神经妥乐平治疗糖尿病神经病变的研究

目的：评价神经妥乐平治疗2型糖尿病周围神经病变的疗效。方法：74例糖尿病神经病变患者随机进入神经妥乐平组（38例）和胰激肽原酶组（36例）。神经妥乐平组每天1次静脉点滴神经妥乐平针，每次2支（3．6u／支），14天后口服神经妥乐平片，每次2片，每天2次，共14天。胰激肽原酶组每天1次肌肉注射胰激肽原酶针，每次2支（10u／支），14天后口服胰激肽厚酶肠溶片，每次2片，每日三次，共14天。结果：治疗后，两组的感觉VAS评分皆有明显降低。疼痛改善神经妥乐平组显效率及总有效率明显高于胰激肽原酶组。神经妥乐平组麻木感改善显效率明显高于胰激肽原酶组。结论：神经妥乐平对2型糖尿病神经损害的自发性疼痛，感觉障碍有较好疗效。     

神经妥乐平治疗神经病理性疼痛41例临床观察

本文观察神经妥乐平治疗神经病理性疼痛的疗效以及安全性。临床治疗41例神经病理性疼痛患者，静脉滴注神经妥乐平7．2NU／天，疗程14天。观察治疗疼痛效果及不良反应。现报告如下：     

牛痘疫苗接种家兔炎症皮肤提取物治疗三叉神经痛射频热凝术后残余神经症状的疗效观察

目的:观察牛痘疫苗接种家兔炎症皮肤提取物(神经妥乐平)对原发性三叉神经痛射频温控热凝术后面部残余神经症状的疗效.方法:应用随机单盲对照的方法,选择原发性三叉神经痛射频温控热凝术后面部仍残留有神经症状,视觉模拟评分(VAS)在3分以上的患者30例,分成神经妥乐平组和安慰剂组各15例.神经妥乐平组给予神经妥乐平18AGC单位+生理盐水250 ml静脉滴注,连续7 d;安慰剂组给予生理盐水250 ml静脉滴注,连续7 d.观察两组患者用药后面部疼痛和麻木感改变情况.结果:术后1、3d神经妥乐平组疼痛评分和术后7、14 d神经妥乐平组麻木感评分改善率与对照组比较差异均有显著性,神经妥乐平组患者用药后未出现不良反应.结论:神经妥乐平静脉注射可有效治疗原发性三叉神经痛射频温控热凝术后面部残留的疼痛感和麻木感.     

牛痘疫苗接种家兔炎症皮肤提取物治疗腰椎管狭窄症术后残余神经症状的临床研究

目的:观察牛痘疫苗接种家兔炎症皮肤提取物(神经妥乐平)治疗腰椎管狭窄症术后残余神经症状的疗效.方法:随机将腰椎管狭窄症术后仍有残留神经症状的VAS评分在4分以上的患者40例,分为神经妥乐平组和安慰剂组各20例,神经妥乐平组给予10.8NU神经妥乐平+0.9%NS,250ml静脉点滴,连续14天;安慰剂组给予250ml NS静脉点滴连续14天.观察两组患者治疗后疼痛,麻木或冷感变化情况.结果:治疗7天,14天两组间疼痛及麻木等伴随症状VAS评分均有改善,神经妥乐平组VAS评分改善较安慰剂组有显著性差异(P＜0.05).术后14天两组间疼痛及麻木等伴随症状的改善率有显著性差异(P＜0.05).用药后患者无不良反应.结论:神经妥乐平对腰椎管狭窄症术后残留的疼痛、麻木、冷感等感觉异常的神经症状有较好的治疗作用,且使用安全.     

神经妥乐平治疗截肢后幻肢痛的临床观察

目的：评价神经妥乐平对截肢后幻肢痛的疗效及安全性.方法：对17例截肢后幻肢痛患者使用神经妥乐平,采用疼痛视觉模拟评分法（VAS法）来评定疗效并进行统计学分析.结果：治疗后患者疼痛强度有显著性降低（P＜0.01）,无严重的不良反应.结论：神经妥乐平可安全有效治疗截肢后幻肢痛.     

