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目的观察加巴喷丁、曲马多对神经病理性疼痛(NP)不同性质疼痛的缓解情况比较。方法 38例门诊神经病理性疼痛患者,根据用药情况分为加巴喷丁+曲马多组(A组)、加巴喷丁组(B组)、曲马多组(C组)和对照组(D组)。在药物治疗前及治疗后14 d,用神经病理性疼痛量表评价疼痛10个不同方面的改善情况。治疗效果用治疗前后的评分差值表示。结果治疗后,患者的疼痛强度、锐痛、钝痛、深部痛和不适感均有显著改善,差异有统计学意义(P<0.05)。A组的疼痛强度和钝痛显著优于B,C,D组(P<0.05);A组的锐痛和深部痛显著优于B,D组(P<0.05)。A,B,C组不舒适感显著优于D组(P<0.05),A,B,C组间差异无统计学意义(P>0.05)。药物治疗可不同程度降低疼痛持续存在的时间。结论加巴喷丁联合曲马多在降低疼痛强度和钝痛方面有协同效应;曲马多比加巴喷丁更有利于缓解锐痛和深部疼痛;单独使用加巴喷丁或曲马多均可缓解疼痛带来的不适感。
Objective To compare the relief of gabapentin and tramadol on the pain of different neuropathic pain (NP). Methods Thirty - eight outpatients with neuropathic pain were divided into gabapentin + tramadol group (A group), gabapentin group (B group), tramadol group (C group) and control group (group D) according to the medication situation. Neuropathological pain scale was used to evaluate the improvement of 10 different aspects of pain before and after 14 days of treatment. The therapeutic effect is expressed as the difference between before and after treatment. Results After treatment, the patients’ pain intensity, sharp pain, dull pain, deep pain and discomfort were significantly improved, with statistical significance (P <0.05). The pain intensity and dull pain in group A were significantly better than those in group B, C and D (P <0.05). The acute pain and deep pain in group A were significantly better than those in group B and D (P <0.05). The discomfort in group A, B and C was significantly better than that in group D (P <0.05), but there was no significant difference between group A, B and C (P> 0.05). Medication can reduce pain persist to varying degrees. Conclusions Gabapentin combined with tramadol has a synergistic effect in reducing pain intensity and dull pain; tramadol and gabapentin are more beneficial to relieve acute pain and deep pain; and gabapentin or tramadol alone can relieve the discomfort caused by pain.