摘要
目的:探讨血药浓度监测在普瑞巴林治疗带状疱疹后神经痛(postherpetic neuralgia,PHN)中的作用。方法:选择2018年12月至2020年12月就诊于中日友好医院疼痛科的PHN病人149例。所有病人进行疼痛量化评分后,进入第一阶段治疗。给予口服普瑞巴林150 mg,每日2次。治疗14天后,进行疼痛量化评估,记录药物不良反应,同时测定普瑞巴林的血药浓度。并根据疼痛数字评分法(numerical rating scale,NRS)评分情况将病人分为三组进行第二阶段治疗:将NRS评分≤3的病人归入常规药物组(R组,66例);NRS评分>3的病人(83例)再按照病人意愿分为两组:增强药物组(P组,37例)和射频治疗组(F组,46例)。R组病人继续原治疗方案。P组将普瑞巴林治疗量增加100%(每日2次,每次300 mg);F组在原治疗方案的基础上,行选择性神经根脉冲射频。治疗14天后,再次进行疼痛量化评估,同时测定普瑞巴林的血药浓度。结果:治疗前的NRS评分为6.81±1.12,经过第一阶段治疗后,NRS评分降至3.85±1.27(P<0.01)。其中,NRS评分>3病人的普瑞巴林血药浓度为(2252.33±1308.91)μg/L,明显低于NRS≤3病人的血药浓度(P<0.01)。第二阶段治疗后,P组病人NRS评分降至2.81±0.52,F组降至2.68±0.74。F组NRS评分3分以下的病人占入组病人的87.0%,明显高于P组(P<0.05)。P组总体的普瑞巴林血药浓度上升至(2759.55±1810.88)μg/L,明显高于治疗前(P<0.05),R组和P组普瑞巴林血药浓度高于F组病人(P<0.05)。不良反应主要为恶心、头晕和嗜睡。其中,F组的不良反应发生率最低。结论:普瑞巴林的血药浓度与PHN的治疗效果呈现一定的相关性。在血药浓度偏低的状态下,与脉冲射频联用可提高PHN的治疗效果,改善就医体验。
Objective:To explore the role of plasma drug concentration monitoring in the treatment of postherpetic neuralgia(PHN)with pregabalin.Methods:One hundred and forty-nine PHN patients treated in the pain department of China-Japan Friendship Hospital from December 2018 to December 2020 were selected.All patients entered the first stage of treatment.Pregabalin 150 mg was given orally twice a day.After treatment for 14 days,NRS score and adverse reactions were recorded,and the plasma concentration of pregabalin was measured.Then according to the NRS score,the patients were divided into three groups for the second stage of treatment:patients with NRS score≤3 were classified into routine drug group(group R,n=66);patients with NRS score>3(83 cases)were divided into two groups according to the wish of patients:enhancement drug group(group P,n=37)and radiofrequency treatment group(group F,n=46).Patients in group R continued the original treatment.The amount of pregabalin treatment in group P doubled(300 mg twice a day);group F received selective nerve root pulse radiofrequency on the basis of the original treatment scheme.After 14 days of treatment in the second stage,the pain was quantitatively evaluated again and the blood concentration of pregabalin was measured.Results:The average NRS score before treatment was 6.81±1.12.After the first stage of treatment,the NRS score decreased to 3.85±1.27(P<0.01).The plasma concentration of pregabalin in patients with NRS>3 was(2252.33±1308.91)μg/L,which was significantly lower than that in patients with NRS≤3(P<0.01).After the second stage of treatment,NRS score decreased to 2.81±0.52 in group P and 2.68±0.74 in group F.The patients with NRS≤3 in group F accounted for 87.0%of the patients in the group,which was significantly higher than that in group P(P<0.05).The plasma concentration of pregabalin in group P increased to(2759.55±1810.88)μg/L,which was significantly higher than that before treatment(P<0.05).The plasma concentration of pregabalin in group R and group P
作者
朱谦
赵晶
覃旺军
苗羽
苑思禹
康宏霞
闫龙涛
樊碧发
ZHU Qian;ZHAO Jing;QIN Wangjun;MIAO Yu;YUAN Siyu;KANG Hongxia;YAN Longtao;FAN Bifa(Peking Union Medical College,Chinese Academy of Medical Sciences,Beijing 100006,China;Department of Pain Medicine,China-Japan Friendship Hospital,Beijing 100029,China;Department of Anaesthesia,China-Japan Friendship Hospital,Beijing 100029,China;Department of Pharmaceutics,China-Japan Friendship Hospital,Beijing 100029,China;Department of Pharmaceutics,Siping Central Hospital,Jilin 136099,China;Department of Pain Medicine,The People's Hospital of Gansu Provincel,Lanzhou 730000,China)
出处
《中国疼痛医学杂志》
CAS
CSCD
北大核心
2022年第5期340-346,共7页
Chinese Journal of Pain Medicine
基金
国家临床重点专科建设项目资助(2014-zdzk-002)。
关键词
带状疱疹后神经痛
普瑞巴林
血药浓度
脉冲射频
postherpetic neuralgia
pregabalin
blood drug concentration
pulsed-radiofrequency
