目的 探討元胡止痛片聯(lián)合普瑞巴林治療帶狀皰疹后遺神經(jīng)痛的臨床效果。方法 選取2019年1月—2020年12月河南科技大學(xué)第一附屬醫(yī)院收治的100例帶狀皰疹后遺神經(jīng)痛患者，以隨機數(shù)字表法將其隨機分成對照組（n=50）和治療組（n=50）。對照組患者口服普瑞巴林膠囊，起始劑量為75 mg/次，1次/d，1周內(nèi)根據(jù)療效和耐受性，將用藥劑量增至150 mg/次，2次/d。治療組在對照組基礎(chǔ)上口服元胡止痛片，1.5 g/次，3次/d。兩組均連續(xù)治療4周。觀察兩組臨床療效、止痛起效時間及疼痛緩解時間，并比較治療前及治療1、2、3、4周兩組疼痛視覺模擬量表（VAS）評分，同時比較治療前后兩組患者阿森斯失眠量表（AIS）評分及血清降鈣素基因相關(guān)肽（CGRP）、P物質(zhì)（SP）、腫瘤壞死因子（TNF）-α、白細胞介素（IL）-1β、IL-6水平。結(jié)果 治療后，治療組總有效率為96.0%，顯著高于對照組的84.0%（P<0.05）。兩組疼痛VAS評分均隨治療時間的延長而逐漸下降（P<0.05），且治療組治療1、2、3、4周疼痛VAS評分均較同期對照組顯著更低（P<0.05）。治療后，治療組止痛起效時間和疼痛緩解時間均顯著短于對照組（P<0.05）。兩組治療后AIS評分均較本組治療前顯著降低（P<0.05），且治療組AIS評分比對照組降低作用更顯著（P<0.05）。治療后，兩組血清CGRP、SP、TNF-α、IL-1β及IL-6水平均顯著下降（P<0.05）；且治療后，治療組血清學(xué)指標的降低作用均較對照組更顯著（P<0.05）。結(jié)論 元胡止痛片聯(lián)合普瑞巴林治療帶狀皰疹后遺神經(jīng)痛的整體療效滿意，能快速且安全有效地減輕患者疼痛，改善其睡眠質(zhì)量，并可顯著下調(diào)血中相關(guān)疼痛介質(zhì)的表達水平、抑制體內(nèi)炎癥反應(yīng)。

Objective To investigate the clinical effect of Yuanhu Zhitong Tablets combined with pregabalin in treatment of postherpetic neuralgia. Methods A total of 100 patients with postherpetic neuralgia admitted to the First Affiliated Hospital of Henan University of Science and Technology from January 2019 to December 2020 were randomly divided into control group (n=50) and treatment group (n=50) by random number table method. Patients in the control group were po administered with Pregabalin Capsule, the initial dose was 75 mg/time, once daily, and increased to 150 mg/time, twice daily, within one week according to the efficacy and tolerability. Patients in the treatment group were po administered with Yuanhu Zhitong Tablets on the basis of the control group, 1.5 g/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacy, analgesic onset time and pain relief time of the two groups were observed. The pain visual analog scale (VAS) scores of the two groups before treatment and 1, 2, 3, and 4 weeks after treatment were compared. At the same time, Insomnia Scale (AIS) score, serum calcitonin gene-related peptide (CGRP), substance P (SP), tumor necrosis factor (TNF)-α, interleukin (IL)-1β, and IL-6 levels, and tatistics of adverse reactions in the two groups were compared. Results After treatment, the total effective rate of treatment group was 96.0%, significantly higher than that of control group 84.0% (P < 0.05). VAS scores in both groups decreased gradually with the extension of treatment time (P < 0.05), and VAS scores in the treatment group were significantly lower than those in the control group at 1, 2, 3 and 4 weeks of treatment (P < 0.05). After treatment, the analgesic onset time and pain relief time in the treatment group were significantly shorter than those in the control group (P < 0.05). After treatment, AIS score in both groups was significantly lower than that before treatment (P < 0.05), and AIS score in the treatment group was more significantly decreased than that in the control group (P < 0.05). After treatment, the levels of serum CGRP, SP, TNF-α, IL-1β and IL-6 in two groups were significantly decreased (P< 0.05). After treatment, the reduction effect of serological indexes in treatment group was more significant than that in control group (P < 0.05). Conclusion Yuanhu Zhitong Tablets combined with pregabalin has a satisfactory overall effect in the treatment of postherpetic neuralgia, and can quickly, safely and effectively reduce the pain of patients, improve their sleep quality, which can significantly down-regulate the expression of related pain mediators in the blood and inhibit inflammation in the body.

R971

河南科技大學(xué)青年科學(xué)基金資助項目（2019QN089）