普瑞巴林治疗难治性神经病理性疼痛的疗效与耐受性评估

目的评估普瑞巴林治疗难治性神经病理性疼痛的疗效与耐受性。方法采用队列研究,对连续收治的44例难治性神经病理性疼痛患者,予以普瑞巴林可变剂量150～300mg/d(基于药物的反应性和耐受性)治疗4周。采用数字等级评分(NRS)评价基线、第2周、第4周时疼痛强度以及疼痛对睡眠的干扰,应用汉密尔顿抑郁量表(17项)、汉密尔顿焦虑量表和患者总体印象改变(PGIC)进行情绪及总体疗效评定,同时观察普瑞巴林的不良反应。结果 43例患者完成研究,平均普瑞巴林剂量(272.1±59.1)mg。经治疗,疼痛评分由6.3±1.0下降至2周时的4.4±1.4和4周时的3.1±1.6(-50.9%,P<0.01);睡眠干扰评分、汉密尔顿抑郁评分和焦虑评分均明显改善(P<0.01)。24例(55.9%)患者的PGIC为"极为好转"或"明显好转"。不良反应少,仅1例(2.3%)患者因头晕而退出研究。结论普瑞巴林(150～300mg/d)能有效改善难治性神经病理性疼痛以及相关的睡眠及情绪障碍,且耐受性良好。

Efficacy and tolerability of pregabalin on refractory neuropathic pain

Objective To evaluate the efficacy and tolerability of pregabalin in patients with refractory neuropathic pain(NeP).Methods Consecutive patients with refractory neuropathic pain were collected and treated by Pregabalin for 4 weeks at the daily dosage from 150 to 300 mg according to patients′ responses and tolerability.Pain intensity and their sleep interference were evaluated by numerical rating scales at the baseline and 2 and 4 weeks after therapy.The scores of 17-item Hamilton depression rating scale(HAMD-17),Hamilton anxiety rating scale(HAMA)and patient global impression of change(PGIC)were also compared between at baseline and 4 weeks respectively.Results Forty-three patients completed therapy at 4 weeks.The mean dosage of pregabalin was(272.1±59.1)mg.The mean pain score decreased from 6.3±1.07 at baseline to 4.4±1.4 at 2 weeks and 3.1±1.6 at 4 weeks(-50.9%,P<0.01).Also,the mean sleep interference score,the HAMD score and the HAMA score were decreased significantly.24 patients(55.9%)reported"very much improved"or"much improved"in PGIC.Pregabalin was generally well tolerated with few reported severe side effects and only one patient(2.3%)discontinued because of dizziness.Conclusions 150-300 mg/d pregabalin was effective in relieving pain,sleep interference and mood disturbance as well as well-tolerated in patients with refractory neuropathic pain.