本文選題：神經(jīng)病理性疼痛 + 帶狀皰疹后神經(jīng)痛��； 參考：《蘇州大學(xué)》2014年碩士論文

【摘要】：目的：通過對(duì)神經(jīng)病理性疼痛患者的臨床特點(diǎn)及治療轉(zhuǎn)歸進(jìn)行分析，以加深對(duì)神經(jīng)病理性疼痛認(rèn)識(shí)，并為進(jìn)一步指導(dǎo)臨床治療提供幫助。 方法：本研究共收集神經(jīng)內(nèi)科門診確診的196例神經(jīng)病理性疼痛患者的臨床資料，詳細(xì)記錄患者一般情況（性別、年齡、文化程度、職業(yè)狀況等）、疼痛的類型、病程、臨床表現(xiàn)，用視覺模擬量表評(píng)估疼痛強(qiáng)度、睡眠及情緒障礙程度，記錄藥物治療情況及治療轉(zhuǎn)歸。對(duì)單用普瑞巴林或加巴噴丁治療的帶狀皰疹后神經(jīng)痛患者，采用視覺模擬量表評(píng)估兩組患者治療前及治療后第1周、第2周、第4周和第8周的疼痛強(qiáng)度及睡眠和情緒障礙程度，比較其療效，并記錄不良反應(yīng)發(fā)生率。 結(jié)果：196例神經(jīng)病理性疼痛患者中，周圍性神經(jīng)病理性疼痛172例（87.8%）明顯多于中樞性神經(jīng)病理性疼痛19例（9.7%)，且治愈率（33.1%）明顯高于后者（0.0%）（χ2=8.975，p=0.001)。中老年人更易發(fā)生神經(jīng)病理性疼痛，50歲以上患者所占比例78.6%。病程從7天到10年不等，86.2%患者病程超過30天；88.3%患者表現(xiàn)為中至重度疼痛，66.3%患者合并不同程度睡眠或情緒障礙。經(jīng)治療，所有患者疼痛視覺模擬量表（VAS）評(píng)分（2.17+1.64）較治療前基線期（6.63+1.41）顯著降低（p=0.000）；與治療前相比，睡眠及情緒障礙評(píng)分均顯著改善（p0.05）。196例患者中33例（16.8%）完全治愈；23例（11.8%）顯著有效；101例（51.5%）有效；39例（19.9%）患者無效；臨床總有效率為80.1%；僅22例（11.2%）患者出現(xiàn)短時(shí)頭暈、乏力、外周水腫等不良反應(yīng)。單獨(dú)使用普瑞巴林或加巴噴丁的帶狀皰疹后神經(jīng)痛者，治療后兩組患者疼痛VAS評(píng)分、情緒及睡眠狀態(tài)VAS評(píng)分均較治療前有明顯改善，且普瑞巴林治療組各時(shí)間點(diǎn)的觀察指標(biāo)均優(yōu)于加巴噴丁組（p0.05）；兩組不良反應(yīng)發(fā)生率差別無統(tǒng)計(jì)學(xué)意義（χ2=1.412,p=0.235）。 結(jié)論：神經(jīng)病理性疼痛病因復(fù)雜多樣，周圍性神經(jīng)病理性疼痛占多數(shù)。中老年人群患病率較高，疼痛劇烈且持續(xù)時(shí)間長(zhǎng)，常合并情緒及睡眠障礙，，嚴(yán)重影響患者生活質(zhì)量，臨床治愈率低。普瑞巴林和加巴噴丁治療帶狀皰疹后神經(jīng)痛均可獲得比較滿意的療效，普瑞巴林療效更優(yōu)。
[Abstract]:Objective: to analyze the clinical characteristics and therapeutic outcome of neuropathic pain patients in order to deepen the understanding of neuropathic pain and provide help for clinical treatment. Methods: the clinical data of 196 patients with neuropathic pain were collected and recorded in detail (sex, age, education, occupational status, type of pain, course of disease, clinical manifestation). Visual analogue scale was used to evaluate the intensity of pain, sleep and mood disorder, and to record the drug treatment and outcome. In patients with postherpetic neuralgia treated with PreBahrain or gabapentin alone, visual analogue scale was used to evaluate the first and second week before and after treatment in both groups. Pain intensity and degree of sleep and mood disorders were compared between week 4 and week 8, and the incidence of adverse reactions was recorded. Results among 196 patients with neuropathic pain, 172 patients with peripheral neuropathic pain were significantly higher than those with central neuropathic pain in 19 patients with neuropathic pain, and the cure rate was significantly higher than that in the latter group. Neuropathic pain was more common in middle aged and elderly patients than in patients over 50 years old. The course of disease ranged from 7 days to 10 years. 86.2% of the patients showed moderate to severe pain and 66.3% of them had different degrees of sleep or mood disorder. After treatment, the VAS score of all patients was 2.17 1.64) significantly lower than that of baseline period 6.63 1.41). The scores of sleep and mood disorders were significantly improved in 33 patients (16.8g / 196) and completely cured (11.8%). 101 cases (51.5%) were effective. 39 cases (19.9%) were ineffective. The total clinical effective rate was 80.1%; only 22 cases had short-term dizziness and fatigue. Peripheral edema and other adverse reactions. The pain VAS scores, mood and sleep state VAS scores of patients treated with PreBahrain or gabapentin alone were significantly improved compared with those before treatment. The observation index of each time point in PreBahrain treatment group was better than that in gabapentin group (P 0.05), and there was no significant difference in the incidence of adverse reactions between the two groups (蠂 ~ 2 ~ 2 ~ (1.412) P ~ + 0.235). Conclusion: the etiology of neuropathic pain is complex and varied, and peripheral neuropathic pain is the majority. The prevalence rate of middle and old people is high, the pain is severe and lasting for a long time, often accompanied by emotional and sleep disorders, which seriously affects the quality of life of patients, and the clinical cure rate is low. PreBahrain and gabapentin are more satisfactory in the treatment of post herpes zoster neuralgia, and PreBahrain is better in the treatment of post herpes zoster neuralgia.
【學(xué)位授予單位】：蘇州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R741

【參考文獻(xiàn)】

相關(guān)期刊論文 前2條

1 李小梅;董艷娟;李慧莉;王蘇;劉端祺;;癌性神經(jīng)病理性疼痛的阿片藥物治療[J];中國(guó)疼痛醫(yī)學(xué)雜志;2011年08期

2 朱小勇;陳百松;;硫酸嗎啡控釋片聯(lián)合加巴噴丁治療癌性神經(jīng)痛的臨床觀察[J];中國(guó)疼痛醫(yī)學(xué)雜志;2011年08期

本文編號(hào)：1961495