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单独和组合用于神经性疼痛的诺特利普提林和 gabapentin:一个双盲随机对照交叉试验
Ian Gilron1, Joan M Bailey, Dongsheng Tu
1Department of Anesthesiology, Queen's University, Kingston, ON, Canada. gilroni@queensu.ca
Lancet (London, England)
|October 3, 2009
概括
与单独治疗相比,将 gabapentin 和 nortriptyline 结合起来可以为神经病痛提供更好的缓解疼痛. 建议这种组合适用于需要增强疼痛管理的患者.
科学领域:
- 神经学 神经学
- 药理学 药理学是指药理学的学科.
- 疼痛管理 疼痛管理
背景情况:
- 神经病痛治疗通常具有有限的疗效和副作用.
- 与现有药物单一治疗在控制疼痛强度和耐受性方面存在挑战.
研究的目的:
- 为了评估联合诺特林和 gabapentin 与单独药物管理的疗效和耐受性.
- 确定神经性疼痛管理的最佳治疗策略.
主要方法:
- 这是一项双盲,双模拟,交叉试验,涉及患有糖尿病多神经病或后神经疼痛的患者.
- 患者接受口服 gabapentin,nortriptyline 或它们的组合,剂量定位至最大耐受水平.
- 测量的主要终点是最大耐受剂量的平均每日疼痛得分.
主要成果:
- 与单独使用 gabapentin (p=0.001) 和单独使用 nortriptyline (p=0.02) 相比,联合治疗显著降低了每日疼痛评分.
- 最常见的不良事件,口腔干燥,在 gabapentin 单一治疗中比在 nortriptyline 或组合治疗中少见.
- 在试验期间没有报告任何严重不良事件.
结论:
- 结合的 gabapentin 和 nortriptyline 显示出对神经病痛的疗效比单独使用任何一种药物都更大.
- 这种组合推给那些对单一治疗有部分反应,希望改善疼痛缓解的患者.
- 进一步的研究是有必要的,以探索神经病痛的其他组合疗法.
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