口服加巴喷丁治疗带状疱疹后神经痛的临床观察

目的探讨加巴喷丁治疗带状疱疹后神经痛(PHN)的临床效果与安全性。方法PHN患者20例,经常规药物疗效不佳,在阿米替林(每晚25 mg,睡前服用)的基础上口服加巴喷丁,剂量自300 mg/d起,根据服药后患者疼痛的缓解程度以及不良反应予以调整,每2 d增加剂量1次,直至VAS≤3,然后以此剂量维持,疗程4周。结果服药后,VAS评分均降低、24 h疼痛持续时间减少,而24 h睡眠时间延长;镇痛起效最低剂量为300 mg,1次/d,80%患者每日有效镇痛剂量在1 800~2 400mg,日最大剂量达3 600 mg。结论口服加巴喷丁治疗带状疱疹后神经痛,效果确切,见效快,治疗的稳定性和连续性较好,患者易于耐受且不良反应发生率低,有利于缓解PHN患者的疼痛、延长其睡眠时间并改善其睡眠质量。

Clinical study on post-herpetic neuralgia treated with gabapentin

Objective To observe the effects and security of gabapentin for oral use on post-herpetic neuralgia.Methods Twenty patients suffering from post-herpetic neuralgia whose curative effects were not good by routing medicine were treated with gabapentin for orall use based on amitriptyline 25 mg once an evening(before sleeping).The beginning dose of gabapentin was 300 mg every day.The dose was adjusted according to the alleviating degree of pain and side effects.The dose was increased every two days till visual analogue scale(VAS) was under 3,then was maintained for four weeks.Results After treatment,all the score of VAS and the duration of pain during 24 hours decreased significantly comparing with that before the treatment.The minimal dosage of beginning analgesia was 300 mg once a day.The dosage of effective analgesia of 80 percent of patients was from 1 800 to 2 400 mg.The maximal dosage was 3 600 mg.Conclusion The effect of gabapentin on post-herpetic neuralgia was significant,accompanying with low side effect and better sleeping.