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阿米替林与普瑞巴林治疗纤维肌痛患者的疗效比较。

A comparison of the effectiveness of amitriptilin and pregabalin treatment in fibromyalgia patients.

作者信息

Acet Gunseli, Kaya Arzu, Akturk Semra, Akgol Gurkan

机构信息

Department of Physical Medicine and Rehabilitation, Malatya Training and Research Hospital, Malatya, Turkey.

Department of Physical Medicine and Rehabilitation, Firat University Faculty of Medicine, Elazig, Turkey.

出版信息

North Clin Istanb. 2017 Aug 26;4(2):151-159. doi: 10.14744/nci.2017.61687. eCollection 2017.

Abstract

OBJECTIVE

The present study is a comparison of the effectiveness of amitriptyline and pregabalin on the symptoms of fibromyalgia patients.

METHODS

A total of 71 female patients aged ≥18 years were included in this study. The patients were divided into 2 groups. Pregabalin (n=36) or amitriptyline (n=35) treatment was initiated at daily oral dose of 450 mg and 25 mg, respectively for the indicated number of patients. The patients were evaluated at the start of treatment and at the end of 12 weeks. The Fibromyalgia Impact Questionnaire, Fatigue Severity Scale, Modified Fatigue Impact Scale, Hospital Anxiety Depression Scale, Nottingham Health Profile, Mini Mental State Test, and the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) were administered to all study participants. Pain at all tender points was measured using a pressure algometer.

RESULTS

Significant improvement was observed in both groups after 12 weeks of treatment (p<0.05). Percent change in LANSS was greater in the pregabalin group compared with the amitriptyline group. Tender point pressure pain thresholds and total myalgic score improved significantly in both groups (p<0.05); however higher percentage change in these parameters was achieved in the amitriptyline group when compared with the pregabalin group (p<0.05).

CONCLUSION

Both drugs improved pain, fatigue, sleep disorder, disability, psychological evaluation, and cognitive function; however, amitriptyline was more effective at reducing experimentally measured pain than neuropathic pain. According to these results, preference for pregabalin may be recommended in fibromyalgia patients whose primary complaint is neuropathic pain.

摘要

目的

本研究旨在比较阿米替林和普瑞巴林对纤维肌痛患者症状的疗效。

方法

本研究共纳入71名年龄≥18岁的女性患者。患者被分为两组。分别对指定数量的患者开始口服普瑞巴林(n = 36)或阿米替林(n = 35)治疗,每日剂量分别为450毫克和25毫克。在治疗开始时和12周结束时对患者进行评估。对所有研究参与者进行纤维肌痛影响问卷、疲劳严重程度量表、改良疲劳影响量表、医院焦虑抑郁量表、诺丁汉健康概况、简易精神状态测试以及利兹神经病理性症状和体征评估(LANSS)。使用压力痛觉计测量所有压痛点的疼痛程度。

结果

治疗12周后,两组均观察到显著改善(p < 0.05)。与阿米替林组相比,普瑞巴林组LANSS的变化百分比更大。两组的压痛点压力痛阈值和总肌痛评分均显著改善(p < 0.05);然而,与普瑞巴林组相比,阿米替林组在这些参数上的变化百分比更高(p < 0.05)。

结论

两种药物均改善了疼痛、疲劳、睡眠障碍、残疾、心理评估和认知功能;然而,阿米替林在减轻实验测量的疼痛方面比神经性疼痛更有效。根据这些结果,对于以神经性疼痛为主要诉求的纤维肌痛患者,可能推荐优先使用普瑞巴林。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/46d1/5613263/9014e1f55bb5/NCI-4-151-g001.jpg

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