潘浩　陈霞

【摘要】 目的：观察加巴喷丁联合度洛西汀治疗带状疱疹后神经痛的临床效果。方法：选取2018年1月-2019年6月笔者所在医院收治的带状疱疹后神经痛患者276例，随机分为A组和B组，每组138例。A组给予加巴喷丁联合度洛西汀治疗，B组给予加巴喷丁治疗。治疗4周后，比较两组临床效果及治疗前后疼痛评分，观察两组治疗后不良反应情况。结果：A组总有效率为92.75%，显著高于B组的68.84%（字2=8.402，P<0.05）。两组治疗后疼痛评分均较治疗前降低（t=2.018、2.322，P<0.05）;A组治疗后疼痛评分显著低于B组（t=14.366，P<0.05）。治疗期间，两组不良反应发生率比较，差异无统计学意义（P>0.05）。结论：加巴喷丁联合度洛西汀是治疗带状疱疹后神经痛安全有效的方法，可显著缓解患者的疼痛感，改善生活质量，提高临床治疗有效率，值得推广。

【关键词】 带状疱疹后神经痛 加巴喷丁 度洛西汀 临床疗效

doi：10.14033/j.cnki.cfmr.2020.21.003 文献标识码 A 文章编号 1674-6805（2020）21-000-03

Clinical Efficacy of Gabapentin Combined with Duloxetine in Treatment of Postherpetic Neuralgia/PAN Hao， CHEN Xia. //Chinese and Foreign Medical Research， 2020， 18（21）： -9

[Abstract] Objective： To observe the effect of Gabapentin combined with Duloxetine in treatment of postherpetic neuralgia. Method： A total of 276 patients with postherpetic neuralgia in department of neurology in our hospital from January 2018 to June 2019 were randomly divided into two groups， with 138 patients in each group. The group A was given Gabapentin combined with Duloxetine， and the group B was given Gabapentin. After 4 weeks of treatment， the clinical effect and pain scores before and after treatment were compared between the two groups， and the adverse reactions after treatment were observed. Result： The total of effective rate in the group A was 92.75%， which was higher than 68.84% of the group B （字2=8.402， P<0.05）. After treatment， the pain scores in both groups were lower than those before treatment （t=2.018， 2.322， P<0.05）. And the pain score in the group A after treatment was lower than that of the group B （t=14.366， P<0.05）. During treatment， the incidence of adverse reactions were compared between the two groups， and the difference was not statistically significant （P>0.05）. Conclusion： The combination of Gabapentin and Duloxetine to treat postherpetic neuralgia is safe and effective， which can relieve the pain， improve the quality of life， and improve the effective rate. It is worthy of promotion.

[Key words] Postherpetic neuralgia Gabapentin Duloxetine Clinical efficacy

First-authors address： Fuzhou Second Hospital Affiliated to Xiamen University， Fuzhou 350007， China

帶状疱疹是一种由水痘-带状疱疹病毒引起的急性感染性皮肤病，患者发病后常表现为受损部位感觉异常、疱疹及明显疼痛[1]。带状疱疹后神经痛（postherpeticneuralgia，PHN）是指急性感染期皮损消退后，受损局部仍然持续存在针刺样、刀割样、烧灼样的慢性剧烈神经痛，多发生于机体免疫力低下患者及老年患者，疼痛持续时间可达数月至数年[2]。约10%带状疱疹患者出现后遗神经痛，且在50岁以上患病人群中，后遗神经痛发生率高达15%～25%[3]。持续的剧烈疼痛，往往使患者产生焦虑、抑郁、恐惧等情感障碍，严重影响身心健康及生活质量，需及时进行治疗。鉴于带状疱疹后神经痛的发病机制复杂多样，临床常采用多种方法相结合的治疗方式，常用药物包括抗惊厥药、三环类抗抑郁药、阿片类镇痛药等。……