Control study on the treatment of refractory neuropathic pain with pregabalin and sertraline hydrochloride / 中国医师进修杂志

ABSTRACT

Objective To investigate the effect,security and tolerance of pregabalin combined with sertraline hydrochloride for refractory neuropathic pain.Methods Forty-six patients with refractory neuropathic pain were divided into two groups by random digits table.The patients in pregabalin group (24 patients) were treated by pregabalin combined with sertraline hydrochloride,and the patients in carbamazepine group (22 patients) were treated by carbamazepine combined with sertraline hydrochloride.They were treated for 4 weeks.The scores of visual analogue scales (VAS),Hamilton rating scale of depression (HAMD),Hamilton rating scale for anxiety (HAMA) and the dose,adverse reaction were compared between two groups.Results The total effective rate of pregabalin group was 83.3％(20/24) and carbamazepine group was 86.4％ (19/22),there was no significant difference (P＞ 0.05).After treatment of 1,2,4 weeks,the scores of VAS in two groups were significantly decreased compared with those before treatment[pregabalin group(5.90 ± 1.11),(4.59 ± 1.33),(3.59 ± 1.94) scores vs.(6.50 ± 0.85) scores; carbamazepine group(5.50 ± 1.06),(4.18 ± 1.71),(3.73 ± 1.88) scores vs.(6.50 ± 0.80) scores] (P ＜0.05).After treatment of 2 weeks,the scores of VAS in carbamazepine group was significantly lower than that in pregabalin group (P ＜ 0.05).In pregabalin group,the scores of HAMD/HAMA after treatment of 1 week had no significant difference compared with before treatment (P ＞ 0.05),and the scores of HAMD/HAMA after treatment of 2,4 weeks were significantly increased [(15.25 ± 4.15),(11.29 ± 4.16)scores vs.(16.08 ± 3.56) scores and (14.21 ± 4.72),(11.63 ± 4.50) scores vs.(15.25 ± 4.05) scores] (P ＜0.05).In carbamazepine group,the scores of HAMD/HAMA after treatment of 1,2 weeks was decreased compared with those before treatment,but there was no significant difference (P ＞ 0.05).The scores of HAMD/HAMA after treatment of 4 weeks was significantly decreased [(13.18 ± 2.42) scores vs.(15.20 ±1.05) scores,(12.32 ± 2.64) scores vs.(14.55 ± 4.43) scores] (P ＜ 0.05).The scores of HAMD/HAMA in pregabalin group after treatment of 4 weeks was significantly lower than that in carbamazepine group (P ＜0.05).There was no severe adverse reaction.Conclusion Pregabalin combined with sertraline hydrochloride is worth to recommend for refractory neuropathic pain,and has no serious adverse reaction.