目的 探讨元胡止痛片联合普瑞巴林治疗带状疱疹后遗神经痛的临床效果。方法 选取2019年1月—2020年12月河南科技大学第一附属医院收治的100例带状疱疹后遗神经痛患者，以随机数字表法将其随机分成对照组（n=50）和治疗组（n=50）。对照组患者口服普瑞巴林胶囊，起始剂量为75 mg/次，1次/d，1周内根据疗效和耐受性，将用药剂量增至150 mg/次，2次/d。治疗组在对照组基础上口服元胡止痛片，1.5 g/次，3次/d。两组均连续治疗4周。观察两组临床疗效、止痛起效时间及疼痛缓解时间，并比较治疗前及治疗1、2、3、4周两组疼痛视觉模拟量表（VAS）评分，同时比较治疗前后两组患者阿森斯失眠量表（AIS）评分及血清降钙素基因相关肽（CGRP）、P物质（SP）、肿瘤坏死因子（TNF）-α、白细胞介素（IL）-1β、IL-6水平。结果 治疗后，治疗组总有效率为96.0%，显著高于对照组的84.0%（P<0.05）。两组疼痛VAS评分均随治疗时间的延长而逐渐下降（P<0.05），且治疗组治疗1、2、3、4周疼痛VAS评分均较同期对照组显著更低（P<0.05）。治疗后，治疗组止痛起效时间和疼痛缓解时间均显著短于对照组（P<0.05）。两组治疗后AIS评分均较本组治疗前显著降低（P<0.05），且治疗组AIS评分比对照组降低作用更显著（P<0.05）。治疗后，两组血清CGRP、SP、TNF-α、IL-1β及IL-6水平均显著下降（P<0.05）；且治疗后，治疗组血清学指标的降低作用均较对照组更显著（P<0.05）。结论 元胡止痛片联合普瑞巴林治疗带状疱疹后遗神经痛的整体疗效满意，能快速且安全有效地减轻患者疼痛，改善其睡眠质量，并可显著下调血中相关疼痛介质的表达水平、抑制体内炎症反应。

Objective To investigate the clinical effect of Yuanhu Zhitong Tablets combined with pregabalin in treatment of postherpetic neuralgia. Methods A total of 100 patients with postherpetic neuralgia admitted to the First Affiliated Hospital of Henan University of Science and Technology from January 2019 to December 2020 were randomly divided into control group (n=50) and treatment group (n=50) by random number table method. Patients in the control group were po administered with Pregabalin Capsule, the initial dose was 75 mg/time, once daily, and increased to 150 mg/time, twice daily, within one week according to the efficacy and tolerability. Patients in the treatment group were po administered with Yuanhu Zhitong Tablets on the basis of the control group, 1.5 g/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacy, analgesic onset time and pain relief time of the two groups were observed. The pain visual analog scale (VAS) scores of the two groups before treatment and 1, 2, 3, and 4 weeks after treatment were compared. At the same time, Insomnia Scale (AIS) score, serum calcitonin gene-related peptide (CGRP), substance P (SP), tumor necrosis factor (TNF)-α, interleukin (IL)-1β, and IL-6 levels, and tatistics of adverse reactions in the two groups were compared. Results After treatment, the total effective rate of treatment group was 96.0%, significantly higher than that of control group 84.0% (P < 0.05). VAS scores in both groups decreased gradually with the extension of treatment time (P < 0.05), and VAS scores in the treatment group were significantly lower than those in the control group at 1, 2, 3 and 4 weeks of treatment (P < 0.05). After treatment, the analgesic onset time and pain relief time in the treatment group were significantly shorter than those in the control group (P < 0.05). After treatment, AIS score in both groups was significantly lower than that before treatment (P < 0.05), and AIS score in the treatment group was more significantly decreased than that in the control group (P < 0.05). After treatment, the levels of serum CGRP, SP, TNF-α, IL-1β and IL-6 in two groups were significantly decreased (P< 0.05). After treatment, the reduction effect of serological indexes in treatment group was more significant than that in control group (P < 0.05). Conclusion Yuanhu Zhitong Tablets combined with pregabalin has a satisfactory overall effect in the treatment of postherpetic neuralgia, and can quickly, safely and effectively reduce the pain of patients, improve their sleep quality, which can significantly down-regulate the expression of related pain mediators in the blood and inhibit inflammation in the body.

R971

河南科技大学青年科学基金资助项目（2019QN089）