纪炳能+林凯胜+黄晓新

[摘要] 目的 观察普瑞巴林联合丙戊酸镁在脑卒中后中枢神经痛患者中的临床效果。 方法 取2015年1月～2017年1月我院收治脑卒中后中枢神经痛患者90例，采用随机数字表法分为对照组（n=30）、安慰剂组（n=30）和观察组（n=30）。对照组采用卡马西平联合丙戊酸镁治疗，安慰剂组给予B族维生素治疗，观察组采用普瑞巴林联合丙戊酸镁治疗，采用VAS疼痛评分量表、汉密尔顿抑郁量表及汉密尔顿焦虑量表对患者治疗前、后疼痛及心理波动情况进行评估，比较三组近期疗效。 结果 安慰剂组与对照组疗效率比较差异无统计学意义（P>0.05）；观察组与安慰剂、对照组疗效率比较有统计学意义（P<0.05）；观察组治疗后3、6周VAS评分，低于安慰剂组和对照组（P<0.05）；安慰剂组和对照组治疗后3、6周VAS評分比较差异无统计学意义（P>0.05）；观察组治疗后3、6周HAMD-17、HAMA评分，低于安慰剂组及对照组（P<0.05）；安慰剂组与对照组治疗3、6周HAMD-17、HAMA评分差异无统计学意义（P>0.05）；3组治疗6周后药物不良反应发生率情况比较差异无统计学意义（P>0.05）。 结论 脑卒中后中枢神经痛患者采用普瑞巴林联合丙戊酸镁治疗效果理想，值得推广应用。

[关键词] 普瑞巴林；丙戊酸镁；脑卒中；中枢神经痛

[中图分类号] R743.3 [文献标识码] A [文章编号] 2095-0616（2017）13-59-04

[Abstract] Objective To observe the clinical effect of pregabalin combined with magnesium valproate in treatment of 90 cases of central nervous system after stroke. Methods 90 cases of central nervous system after stroke cured in our hospital from January 2015 to January 2017 were selected and divided into control group（n=30），placebo group（n=30） and observation group（n=30） according to random digital method.Patients in control group were treated with carbamazepine combined with magnesium valproate，patients in placebo group were treated with B vitamins，and patients in observation group were treated with pregabalin combined with magnesium valproate.VAS pain rating scale，Hamilton depression rating scale and the Hamilton anxiety scale were used to evaluate the pain and psychological fluctuations of patients before and after treatment.Recent effect of the three groups were compared. Results There was no significant difference between the placebo group and the control group（P>0.05）.It was statistically significant between the observation group compared with the placebo group， the control group was（P<0.05）.The VAS score of the observation group at 3 and 6 weeks after treatment was lower than that in the placebo group and the control group（P<0.05）.There was no significant difference in the VAS score between the 3 groups and the placebo group at week 6 and week after treatment（P>0.05）.The HAMD-17 and HAMA scores of the observation group at 3 and 6 weeks after treatment were lower than those in the placebo group and the control group（P<0.05）.There was no significant difference between the placebo group and the control group in the 3 week and the 6 week HAMD-17 and HAMA score（P>0.05）.There was no significant difference in the incidence of adverse drug reactions between the 3 groups after treatment for weeks（P>0.05）. Conclusion The clinical effect of pregabalin combined with magnesium valproate in treatment of 90 cases of central nervous system after stroke is ideal.It is worthy of promotion.

[Key words] Pregabalin；Magnesium valproate；Stroke；Central neuralgia

脑卒中是临床上常见的疾病，该疾病多发生在中老年人群中，具有发病率高、致残率高及病死率高，脑卒中是中枢神经痛（CPSP）的主要发病原因之一，患者发病后临床上表现为偏侧肢体、躯干间断或持续性疼痛，部分患者呈烧灼样、针刺样、刀割样，是一种难以忍受、顽固的神经病理疼痛[1]。同时，由于CPSP病程较长，反复迁延，部分患者常伴有焦虑、抑郁等症状，从而进一步加剧疼痛症状，形成一种恶性循环，严重影响患者健康。目前……