目的 探討潑尼松聯(lián)合普瑞巴林治療帶狀皰疹后神經(jīng)痛的臨床療效。方法 選取上海市中醫(yī)醫(yī)院2011年1月—2016年8月收治的86例帶狀皰疹后神經(jīng)痛患者，根據(jù)患者入院順序分為對(duì)照組和治療組，每組各43例。兩組患者口服普瑞巴林膠囊，起始劑量為75 mg/次，2次/d，服用2周后，疼痛緩解者繼續(xù)按照該劑量口服，未緩解者增加劑量至150 mg/次，2次/d，服用至第3周末仍未緩解者再增加劑量至300 mg/次，2次/d；治療組在對(duì)照組的基礎(chǔ)上口服醋酸潑尼松片，10 mg/次，3次/d，兩組均連續(xù)治療15 d。治療后，觀察兩組的臨床療效，比較兩組治療前后的VAS評(píng)分、止痛起效時(shí)間與疼痛消失時(shí)間和24 h持續(xù)睡眠時(shí)間及其不良反應(yīng)情況。結(jié)果 治療后，對(duì)照組的總有效率為86.05%，顯著低于治療組的97.67%，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P< 0.05）。治療1、2、4周后，兩組VAS評(píng)分均顯著降低，同組治療前后比較差異具有統(tǒng)計(jì)學(xué)意義（P< 0.05）；且治療組VAS評(píng)分顯著低于同期對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P< 0.05）；治療1、2、4周后，兩組24 h持續(xù)睡眠時(shí)間均顯著長(zhǎng)于治療前，同組治療前后比較差異具有統(tǒng)計(jì)學(xué)意義（P< 0.05）；且治療組24 h持續(xù)睡眠時(shí)間顯著長(zhǎng)于同期對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P< 0.05）；治療組止痛起效時(shí)間與疼痛消失時(shí)間均顯著短于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P< 0.05）。結(jié)論 潑尼松聯(lián)合普瑞巴林治療帶狀皰疹后神經(jīng)痛療效顯著，可有效減輕疼痛程度，改善患者的睡眠狀況，且無明顯不良反應(yīng)，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To investigate the clinical efficacy of prednisone combined with pregabalin in treatment of postherpetic neuralgia. Methods Patients (86 cases) with postherpetic neuralgia in Shanghai Traditional Chinese Medicine Hospital from January 2011 to August 2016 were randomly divided into control and treatment groups, and each group had 43 cases. Patients in the control group were po administered with Pregabalin Capsules, and the initial dose was 75 mg/time, twice daily. After treatment for two weeks, patients with pain relief were given the dose, while patients with non-pain relief were given the dose of 150 mg/time, twice daily. After treatment for three weeks, patients with pain relief were given the dose of 300 mg/time, twice daily. Patients in the treatment group were po administered with Prednisone Acetate Tablets 10 mg/time, three times daily. Patients in two groups were treated for 15 d. After treatment, the clinical efficacy was evaluated, and VAS score, time of producing analgesic effect and time of pain loss, sleep lasting time in 24 h, and adverse reactions in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 86.05%, which was significantly lower than 97.67% in the treatment group, and there were differences between two groups (P < 0.05). After treatment for 1, 2, and 4 weeks, VAS scores in two groups significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And VAS score in the treatment group was significantly lower than that in the control group in the same period, with significant difference between two groups (P < 0.05). After treatment for 1, 2, and 4 weeks, sleep lasting time in 24 h was significantly longer than that in the control group, and the difference was statistically significant in the same group (P < 0.05). And the time in the treatment group was significantly longer than that in the control group in the same period, with significant difference between two groups (P < 0.05). The time of producing analgesic effect and time of pain loss in the treatment group were significantly shorter than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Prednisone combined with pregabalin has a significant curative effect in treatment of postherpetic neuralgia, and can effectively alleviate the pain and improve the sleep with less adverse reactions, which has a certain clinical application value.