三氧大自体血联合普瑞巴林治疗脑卒中后中枢神经痛的临床研究

黄志雄　李晶　吴爱花　游平弟

【摘要】 目的：觀察三氧大自体血联合普瑞巴林胶囊治疗脑卒中后中枢神经痛的临床效果。方法：选取2013年6月-2017年7月笔者所在科诊治的脑卒中后中枢神经痛患者63例，将其随机分为观察组、对照组和安慰剂组，每组21例。观察组使用三氧大自体血配合普瑞巴林胶囊口服治疗，对照组使用卡马西平和甲钴胺片口服治疗，安慰剂组单纯使用口服甲钴胺片治疗。比较三组近期疗效、治疗前后1、3个月的疼痛程度、不良反应发生情况。结果：观察组治疗总有效率为95.2%，安慰剂组治疗总有效率为14.3%，对照组治疗总有效率为71.4%，观察组与对照组、安慰剂组比较，差异均有统计学意义（P<0.05），对照组与安慰剂组比较差异有统计学意义（P<0.05）。治疗后1、3个月观察组和对照组NRS评分均明显下降（P<0.05），且观察组明显低于对照组（P<0.05）。观察组治疗后1个月NRS评分和治疗后3个月比较，差异无统计学意义（P>0.05）。观察组的不良反应发生率明显较对照组低（P<0.05）。结论：三氧大自体血联合普瑞巴林胶囊治疗脑卒中后中枢神经痛临床效果显著，且副作用低，值得临床广泛应用。

【关键词】 中枢神经痛; 脑卒中; 三氧大自体血; 普瑞巴林胶囊

doi：10.14033/j.cnki.cfmr.2019.18.009 文献标识码 B 文章编号 1674-6805（2019）18-00-03

【Abstract】 Objective：To observe the clinical effect of ozonated autohemotherapy（O3-AHT） combined with Pregabalin Capsule in the treatment of central neuralgia after stroke.Method：Sixty-three patients with post-stroke central neuralgia diagnosed and treated in our department from June 2013 to July 2017 were selected.They were randomly divided into observation group，control group and placebo group，with 21 cases in each group.The observation group was treated with ozonated autohemotherapy plus Pregabalin Capsule，the control group was treated with Carbamazepine and Mecobalamin Tablets，and the placebo group was treated with Mecobalamin Tablets only.The short-term efficacy，pain degree before and after treatment for 1 and 3 months，and adverse reactions of the three groups were compared.Result：The total effective rate was 95.2% in the observation group，14.3% in the placebo group，and 71.4% in the control group.There were significant differences between the observation group and the control group and the placebo group（P<0.05）.There was significant difference between the control group and placebo group（P<0.05）.The NRS scores of the observation group and the control group decreased significantly in 1 and 3 months after treatment（P<0.05），and the NRS scores of the observation group were significantly lower than those of the control group（P<0.05）.There was no significant difference in the NRS scores of the observation group between 1 month and 3 months after treatment（P>0.05）.The incidence of adverse reactions in the observation group was significantly lower than that in the control group（P<0.05）.Conclusion：Ozonated autohemotherapy combined with Pregabalin Capsule has obvious clinical effect in the treatment of central neuralgia after stroke with low side effects，which is worthy of wide clinical application.

【Key words】 Central neuralgia; Cerebral apoplexy; Ozonated autohemotherapy; Pregabalin

First-authors address：Fujian East Hospital Affiliated to Fujian Medical University，Fuan 355000，China

目前中国人口老龄化不断加重，脑卒中的发生率也越来越高，临床上也就不断有脑卒中后中枢神经痛（CPSP）的患者出现，常常表现为偏侧肢体和（或）躯干的阵法性或持续性针刺样、束紧样疼痛，疼痛特点各异，表现不一，是一种疼痛剧烈且顽固的神经病理性疼痛[1]，严重影响患者身心健康及生存质量。目前脑卒中后中枢神经痛发病机理尚不完全明确，可能与脊髓、丘脑病变及中枢敏化有关，一般常规单纯药物治疗效果欠佳，副作用多且大，安全性也较差，临床预期疗效不理想，患者依从性差，本研究探讨三氧大自体血联合普瑞巴林胶囊治疗脑卒中后中枢神经痛的临床效果，现报告如下。……