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对于已被转诊至疼痛诊所但神经病理性疼痛控制不佳的患者,加用普瑞巴林进行治疗。

Add-on treatment with pregabalin for patients with uncontrolled neuropathic pain who have been referred to pain clinics.

作者信息

de la Calle José-Luis, De Andres José, Pérez María, López Vanessa

机构信息

Pain Unit, Hospital Ramón y Cajal, Madrid, Spain.

出版信息

Clin Drug Investig. 2014 Dec;34(12):833-44. doi: 10.1007/s40261-014-0239-5.

Abstract

OBJECTIVE

The aim of this study was to investigate the impact of pregabalin on pain, other symptoms, and patient-reported outcomes for patients with uncontrolled pain who have been referred to pain clinics.

PATIENTS AND METHODS

Adult patients with uncontrolled pain who had a score of ≥4 in the DN4 questionnaire were evaluated at baseline, month 3, and month 6. Evaluations included pain levels using a visual analog (VAS) scale as well as anxiety, depression, sleep, disability, and treatment satisfaction employing validated tools.

RESULTS

Our sample comprised 413 patients who met the selection criteria, had not received pregabalin previously, and were prescribed pregabalin at the study initiation, mainly (97 %) as add-on therapy. Overall, patients had a statistically significant reduction in VAS pain score of 41 points (54 % reduction, p < 0.001), varying from 64 % reduction (oncological pain) to 31 % reduction (central neuropathic pain). Effect sizes for anxiety, depression, sleep, and treatment satisfaction improvement were moderate to large depending on the dimension and clinical entity.

CONCLUSION

Our results suggest that in patients with uncontrolled neuropathic pain of various origins who were treated at pain clinics, the addition of pregabalin to a wider pharmacological treatment regimen was associated with a clinically relevant improvement of pain and psychological well-being and a reduction in the impact of neuropathic pain on daily activities. Add-on treatment with pregabalin was well tolerated.

摘要

目的

本研究旨在调查普瑞巴林对转诊至疼痛诊所的疼痛未得到控制的患者的疼痛、其他症状及患者报告结局的影响。

患者与方法

对DN4问卷评分≥4分的疼痛未得到控制的成年患者在基线、第3个月和第6个月进行评估。评估包括使用视觉模拟(VAS)量表评估疼痛程度,以及使用经过验证的工具评估焦虑、抑郁、睡眠、功能障碍和治疗满意度。

结果

我们的样本包括413名符合入选标准、此前未接受过普瑞巴林治疗且在研究开始时被处方使用普瑞巴林的患者,主要(97%)作为附加治疗。总体而言,患者的VAS疼痛评分在统计学上显著降低了41分(降低54%,p<0.001),降低幅度从64%(肿瘤疼痛)到31%(中枢神经性疼痛)不等。根据维度和临床类型,焦虑、抑郁、睡眠和治疗满意度改善的效应大小为中度至高度。

结论

我们的结果表明,在疼痛诊所接受治疗的各种病因的疼痛未得到控制的神经性疼痛患者中,在更广泛的药物治疗方案中添加普瑞巴林与疼痛和心理健康的临床相关改善以及神经性疼痛对日常活动影响的降低相关。普瑞巴林附加治疗耐受性良好。

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