舍曲林联合普瑞巴林治疗胸背部带状疱疹后神经痛的临床疗效分析
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摘要
目的探讨舍曲林联合普瑞巴林治疗胸背部带状疱疹后神经痛的临床疗效。方法将2015年3月—2016年3月绍兴市人民医院收治的96例胸背部带状疱疹后神经痛患者按照随机数字表法分为对照组和研究组,每组48例。对照组在常规对症治疗基础上行口服普瑞巴林治疗;研究组在对照组治疗的基础上行口服盐酸舍曲林治疗。于治疗前、治疗后2周、1个月、2个月、3个月,采用视觉模拟评分法(VAS)评价患者疼痛程度,采用生活量表(QOL)评价患者生存质量变化;观察并记录2组治疗过程中药物相关不良反应的发生情况。结果研究组疗效显著高于对照组,差异有统计学意义(Z=2.288,P<0.05)。治疗后2周、1个月、2个月、3个月,2组VAS评分显著降低(均P<0.05);治疗后2周、1个月、2个月、3个月,研究组VAS评分显著低于对照组,差异有统计学意义(均P<0.05)。2组治疗后QOL评分均较治疗前显著降低(P<0.05);治疗后2周、1个月、2个月、3个月,研究组在食欲、睡眠、情绪、精神状态的评分均显著低于对照组同期的水平,差异有统计学意义(均P<0.05)。研究组药物相关不良反应发生率(16.67%)与对照组(12.50%)相比,差异无统计学意义(P>0.05)。结论舍曲林联合普瑞巴林能显著改善胸背部带状疱疹后神经痛患者临床症状,提高治疗有效率,改善疼痛程度和生活质量。
Objective To investigate the clinical efficacy of sertraline combined with pregabalin in the treatment of thoracic back postherpetic neuralgia. Methods Total 96 patients with postherpetic neuralgia of chest and back were divided into control group and research group according to random number table method,with 48 cases in each group. The control group received oral pregabalin based on the conventional treatment. The research group received additional sertraline.The patients were evaluated by visual analogue scale( VAS) before the treatment,2 weeks,1 months,2 months and 3 months after the treatment. Life quality scale( QOL) was used to evaluate the quality of life of patients. The incidence of adverse drug reactions in the two groups were observed and recorded. Results The curative effect of the research group was significantly higher than that of the control group,the difference was statistically significant( Z = 2. 288,P < 0. 05).After 2 weeks,at the end of the 1 month,the 2 month and the 3 month,the VAS scores of the two groups were significantly decreased( P < 0. 05). After treatment for 2 weeks,1 month,2 months,and 3 months,the VAS score of the study group was significantly lower than that of the control group,the difference was statistically significant( P < 0. 05).The QOL scores of the two groups after the treatment were significantly lower than those before the treatment( P < 0. 05).After 2 weeks,1 months,2 months,and 3 months after treatment,the scores of appetite,sleep,mood and mental state of the study group were significantly lower than those of the control group,the difference was statistically significant( P <0. 05). The incidence of adverse drug reactions( 16. 66%) in the study group was significantly higher than that in the control group( 12. 50%),there was no significant difference( P > 0. 05). Conclusion Sertraline combined with pregabalin can significantly improve the clinical symptoms of patients with postherpetic neuralgia of chest and back,improve the treatment efficiency,improve the degree of pain and quality of life.
