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盐酸文拉法辛对2型糖尿病患者疼痛性周围神经病变的影响。

The effect of venlafaxine HCl on painful peripheral diabetic neuropathy in patients with type 2 diabetes mellitus.

作者信息

Kadiroglu Ali Kemal, Sit Dede, Kayabasi Hasan, Tuzcu Alpaslan Kemal, Tasdemir Nebahat, Yilmaz M Emin

机构信息

Department of Nephrology, Dicle University Medical Faculty, Diyarbakir, Turkey.

出版信息

J Diabetes Complications. 2008 Jul-Aug;22(4):241-5. doi: 10.1016/j.jdiacomp.2007.03.010. Epub 2008 Apr 16.

Abstract

OBJECTIVE

The objective of this study was to evaluate the efficacy of venlafaxine HCl in the symptomatic treatment of painful peripheral diabetic neuropathy (PPDN) among patients with type 2 diabetes mellitus (DM).

DESIGN

This study was designed as a prospective, randomized, and controlled trial.

SETTING

This study was conducted at the Dicle University Medical Faculty (Diyarbakir, Turkey).

PATIENTS

Sixty type 2 DM outpatients (47 females and 13 males) with PPDN who had a minimum visual analog scale (VAS) score of 40 mm were enrolled in this study.

INTERVENTIONS

Patients randomized to the treatment group (n=30) received venlafaxine HCl, whereas those randomized to the control group (n=30) received a combination of vitamins B(1)and B(6) tablets.

MEASURES

Severity of pain was measured by VAS, Short-Form McGill Pain Questionnaire, and numerical analog scale scores at admission and at the second, fourth, and eighth weeks of the study. Polyneuropathy was supported by electromyelography.

OUTCOME

In the treatment group, severity of pain was measured as 70.0+/-13.0 in the VAS, as 24.9+/-6.2 in the Short-Form McGill Pain Questionnaire, and as 7.2+/-1.1 in the numerical analog scale. In the control group, it was measured as 73.0+/-8.0 in the VAS, as 26.8+/-6.2 in the Short-Form McGill Pain Questionnaire, and as 7.4+/-0.8 in the numerical analog scale (P>.05).

RESULTS

The most common form of PPDN was distal symmetrical sensorimotor polyneuropathy in both groups (46.8% vs. 50.0%). At the end of the study, there was a significant difference in severity of pain between the groups. In the treatment group, scores were 8.5+/-5.2 and 3.1+/-1.6 in the Short-Form McGill Pain Questionnaire and numerical analog scale, respectively; in the control group, these were 20.5+/-7.0 and 5.5+/-1.6, respectively (P<.001).

CONCLUSIONS

Venlafaxine HCl is a safe and well-tolerable analgesic drug in the symptomatic treatment of PPDN; however, it has minimal adverse effects. It showed its efficacy markedly in the second week of therapy.

摘要

目的

本研究旨在评估盐酸文拉法辛对2型糖尿病(DM)患者疼痛性周围糖尿病神经病变(PPDN)进行症状治疗的疗效。

设计

本研究设计为一项前瞻性、随机对照试验。

地点

本研究在土耳其迪亚巴克尔的迪克莱大学医学院进行。

患者

60例患有PPDN的2型糖尿病门诊患者(47名女性和13名男性),其视觉模拟量表(VAS)评分至少为40毫米,纳入本研究。

干预措施

随机分配至治疗组(n = 30)的患者接受盐酸文拉法辛治疗,而随机分配至对照组(n = 30)的患者接受维生素B₁和B₆片的联合治疗。

测量指标

在入院时以及研究的第2、4和8周,通过VAS、简化麦吉尔疼痛问卷和数字模拟量表评分来测量疼痛的严重程度。通过肌电图来辅助诊断多发性神经病变。

结果

治疗组中,VAS疼痛严重程度评分为70.0±13.0,简化麦吉尔疼痛问卷评分为24.9±6.2,数字模拟量表评分为7.2±1.1。对照组中,VAS评分为73.0±8.0,简化麦吉尔疼痛问卷评分为26.8±而6.2,数字模拟量表评分为7.4±0.8(P>0.05)。

结果

两组中最常见的PPDN形式均为远端对称性感觉运动性多发性神经病变(46.8%对50.0%)。在研究结束时,两组之间疼痛严重程度存在显著差异。治疗组中,简化麦吉尔疼痛问卷和数字模拟量表的评分分别为8.5±5.2和3.1±1.6;对照组中,这些评分分别为20.5±7.0和5.5±1.6(P<0.001)。

结论

盐酸文拉法辛在PPDN的症状治疗中是一种安全且耐受性良好的镇痛药;然而,其不良反应极小。它在治疗的第二周就显著显示出疗效。

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