（hospital anxiety and depression scale，HAD）、匹茨堡睡眠质量指数量表（Pittsburgh sleep quality index，PSQI)对患者进行疼痛、情绪和睡眠质量的评估。由专业的康复治疗师对患者服药前和疗程结束后的疗效分别进行评估。 结果：单独使用神经妥乐平可以缓解脊髓损伤患者神经病理性疼痛，同时改善患者睡眠质量，治疗前后比较差异有显著性意义(P<0.05)；而联合使用普瑞巴林和神经妥乐平治疗后，患者的VAS和HAD评分均较神经妥乐平组明显降低，差异有显著性意义(P<0.05)。 结论：神经妥乐平可以缓解脊髓损伤患者的疼痛症状，联合使用普瑞巴林和神经妥乐平不仅明显缓解脊髓损伤神经病理性疼痛患者的疼痛症状，同时显著改善了患者的焦虑抑郁情绪，提高患者睡眠质量，进而提升患者生存质量，是一种有效的临床治疗方法。

Abstract:

      Abstract Objective:To investigate clinical effect of neurotropin in the treatment of neuropathic pain after spinal cord injury, and compare the clinical effect of using neurotropin alone with the combination of pregabalin and neurotropin. Method:A total of 62 patients with neuropathic pain after spinal cord injury were randomly divided into treatment group and control group. The control group received neurotropin treatment alone and the treatment group received the treatment of neurotropin combined with pregabalin. Clinical effects of the two groups were evaluated by visual analogue scale (VAS), hospital anxiety and depression scale score (HAD) and Pittsburgh sleep quality index score (PSQI) before and after four weeks’ treatment. The clinical effect of the patient was assessed by a professional rehabilitation therapist before and after the treatment. Result:The single use neurotropin can relieve neuropathic pain in patients with spinal cord injury and improve the quality of sleep. After treatment, both groups had decrease in VAS scores and the treatment group had more obvious decrease in VAS score. Moreover, the treatment group also had decrease in HAD score when compared with the control group. Their differences all had statistical significance (P<0.05). Conclusion:Neurotropin can relieve the pain symptoms in patients with spinal cord injury. The combined use of pregabalin and neurotropin not only relieves neuropathic pain of patients, but also significantly relieves the anxiety and depression of patients and improves the quality of sleep.