加巴喷丁治疗带状疱疹后神经痛(附26例临床观察)

目的探讨加巴喷丁治疗带状疱疹后神经痛(Post herpetic neuralgia,PHN)的疗效及副作用。方法26例PHN患者,病程3个月~6年。均已接受多种治疗方法,但效果不佳,VAS评分4~8分。开始口服剂量加巴喷丁100 mg/次、3次/d。每间隔2~4 d增加剂量300 mg/d,直至疼痛缓解或出现难以耐受的副作用,最高用量为3 600 mg/d。以疼痛明显缓解或疼痛缓解的剂量维持用药。以维持用药或最高用量时VAS评分与用药前VAS评分比较,判定治疗效果。显效:VAS评分下降≥3分,病人生活质量明显改善;有效:VAS评分下降<3且≥1;无效:VAS评分无下降或<1分。结果显效17例(65.4%),有效8例(30.8%),无效1例(3.8%)。治疗有效率95.2%。治疗期间的副作用主要有乏力4例(15.4%)、头晕3例(11.5%)、嗜睡2例(7.7%)、恶心1例(3.8%)。结论加巴喷丁用于治疗带状疱疹后神经痛确实有效,耐受性好,不良反应轻。

Post Herpetic Neuralgia Treated with Gabapentin

Objective To discuss the curative and side effect of gabapentin in treatment of post herpetic neuralgia(PHN).Methods 26 cases of PHN with course of 3 months to 6 years after varied treatments and less effects whose VAS was 4-8 were treated with gabapentin 100mg t.i.d.and added dosage 300 mg/d every 2-4 day until the pain was eased or un-toleranced side effect appeared with highest dosage of 3 600 mg/d.Then the dosage was maintained thus the VAS score was compared with that pre-therapy.The excellent was decreasing more than 3 scores,good was decreasing 1-3 score and invalid was less than 1.Results There were 17 cases excellent,8 cases good and 1 case invalid.The main side effect were fatigue(15.4%),dizziness(11.5%) drowsiness(7.7%) and nausea(3.8%).Conclusion The treatment of PHN with gabapentin might be effective with good tolerance and less side effect.