Objective To investigate the clinical efficacy of sertraline combined with pregabalin in the treatment of thoracic back postherpetic neuralgia. Methods Total 96 patients with postherpetic neuralgia of chest and back were divided into control group and research group according to random number table method,with 48 cases in each group. The control group received oral pregabalin based on the conventional treatment. The research group received additional sertraline.The patients were evaluated by visual analogue scale( VAS) before the treatment,2 weeks,1 months,2 months and 3 months after the treatment. Life quality scale( QOL) was used to evaluate the quality of life of patients. The incidence of adverse drug reactions in the two groups were observed and recorded. Results The curative effect of the research group was significantly higher than that of the control group,the difference was statistically significant( Z = 2. 288,P < 0. 05).After 2 weeks,at the end of the 1 month,the 2 month and the 3 month,the VAS scores of the two groups were significantly decreased( P < 0. 05). After treatment for 2 weeks,1 month,2 months,and 3 months,the VAS score of the study group was significantly lower than that of the control group,the difference was statistically significant( P < 0. 05).The QOL scores of the two groups after the treatment were significantly lower than those before the treatment( P < 0. 05).After 2 weeks,1 months,2 months,and 3 months after treatment,the scores of appetite,sleep,mood and mental state of the study group were significantly lower than those of the control group,the difference was statistically significant( P <0. 05). The incidence of adverse drug reactions( 16. 66%) in the study group was significantly higher than that in the control group( 12. 50%),there was no significant difference( P > 0. 05). Conclusion Sertraline combined with pregabalin can significantly improve the clinical symptoms of patients with postherpetic neuralgia of chest and back,improve the treatment efficiency,improve the degree of pain and quality of life.
引文
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[13]叶毓莲,李建梅,刘雅静,等.硬膜外自控镇痛联合药物治疗躯干部带状疱疹后神经痛的护理[J].海南医学,2014,25(12):1867-1869.
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[15]侯宇,宋梅,张婷,等.普瑞巴林联合舍曲林治疗难治性神经病理性疼痛的对照研究[J].中国医师进修杂志,2014,37(7):31-33.
[2]翟志超,刘思同,李慧莹,等.带状疱疹后神经痛治疗研究进展[J].中国疼痛医学杂志,2016,22(1):55-59.
[3]杨国亮,王侠生.现代皮肤病学[M].上海:上海医科大学出版社,2000:293-297.
[4]Ginieri CM,Triantafillou E,Tomaras V,et al.Quality of life in mentally ill,physically ill and healthy individuals:The validation of the Greek version of the World Health Organization Quality of Life(WHOQOL-100)questionnaire[J].Ann Gen Psychiatry,2009,13(8):23-37.
[5]赵辨.中国临床皮肤病学[M].南京:江苏科学技术出版社,2010:396.
[6]陈海谊,陈焕高.不同剂量糖皮质激素治疗带状疱疹神经痛疗效观察[J].海南医学,2015,12(17):2587-2589.
[7]陈玉梅.中西医结合治疗带状疱疹后遗神经痛疗效观察[J].现代中西医结合杂志,2016,25(9):961-963.
[8]Tanaka R,Ando T,Yanagishita T,et al.Effect of pregabalin on acute herpes zoster pain[J].Journal of Dermatological Science,2016,84(1):e34.
[9]姜小琴,杨开仁,郑利锋,等.舍曲林合并无抽搐电休克治疗老年抑郁症的临床研究[J].浙江医学,2014,36(14):1245-1247,1254.
[10]王涛.度洛西汀与舍曲林治疗抑郁症伴躯体疼痛障碍疗效比较[J].临床医学,2014,34(2):76-77.
[11]陈英,杨军,李莺,等.舍曲林联合普瑞巴林治疗老年带状疱疹后神经痛镇痛疗效的研究[J].中国临床药理学杂志,2015,31(2):93-95.
[12]皮治兵,林海,彭宇,等.舍曲林联合泛昔洛韦治疗带状疱疹神经痛的临床研究[J].中国临床药理学杂志,2016,32(13):1155-1157.
[13]叶毓莲,李建梅,刘雅静,等.硬膜外自控镇痛联合药物治疗躯干部带状疱疹后神经痛的护理[J].海南医学,2014,25(12):1867-1869.
[14]张海芳,周国明.CT引导下椎旁注射不同药物治疗早期带状疱疹后神经痛临床疗效比较[J].河北医学,2016,22(7):1155-1157.
[15]侯宇,宋梅,张婷,等.普瑞巴林联合舍曲林治疗难治性神经病理性疼痛的对照研究[J].中国医师进修杂志,2014,37(7):31-33.