泼尼松联合普瑞巴林治疗带状疱疹后神经痛的疗效观察

目的探讨泼尼松联合普瑞巴林治疗带状疱疹后神经痛的临床疗效。方法选取上海市中医医院2011年1月—2016年8月收治的86例带状疱疹后神经痛患者,根据患者入院顺序分为对照组和治疗组,每组各43例。两组患者口服普瑞巴林胶囊,起始剂量为75 mg/次,2次/d,服用2周后,疼痛缓解者继续按照该剂量口服,未缓解者增加剂量至150 mg/次,2次/d,服用至第3周末仍未缓解者再增加剂量至300 mg/次,2次/d;治疗组在对照组的基础上口服醋酸泼尼松片,10 mg/次,3次/d,两组均连续治疗15 d。治疗后,观察两组的临床疗效,比较两组治疗前后的VAS评分、止痛起效时间与疼痛消失时间和24 h持续睡眠时间及其不良反应情况。结果治疗后,对照组的总有效率为86.05%,显著低于治疗组的97.67%,两组比较差异具有统计学意义(P0.05)。治疗1、2、4周后,两组VAS评分均显著降低,同组治疗前后比较差异具有统计学意义(P0.05);且治疗组VAS评分显著低于同期对照组,两组比较差异具有统计学意义(P0.05);治疗1、2、4周后,两组24 h持续睡眠时间均显著长于治疗前,同组治疗前后比较差异具有统计学意义(P0.05);且治疗组24 h持续睡眠时间显著长于同期对照组,两组比较差异具有统计学意义(P0.05);治疗组止痛起效时间与疼痛消失时间均显著短于对照组,两组比较差异具有统计学意义(P0.05)。结论泼尼松联合普瑞巴林治疗带状疱疹后神经痛疗效显著,可有效减轻疼痛程度,改善患者的睡眠状况,且无明显不良反应,具有一定的临床推广应用价值。

Clinical observation of prednisone combined with pregabalin in treatment of postherpetic neuralgia

Objective To investigate the clinical efficacy of prednisone combined with pregabalin in treatment of postherpetic neuralgia. Methods Patients (86 cases) with postherpetic neuralgia in Shanghai Traditional Chinese Medicine Hospital from January 2011 to August 2016 were randomly divided into control and treatment groups, and each group had 43 cases. Patients in the control group were po administered with Pregabalin Capsules, and the initial dose was 75 mg/time, twice daily. After treatment for two weeks, patients with pain relief were given the dose, while patients with non-pain relief were given the dose of 150 mg/time, twice daily. After treatment for three weeks, patients with pain relief were given the dose of 300 mg/time, twice daily. Patients in the treatment group were po administered with Prednisone Acetate Tablets 10 mg/time, three times daily. Patients in two groups were treated for 15 d. After treatment, the clinical efficacy was evaluated, and VAS score, time of producing analgesic effect and time of pain loss, sleep lasting time in 24 h, and adverse reactions in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 86.05%, which was significantly lower than 97.67% in the treatment group, and there were differences between two groups (P < 0.05). After treatment for 1, 2, and 4 weeks, VAS scores in two groups significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And VAS score in the treatment group was significantly lower than that in the control group in the same period, with significant difference between two groups (P < 0.05). After treatment for 1, 2, and 4 weeks, sleep lasting time in 24 h was significantly longer than that in the control group, and the difference was statistically significant in the same group (P < 0.05). And the time in the treatment group was significantly longer than that in the control group in the same period, with significant difference between two groups (P < 0.05). The time of producing analgesic effect and time of pain loss in the treatment group were significantly shorter than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Prednisone combined with pregabalin has a significant curative effect in treatment of postherpetic neuralgia, and can effectively alleviate the pain and improve the sleep with less adverse reactions, which has a certain clinical application value.