普瑞巴林联合神经妥乐平治疗脊髓损伤患者神经病理性疼痛的疗效观察

目的:探讨神经妥乐平对于脊髓损伤后神经病理性疼痛的临床疗效,同时比较单独使用神经妥乐平与联合使用普瑞巴林和神经妥乐平对神经病理性疼痛的缓解程度、对患者情绪以及睡眠状况的改善情况。方法:选取符合入组标准的脊髓损伤伴神经病理性疼痛患者62例,电脑随机分2组,分别为神经妥乐平组、普瑞巴林联合神经妥乐平组,神经妥乐平组起始剂量为4U bid,普瑞巴林联合神经妥乐平组起始剂量为普瑞巴林75mg bid+神经妥乐平4U bid,间隔3d调整药物剂量,疗程为4周。采用视觉模拟评分量表(visual analogue scale,VAS)、医院焦虑抑郁量表(hospital anxiety and depression scale,HAD)、匹茨堡睡眠质量指数量表(Pittsburgh sleep quality index,PSQI)对患者进行疼痛、情绪和睡眠质量的评估。由专业的康复治疗师对患者服药前和疗程结束后的疗效分别进行评估。结果:单独使用神经妥乐平可以缓解脊髓损伤患者神经病理性疼痛,同时改善患者睡眠质量,治疗前后比较差异有显著性意义(P0.05);而联合使用普瑞巴林和神经妥乐平治疗后,患者的VAS和HAD评分均较神经妥乐平组明显降低,差异有显著性意义(P0.05)。结论:神经妥乐平可以缓解脊髓损伤患者的疼痛症状,联合使用普瑞巴林和神经妥乐平不仅明显缓解脊髓损伤神经病理性疼痛患者的疼痛症状,同时显著改善了患者的焦虑抑郁情绪,提高患者睡眠质量,进而提升患者生存质量,是一种有效的临床治疗方法。     

神经妥乐平对血液透析患者慢性疼痛的治疗作用

对20例维持性血液透析伴有慢性疼痛(疼痛时间超过6个月)的患者应用神经妥乐平治疗慢性疼痛，口服2片／次，2次／d，6周为1个疗程。接受神经妥乐平治疗后疼痛积分在治疗2周后即有明显降低，随疗程的延长，至治疗6周时疼痛积分继续下降。接受2周和4周药物治疗后的临床显效率为25％和40％，完成6周药物治疗后患者的临床总有效率为80％。神经妥乐平对缓解血液透析患者慢性疼痛有较好的疗效。     

神经妥乐平联合灯盏花素治疗周围神经病变105例分析

目的：观察神经妥乐平与灯盏花素合用治疗周围神经病变的临床疗效。方法：静脉点滴神经妥乐平7.2 U,灯盏花素10 ml,1次/d,用2周;后口服神经妥乐平片,2片/次,2次/d,再用2周,比较用药前后患者神经系统症状与神经传导速度的变化。结果：治疗后患者视觉模拟评分下降,周围神经传导速度改善。治疗前后比较有显著性差异。结论：神经妥乐平与灯盏花素合用治疗周围神经病变疗效满意。     

牛痘疫苗接种家兔炎症皮肤提取物不同穴位注射对神经病理性疼痛大鼠的疗效比较

目的:比较不同穴位注射牛痘疫苗接种家兔炎症皮肤提取物(神经妥乐平)治疗大鼠神经病理性疼痛的疗效。方法:构建L5脊神经结扎(spinal nerve ligation,SNL)模型大鼠,将成功模型随机分为5组(n=10),分别为SNL组、神经妥乐平+L5"夹脊"穴组、神经妥乐平+L5"环跳"穴组、神经妥乐平+L5"委中"穴组及神经妥乐平+L5"足三里"穴组,于穴位注射0 d、1 d、3 d、5 d、7 d、10 d、14 d测定大鼠双足50%机械缩足反应阈值。结果:神经妥乐平注射四个不同的穴位均有较好的镇痛作用,四个穴位镇痛强度之间无显著差异。结论:在本实验条件下,"委中"、"环跳"、"足三里"、L5"夹脊"穴注射神经妥乐平治疗神经病理性疼痛均有较好的镇痛疗效。     

利多卡因复合神经妥乐平神经阻滞治疗糖尿病合并肩周炎临床疗效观察

目的探讨利多卡因复合神经妥乐平进行神经阻滞治疗糖尿病合并肩周炎的临床效果。方法选择糖尿病合并肩周炎患者60例,随机分为两组,治疗组应用利多卡因复合神经妥乐平,对照组应用利多卡因,分别于患肩行神经阻滞。结果与治疗前相比,两组患者VAS评分和肩关节功能评分均有所改善(P0.05);治疗组较对照组的指标改善更明显,差异有统计学意义(P0.05)。结论应用利多卡因复合神经妥乐平进行神经阻滞治疗糖尿病合并肩周炎,可改善患肩的疼痛症状及功能障碍。     

神经妥乐平治疗带状疱疹后遗神经痛的临床研究

目的:研究神经妥乐平治疗带状疱疹后遗神经疼痛的疗效、方法和安全性.方法:将患者随机分为对照组和神经妥乐平不同剂量组(3.8u/日,10.8u/日),疗程14天.结果:神经妥乐平使带状疱疹后遗神经痛明显改善,并具有快速起效、长时间止痛作用.尤其神经妥乐平10.8u/日组,疗效显著.结论:神经妥乐平是治疗带状疱疹后遗神经痛有效和安全药物.     

