普瑞巴林联合曲马多治疗硼替佐米所致外周神经病理性疼痛的疗效研究

Efficacy of pregabalin combined with tramadol in the treatment of bortezomib-induced peripheral neuropathic pain

摘要:

目的 探讨普瑞巴林联合曲马多治疗硼替佐米所致外周神经病理性疼痛的疗效。方法 选取2023年2月—2024年8月在新沂市人民医院血液科接受以硼替佐米为基础治疗的96例多发性骨髓瘤患者为研究对象，患者均因硼替佐米致外周神经病理性疼痛，第1周接受曲马多缓释片治疗。治疗1周后根据视觉模拟评分法（VAS）评分进行分组，30例VAS评分< 4分的患者入A组，继续口服曲马多缓释片治疗2周；34例VAS评分≥ 4分患者入B1组，继续口服曲马多缓释片治疗2周；32例VAS评分≥4分患者入B2组，在曲马多基础上加用普瑞巴林镇痛。共治疗3周后观察并记录3组患者的临床疗效，并比较患者治疗前后的睡眠质量、负性情绪及生活质量，同时记录用药期间不良反应发生情况。结果 3组患者总有效率比较，差异有统计学意义（P <0.05）；A组和B2组的总有效率均高于B1组（P <0.0125），而A组与B2组比较，差异无统计学意义（P >0.0125）。3组患者治疗前后睡眠质量、入睡时间、睡眠时间、睡眠频率、睡眠障碍、催眠药物、日间功能、HAMA、HAMD、生理、心理、社会关系和环境评分的差值比较，差异均有统计学意义（P <0.05）；A组和B2组的治疗前后睡眠质量、入睡时间、睡眠时间、睡眠频率、睡眠障碍、催眠药物、日间功能、HAMA、HAMD、生理、心理、社会关系和环境评分差值均高于B1组（P <0.05），而A组与B2组比较，差异无统计学意义（P >0.05）。结论 普瑞巴林联合曲马多治疗硼替佐米所致外周神经病理性疼痛较单纯曲马多治疗更有效，能够显著改善患者的生存质量，且不增加不良反应风险。

Abstract:

Objective To investigate the efficacy of pregabalin combined with tramadol in the treatment of bortezomib-induced peripheral neuropathic pain.Methods The study included 96 patients with multiple myeloma who received bortezomib-based therapy at Xinyi People's Hospital between February 2023 and August 2024. All patients experienced bortezomib-induced peripheral neuropathic pain. The first week of treatment involved tramadol sustained-release tablets. After one week, patients were grouped based on Visual Analogue Scale (VAS) pain score: Group A (VAS < 4, n = 30) continued tramadol for 2 weeks; Group B1 (VAS ≥ 4, n = 34) continued tramadol for 2 weeks; Group B2 (VAS ≥ 4, n = 32) received pregabalin added to tramadol for 2 weeks. After 3 weeks of treatment, clinical efficacy, sleep quality, negative emotions, and quality of life were compared, and adverse drug reactions were recorded.Results The comparison of total effective rates among the three groups showed statistically significant differences by χ2 test (P < 0.05), with both Group A and Group B2 demonstrating higher total effective rates than Group B1 (P < 0.0125), while no significant difference was observed between Group A and Group B2 (P > 0.0125). Significant differences were found in the score changes (pre- vs post-treatment) among the three groups for sleep quality, sleep latency, sleep duration, sleep frequency, sleep disturbance, use of hypnotic medications, daytime function, Hamilton Anxiety Rating Scale (HAMA), Hamilton Depression Rating Scale (HAMD), and physical, psychological, social relationships, and environment domains (by ANOVA, all P < 0.05). Both Group A and Group B2 showed greater improvements than Group B1 in all these score changes (all P < 0.05), with no significant differences between Group A and Group B2 (all P > 0.05). The comparison of adverse reaction rates among the three groups showed no statistically significant difference by χ2 test (P > 0.05).Conclusion Pregabalin combined with tramadol is more effective than tramadol alone in treating bortezomib-induced peripheral neuropathic pain, significantly improving patients' quality of life without increasing the risk of adverse reactions.