陈志龙 李志伟 李水娇

【摘要】 目的：观察普瑞巴林（PGB）治疗带状疱疹后神经痛（PHN）的临床效果。方法：选取2018年6月-2020年12月于本院治疗的60例PHN患者为研究对象，依据随机数字表法将其分为普瑞巴林组和对照组，各30例。对照组给予卡马西平口服治疗，普瑞巴林组给予PGB口服治疗。比较两组患者的临床疗效、不良反应发生情况、疼痛程度、睡眠质量和生活质量。结果：普瑞巴林组治疗总有效率为96.67%，明显高于对照组的80.00%，差异有统计学意义（P<0.05）;治疗1、2、3、4周后，两组患者VAS、PSQI评分较治疗前均显著降低，且普瑞巴林组均明显低于对照组（P<0.05）。治疗4周后，两组患者SF-36各维度评分较治疗前均显著升高，且普瑞巴林组均明显高于对照组（P<0.05）。普瑞巴林组不良反应发生率为33.33%，对照组为36.67%，两组比较差异无统计学意义（P>0.05）。结论：PGB可有效缓解PHN患者疼痛程度，改善其睡眠质量和生活质量，临床疗效较好，具有一定的应用价值。

【关键词】 普瑞巴林 卡马西平 带状疱疹后神经痛

Clinical Study of Pregabalin in the Treatment of Postherpetic Neuralgia/CHEN Zhilong， LI Zhiwei， LI Shuijiao. //Medical Innovation of China， 2021， 18（14）： 0-055

[Abstract] Objective： To observe the clinical effect of Pregabalin （PGB） in the treatment of postherpetic neuralgia （PHN）. Method： A total of 60 PHN patients treated in our hospital from June 2018 to December 2020 were selected as the research objects. According to random number table method， they were divided into Pregabalin group and control group， 30 cases in each group. The control group was given Carbamazepine orally， the Pregabalin group was given PGB oral therapy. Clinical efficacy， adverse reactions， pain， sleep quality and life quality were compared between the two groups. Result： The total effective rate of Pregabalin group was 96.67%， which was significantly higher than 80.00% of control group， the difference was statistically significant （P<0.05）. After 1， 2， 3 and 4 weeks of treatment， VAS and PSQI scores in two groups were significantly lower than those in before treatment， and those in Pregabalin group were significantly lower than those in control group （P<0.05）. After 4 weeks of treatment， all dimensions of SF-36 scores in two groups were significantly higher than those before treatment， and those in Pregabalin group were significantly higher than those in control group （P<0.05）. The total incidence of adverse reactions was 33.33% in the Pregabalin group and 36.67% in the control group， there was no statistical significance between the two groups （P>0.05）. Conclusion： PGB can effectively relieve the pain degree of PHN patients， improve their sleep quality and quality of life， with good clinical efficacy， and has certain application value.

[Key words] Pregabalin Carbamazepine Postherpetic neuralgia

First-authors address： Luoding Peoples Hospital， Luoding 527200， China

doi：10.3969/j.issn.1674-4985.2021.14.013

帶状疱疹后神经痛（PHN）是一类神经病理性疼痛，带状疱疹患者痊愈后仍出现1个月以上持续性疼痛或3个月以上阵发性疼痛，疼痛主要特征为灼痛、深在性跳痛和刀割样痛，其发病原因可能与水痘-带状疱疹病毒（VZV）有关[1-2]。VZV是指儿童初次感染水痘后潜伏在其体内的病毒，恢复后大部分病毒会被清除，但仍有少量残留，成年后，若机体免疫功能受损，潜伏的VZV病毒则会被激活并大量复制，引起受累神经节炎症、坏死，产生神经痛[3]。据统计，PHN多发生于老年患者[4]，由于疼痛程度重、持续时间长，严重影响患者生活质量和精神状态，需尽早治疗。迄今为止，已发现非甾体消炎药、局麻药、阿片类药物等可显著缓解疼痛，但上述药物副作用较多，不适于长期应用。现有研究发现，普瑞巴林（PGB）治疗带状疱疹后神经痛效果显著，PGB是一类新型抗惊厥药，可通过阻断电压依赖性钙通道，减少神经递质释放，抑制神经元兴奋性，镇痛、抗惊厥疗效好，具有较高的应用价值，但PGB治疗PHN的有效性和安全性尚未明确[5-6]。……