普瑞巴林治疗脑卒中后中枢性疼痛的临床分析

摘要

目的评价普瑞巴林治疗脑卒中后中枢性疼痛的临床效果。方法选取本院2013年6月至2014年8月收治的83例脑卒中后中枢性疼痛住院患者为研究对象，并将其随机分为治疗组（42例）和对照组（41例），对照组患者仅予常规治疗，治疗组患者在常规治疗基础上加用普瑞巴林治疗。于治疗时基线、治疗2周后及治疗1个月后分别采用疼痛数字等级评分法（NRS）评价疼痛强度、17项汉密尔顿抑郁量表（HAMD-17）及汉密尔顿焦虑量表（HAMA）评定患者情绪变化，并记录不良反应发生情况。结果与治疗时基线相比，治疗组患者治疗2周后及治疗1个月后NRS评分逐步下降，且均明显低于对照组（P＜0.05和P＜0.01）。与治疗时基线相比，治疗组患者治疗2周后HAMA和HAMD-17评分比较均无显著差异（P＞0.05）；治疗1个月后两组患者HAMA和HAMD-17评分均较基线明显下降（P＜0.01和P＜0.05），且治疗组患者HAMA和HAMD-17评分均低于对照组（P＜0.05）。治疗组患者出现的不良反应少，且均为一过性。结论普瑞巴林可改善脑卒中后中枢性疼痛症状及情绪障碍，安全性良好。%ObjectiveTo evaluate the therapeutic effects of pregabalin on central post-stroke pain (CPSP) patients.Method83 patients with CPSP admitted in Shaanxi Provincial People's Hospital were randomly divided into standard treatment plus pregabalin group (n=42) and standard treatment control group (n=41). At baseline, 2 weeks after treatment and 1 month after treatment, pain intensity changes were assessed by numerical rating score (NRS); mood changes were assessed by 17-item Hamilton depression scale (HAMD-17) and the Hamilton anxiety scale (HAMA). Adverse reactions were recorded.ResultNRS scores were gradually decreased at 2 weeks after treatment and at 1 month after treatment compared with baseline. The decrease in NRS was more significant in pregabalin group than control group (P<0.05 andP<0.01, respectively). No obvious change of HAMD-17 and HAMA was found in the two groups 2 weeks after treatment. The HAMD-17 and HAMA scores at 1 month after treatment were significantly lower in pregabalin group than control group (P<0.05). Fewer transient adverse reactions were found in pregabalin group.ConclusionPregabalin is effective in relieving pain and mood disturbance in CPSP patients with sound safety.