Sustained-release oxycodone dosing survey of chronic pain patients

OBJECTIVE: To determine the dosing of sustained-release oxycodone that is typically prescribed to achieve pain relief in a mixed group of chronic pain patients. METHODS: One hundred twenty-eight chronic pain patients prescribed stable doses of sustained-release oxycodone for at least 6 months were identified through chart review. Total daily dosing for both long- and short-acting opioids were recorded for each patient. RESULTS: The prescribed frequency of dosing sustained-release oxycodone determined through clinical practice was twice daily for 33% of patients, with 67% requiring greater than twice daily dosing. Ninety-three percent of those using greater than twice daily dosing were prescribed sustained-release oxycodone 3 times daily. The median dose of sustained-release oxycodone was 80 mg for patients prescribed twice daily dosing, 60 mg when prescribed 3 times daily, and 120 mg when 4 times daily. Regularly scheduled, daily supplemental short-acting opioids were used by 47% of patients prescribed twice daily sustained-release oxycodone and 21% prescribed greater than twice daily dosing. The median total oxycodone-equivalent daily dosage (short- + long-acting opioids) was 80 mg for patients treated with either twice daily or greater than twice daily dosing. CONCLUSION: In a mixed group of chronic pain patients referred to a university pain management clinic, sustained-release oxycodone was prescribed more often than twice daily (usually every 8 hours) in 67% of patients. Patients maintained on every-12-hour dosing were twice as likely to use regularly scheduled, daily, short-acting opioids to achieve pain relief.     

神经妥乐平和卡马西平对带状疱疹后神经痛的疗效比较

目的：观察神经妥乐平和卡马西平对带状疱疹后神经痛(PHN)的疗效。方法：将30例PHN患者随机分为神经妥乐平组和卡马西平组，治疗前后观察疼痛和麻木的改善情况。结果：神经妥乐平组对疼痛和麻木的改善情况良好，对疼痛的总有效率和麻木的总有效率明显优于卡马西平组。结论：神经妥乐平治疗PHN安全有效，优于卡马西平。     

肌内注射维生素K3导致局部疼痛的原因分析及处理对策

[目的]探讨肌内注射维生素K3导致局部疼痛的原因,并提出相应的处理对策。[方法]将60例注射维生素K3导致局部疼痛的患儿分为观察组和对照组,每组30例,观察组常规注射法出现疼痛后采用50%硫酸镁湿热敷及红外线烤灯照射,连续3 d,每天2次;对照组常规注射法出现疼痛后采用观察局部情况,下次注射时更换部位,比较两组患儿疼痛减轻的疗效。[结果]观察组患儿疼痛减轻率为96.7%,对照组为20.0%,差异有统计学意义(P<0.01)。[结论]采取50%硫酸镁湿热敷及红外线烤灯照射减少注射维生素K3导致局部疼痛的效果优于常规法。     

Effect on pain intensity of injection sites and speed of injection associated with intramuscular penicillin

The aim of this one‐group, quasi‐experimental study was to examine the effect of choice of injection site and injection duration on the intensity of pain associated with intramuscular penicillin injection. Injections containing the same dose of drug were administered 12 hours apart for each patient over 5 s/mL and 10 s/mL durations in the dorsogluteal and ventrogluteal sites. Sixty patients who had a medical order for intramuscular penicillin at least twice in a day and for two successive days at the same dose were included in the study. No difference in pain was perceived by participants between the two injection durations at either the dorsogluteal or the ventrogluteal site. This study showed that intramuscular penicillin can be administered to either site over 5 s/mL or 10 s/mL durations. There is a need for further research with a randomized controlled design in different settings and in a larger sample on the impact of choice of injection site and injection duration on pain intensity.     

