Perez-Lloret Santiago, Rojas Gloria Meza, Menoni Maria Celia, Ruiz Gabriela, Velásquez Carolina, Rodriguez Hernán, Rey María Verónica, Cardinali And Daniel P
Pharmacology Department, Paul Sabatier University, Toulouse, France.
Clin Neuropharmacol. 2012 Jan-Feb;35(1):21-4. doi: 10.1097/WNF.0b013e31823df2dc.
BACKGROUND: Pregabalin (PGB) has been shown to improve sleep quality and health-related quality of life (HRQoL) as well as pain intensity in patients with neuropathic pain. OBJECTIVE: The objective of the study was to explore the magnitude of the correlations between changes in pain intensity, sleep quality, and HRQoL after PGB treatment. METHODS: One hundred thirty-eight patients with neuropathic pain of any origin and without an adequate response to analgesics received an 8-week treatment course of PGB in an open-label fashion. Pain intensity, sleep quality, and HRQoL outcomes were evaluated at baseline and at week 8 by means of an 11-point (0-10) numerical rating scale (NRS), the Pittsburgh Sleep Quality Index (PSQI), and the EuroQol health-state visuoanalogic scale (EQ-5D VAS) score, respectively. RESULTS: At week 8, mean PGB dose was 166.7 ± 7.8 mg/d. Pain intensity NRS score, PSQI total score, and EQ-5D VAS score were improved by 66.5% ± 1.9%, 40.0% ± 3.6%, and 26.4% ± 4.7% (all P < 0.01), respectively. Correlations between percent change from baseline in pain NRS score and PSQI total score or EQ-5D VAS scores were r = 0.36 (P < 0.01, R = 0.11) and r = -0.20 (P < 0.02, R = 0.05), respectively. A multivariate logistic regression analysis disclosed that PSQI score change below the median (ie, a better outcome) was related to higher EQ-5D VAS score change (odds ratio, 2.15; 95% confidence interval, 1.09-4.25), whereas pain intensity NRS score change below the median was not (odds ratio, 1.58; 95% confidence interval,0.78-3.23). CONCLUSIONS: In our study, PGB-related improvements in sleep quality and HRQoL were marginally related to reductions in pain intensity in patients with neuropathic pain. Improvement in sleep quality was a significant predictor of better HRQoL, whereas pain intensity reduction was not.
背景：已证实普瑞巴林（PGB）可改善神经性疼痛患者的睡眠质量、健康相关生活质量（HRQoL）以及疼痛强度。 目的：本研究的目的是探讨PGB治疗后疼痛强度、睡眠质量和HRQoL变化之间的相关程度。 方法：138例任何病因的神经性疼痛患者且对镇痛药反应不佳者，以开放标签方式接受为期8周的PGB治疗。在基线和第8周时，分别通过11点（0 - 10）数字评分量表（NRS）、匹兹堡睡眠质量指数（PSQI）和欧洲五维度健康量表视觉模拟评分（EQ - 5D VAS）对疼痛强度、睡眠质量和HRQoL结果进行评估。 结果：在第8周时，PGB平均剂量为166.7±7.8mg/d。疼痛强度NRS评分、PSQI总分和EQ - 5D VAS评分分别改善了66.5%±1.9%、40.0%±3.6%和26.4%±4.7%（均P<0.01）。疼痛NRS评分相对于基线的变化百分比与PSQI总分或EQ - 5D VAS评分之间的相关性分别为r = 0.36（P<0.01，R = 0.11）和r = -0.20（P<0.02，R = 0.05）。多因素逻辑回归分析显示，PSQI评分变化低于中位数（即更好的结果）与更高的EQ - 5D VAS评分变化相关（比值比，2.15；95%置信区间，1.09 - 4.25），而疼痛强度NRS评分变化低于中位数则无此相关性（比值比，1.58；95%置信区间，0.78 - 3.23）。 结论：在我们的研究中，PGB相关的睡眠质量和HRQoL改善与神经性疼痛患者疼痛强度的降低略有相关。睡眠质量的改善是更好的HRQoL的重要预测因素，而疼痛强度的降低则不是。
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