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普瑞巴林治疗合并抑郁症的腰椎疾病患者的疗效

Outcomes of pregabalin in lumbar-disease patients with depression.

作者信息

Tetsunaga Tomoko, Tanaka Masato, Sugimoto Yoshihisa, Takigawa Tomoyuki, Ozaki Toshifumi, Tetsunaga Tomonori

机构信息

Department of Orthopaedic Surgery, Okayama University Hospital, 2-5-1 Shikata-cho, Kitaku, Okayama, Okayama 700-8558, Japan.

Department of Orthopaedic Surgery, Okayama Medical Center, 1711-1 Tamasu, Kitaku, Okayama, Okayama 701-1192, Japan.

出版信息

J Orthop Sci. 2014 Mar;19(2):229-234. doi: 10.1007/s00776-013-0529-4. Epub 2014 Jan 16.

Abstract

BACKGROUND

The anti-seizure drug pregabalin is currently used for peripheral neuropathic pain, including degenerative lumbar disease with a neuropathic component. Although there are many reports associated with pregabalin, treatment outcome in low back pain (LBP) patients with depression remains uncertain. This study investigated the outcomes of pregabalin in LBP patients with depression.

METHODS

We assessed 64 patients (29 men and 35 women) using a Visual Analogue Scale, a Self-Rating Depression Scale (SDS) and the Oswestry Disability Index (ODI). Mean age was 63.3 years (range 20-81), and mean duration of disease was 69.8 months (range 3-576). The patients were divided into two groups according to SDS: normal (n = 37) and depressed group (n = 27).

RESULTS

Pregabalin significantly reduced both SDS and ODI in the depressed group (p < 0.05). Effect size was larger for both SDS and ODI in the depressed group than in the normal group. Pain was significantly relieved, even in the depressed group (p < 0.01). Pain reduction was achieved by the direct effect of pregabalin, as well as indirect effects attributed to change in depressive symptoms. Although both somnolence and dizziness were detected, the use of hypnotic agents was decreased in half of cases. Somnolence did not influence the analgesic effects of the drug or psychotic state.

CONCLUSIONS

This investigation indicated that pregabalin is safe and effective for reducing both LBP and mood disturbance in patients with depression.

摘要

背景

抗癫痫药物普瑞巴林目前用于治疗周围神经性疼痛,包括伴有神经病变成分的退行性腰椎疾病。尽管有许多关于普瑞巴林的报道,但抑郁症伴下腰痛(LBP)患者的治疗效果仍不确定。本研究调查了普瑞巴林对抑郁症伴LBP患者的治疗效果。

方法

我们使用视觉模拟量表、自评抑郁量表(SDS)和Oswestry功能障碍指数(ODI)对64例患者(29例男性和35例女性)进行了评估。平均年龄为63.3岁(范围20 - 81岁),平均病程为69.8个月(范围3 - 576个月)。根据SDS将患者分为两组:正常组(n = 37)和抑郁组(n = 27)。

结果

普瑞巴林显著降低了抑郁组的SDS和ODI(p < 0.05)。抑郁组的SDS和ODI效应量均大于正常组。即使在抑郁组,疼痛也得到了显著缓解(p < 0.01)。疼痛减轻是普瑞巴林的直接作用以及抑郁症状改变所带来的间接作用的结果。虽然检测到嗜睡和头晕,但半数病例中催眠药物的使用减少。嗜睡并未影响药物的镇痛效果或精神状态。

结论

本研究表明,普瑞巴林对减轻抑郁症患者的LBP和情绪障碍是安全有效的。

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