Flecainide for the treatment of chronic neuropathic pain: a Phase II trial

BACKGROUND: Management of neuropathic pain is challenging. Medications that interfere with sodium channel transport, such as lidocaine, mexilitene and flecainide, are promising as analgesics. OBJECTIVE: In a general population of patients with a working diagnosis of neuropathic pain, whether if flecainide produces enough of an improvement in pain to warrant further clinical study is determined. DESIGN: Phase I/II prospective exploratory clinical trial. Eligible patients were observed for week 1, then 50 mg flecainide was administered twice daily for week 2 and then administered 100 mg twice daily for week 3. SETTING/ SUBJECTS: Multi-institutional members of the Eastern Co-operative Oncology Group. Patients had neuropathic pain diagnosed by their oncologists as defined by the International Association for the Study of Pain and a diagnosis of cancer or AIDS. MEASUREMENTS: The Wisconsin Brief Pain Inventory was used. The primary endpoint was a decrease of 3 points (0-10 numerical scale) or a decrease of 50% in the worst pain rating at either day 15 or day 22 relative to the average of days 1 and 8 ratings. RESULTS: Nineteen patients were registered for the study. Four patients were ineligible. Of the remaining 15, one was unevaluable due to incomplete pain rating. Four out of 14 patients had an average drop of 5 points or 53% in their worst pain ratings on a 0-10 numerical scale of pain. No patients withdrew from study because of toxicity. There were no life-threatening or lethal toxicities. All patients were alive at the time of the analysis. CONCLUSIONS: Flecainide produced a 30% response rate. Response in this study was defined to be highly relevant and clinically significant reduction in pain. The drug merits study in a randomized placebo-controlled trial.     

椎旁阻滞联合牛痘疫苗接种家兔炎症皮肤提取物治疗带状疱疹神经痛的疗效观察

目的:观察单纯药物治疗及联合椎旁神经阻滞治疗胸腰背部带状疱疹神经痛的疗效。方法:选择2009年3月至2010年5月我院门诊及住院的60例经确诊患带状疱疹皮损已痊愈而后持续、剧烈、顽固性疼痛、痛觉过敏、麻木、感觉异常且自然病程1~22月,病变累及范围限于T1~L5节段神经支配区的患者,将其随机分为椎旁阻滞与牛痘疫苗接种家兔炎症皮肤提取物(神经妥乐平,NTP)联合用药组(阻滞组)及单纯NTP组(单药组),每组30例。分别给予静脉NTP制剂7.2 NU,每日静滴,连续应用15天。阻滞组在此基础上据疱疹累及的脊神经节段分别给予腰椎旁、胸椎旁神经阻滞治疗,观察患者阻滞及用药后1 d、7 d、15 d、30 d麻木、痛觉过敏、睡眠障碍的改善情况。结果:阻滞组镇痛有效率90.0%,与单药组镇痛有效率63.3%比较差异显著(P<0.01),治疗后1、7、15、30天VAS评分,QS评分较治疗前均有改善(P<0.05),睡眠障碍明显改善(P<0.05)。两组间比较,VAS评分、QS评分、痛觉过敏等症状,阻滞组显著降低(P<0.05)。结论:椎旁神经阻滞联合牛痘疫苗接种家兔炎症皮肤提取物治疗带状疱疹神经痛疗效明显优于单纯神经修复药组,且效果持续,副作用小。     

肌内注射维生素K3导致局部疼痛的原因分析及处理对策

[目的]探讨肌内注射维生素K3导致局部疼痛的原因,并提出相应的处理对策。[方法]将60例注射维生素K3导致局部疼痛的患儿分为观察组和对照组,每组30例,观察组常规注射法出现疼痛后采用50%硫酸镁湿热敷及红外线烤灯照射,连续3 d,每天2次;对照组常规注射法出现疼痛后采用观察局部情况,下次注射时更换部位,比较两组患儿疼痛减轻的疗效。[结果]观察组患儿疼痛减轻率为96.7%,对照组为20.0%,差异有统计学意义(P<0.01)。[结论]采取50%硫酸镁湿热敷及红外线烤灯照射减少注射维生素K3导致局部疼痛的效果优于常规法。     

Treatment of Chronic Pain with Zonisamide

? Abstract: Mechanistic similarities underlying neuropathic pain and epilepsy suggest that anticonvulsants can be used for treating neuropathic pain. This open‐label prospective study assesses the use of zonisamide in patients with chronic neuropathic pain. Fifty‐five patients were initiated on zonisamide, given 100 mg every fourth night and titrated to a stable maintenance dosage (mean=285 mg/d, range=100 to 700 mg/d). Patients rated their pain on a 0 to 10 scale in pain diaries. After ≥3 months on a stable maintenance zonisamide dosage, pain ratings were compared with baseline. Adverse events (AEs) were monitored. Forty‐two patients had efficacy data available. Fifteen patients (35.7%) had a >50% improvement in daily pain scores; 10 patients (23.8%) had a 25% to 50% improvement. Zonisamide was well tolerated; only 5 patients discontinued for AEs (drowsiness, nausea, and itching). These results suggest that zonisamide may be useful for treating neuropathic pain. Further investigation in double‐blind, placebo‐controlled trials is warranted. ?