McKinley Emily Carol, Richardson Elizabeth J, McGwin Gerald, Zhang Jie
a Department of Neurology, University of Alabama at Birmingham , Birmingham , Alabama , USA.
b Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham , Birmingham, Alabama , USA.
J Spinal Cord Med. 2018 Nov;41(6):637-644. doi: 10.1080/10790268.2017.1415246. Epub 2018 Jan 10.
To investigate if a combination of anticonvulsant and antidepressant, two primary therapies for neuropathic pain, is associated with improved pain control compared to individual therapy.
Prospective cohort study Setting: The University of Alabama at Birmingham Rehabilitation Center In-patient Program between 2012 and 2015.
Incident SCI cases, 19-65 years of age.
Bryce-Ragnarsson pain classification scheme and the Numerical Rating Scale Results: Twenty-nine eligible patients completed 6-month follow-up; their average age was 36.4 years, 89% were male, and 65% were white. Baseline characteristics were not different by therapy initiated (combination versus single). At 6 months follow-up, therapy initiated at baseline was not associated with level of pain in the past week (p=0.3145) or past 24 hours (p=0.4107). However, patients who remained on the same therapy reported lower levels of pain 30 minutes after waking (p=0.0235).
The initiation of a combination of anticonvulsant and antidepressant shortly after SCI was not associated with improved pain control at 6 months compared to individual therapy. Adherent patients reported lower levels of pain; further analysis is warranted to elucidate this association.
探讨抗惊厥药和抗抑郁药这两种治疗神经性疼痛的主要疗法联合使用时，与单独使用相比，是否能更好地控制疼痛。
前瞻性队列研究
2012年至2015年期间阿拉巴马大学伯明翰分校康复中心住院项目
19至65岁的新发脊髓损伤病例
布莱斯-拉格纳松疼痛分类方案和数字评定量表
29名符合条件的患者完成了6个月的随访；他们的平均年龄为36.4岁，89%为男性，65%为白人。根据起始治疗（联合治疗与单一治疗），基线特征无差异。在6个月随访时，基线时起始的治疗与过去一周（p = 0.3145）或过去24小时（p = 0.4107）的疼痛程度无关。然而，继续接受相同治疗的患者在醒来30分钟后报告的疼痛程度较低（p = 0.0235）。
与单独治疗相比，脊髓损伤后不久开始联合使用抗惊厥药和抗抑郁药在6个月时并未改善疼痛控制。坚持治疗的患者报告的疼痛程度较低；有必要进行进一步分析以阐明这种关联。
