Clinical effects of gabapentin on the treatment of pruritus of scar resulting from deep partial-thickness burn
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摘要: 目的 了解加巴喷丁用于治疗深Ⅱ度烧伤后瘢痕瘙痒的临床疗效。 方法 选择2013年1月—2014年1月笔者单位收治的58例深Ⅱ度烧伤后瘢痕瘙痒患者,按照随机数字表法分为安慰剂组18例、西替利嗪组20例及加巴喷丁组20例。安慰剂组患者口服维生素C 100 mg,西替利嗪组患者口服西替利嗪10 mg,加巴喷丁组患者口服加巴喷丁300 mg,各组患者均用药2次/d,连续服用4周。分别于治疗前及治疗第3、28天应用视觉模拟评分(VAS)法评价患者瘢痕瘙痒程度并记录分值,计算治疗第3、28天瘙痒缓解率,并观察用药过程中有无不良反应。对数据行方差分析、
q 检验、χ 2检验。 结果 与治疗前比较,治疗后安慰剂组轻、中、重度瘙痒患者的瘙痒程度均未缓解;西替利嗪组中、重度瘙痒患者的瘙痒程度均有所缓解,而轻度瘙痒患者未见缓解;加巴喷丁组轻、中、重度瘙痒患者的瘙痒程度均获得明显缓解。治疗前,3组患者的VAS评分相近(F =2.78,P >0.05)。治疗第3、28天,加巴喷丁组患者的VAS评分分别为(2.3±0.8)、(0.6±0.3)分,西替利嗪组患者VAS评分分别为(4.2±1.7)、(2.8±1.2)分,均显著低于安慰剂组[(5.7±2.0)、(5.7±1.9)分,q 值为6.70~7.75,P 值均小于0.05];此外,加巴喷丁组患者的VAS评分均显著低于西替利嗪组(q 值分别为6.30、6.90,P 值均小于0.05)。加巴喷丁组患者治疗第3、28天的瘙痒缓解率分别为(66±20)%、(91±17)%,均显著高于西替利嗪组[(33±8)%、(56±14)%,q 值分别为4.70、3.82,P 值均小于0.05]。安慰剂组患者治疗第3、28天的瘙痒缓解率均为0,均显著低于其余2组(q 值为3.94~6.76,P 值均小于0.05)。治疗期间,加巴喷丁组5例患者出现轻中度嗜睡、头晕等不良反应,用药1周后症状好转或消失;其余2组患者未发生不良反应。 结论 加巴喷丁能有效缓解深Ⅱ度烧伤患者的瘢痕瘙痒,用药期间安全性较好。Abstract: Objective To study the clinical effects of gabapentin on the treatment of pruritus of scar resulting from deep partial–thickness burn. Methods A total of fifty–eight patients suffering from pruritus of scar after deep partial–thickness burn were hospitalized from January 2013 to January 2014. Patients were divided into placebo group (n =18, treated with oral vitamin C in the dose of 100 mg for 4 weeks, twice per day), cetirizine group (n =20, treated with oral cetirizine in the dose of 10 mg for 4 weeks, twice per day), and gabapentin group (n =20, treated with oral gabapentin in the dose of 300 mg for 4 weeks, twice per day). Before treatment and on post treatment day (PTD) 3 and 28, the Visual Analog Scale (VAS) was used to assess the itching degree, and the mean scores were recorded. The remission rates of pruritus on PTD 3 and 28 were calculated. The adverse effects were observed during treatment. Data were processed with analysis of variance,q test, and chi–square test. Results Compared with that before treatment, the itching degree of patients with light, moderate, and severe itching in placebo group was not relieved after treatment; the itching degree of patients with moderate or severe itching in cetirizine group was alleviated after treatment, but not in patients with light itching; itching degree of all patients in gabapentin group was significantly relieved after treatment. There were no obvious differences in VAS scores among the 3 groups before treatment (F =2.78,P >0.05). On PTD 3 and 28, the VAS scores of patients in both gabapentin group [(2.3±0.8) and (0.6±0.3) points] and cetirizine group [(4.2±1.7) and (2.8±1.2) points] were lower than those in placebo group [(5.7±2.0) and (5.7±1.9) points, withq values from 6.70 to 7.75,P values below 0.05]. The VAS scores of patients in gabapentin group on PTD 3 and 28 were lower than those in cetirizine group (withq values respectively 6.30 and 6.90,P values below 0.05). The remission rates of pruritus of patients in gabapentin group on PTD 3 and 28 were respectively (66±20)% and (91±17)%, and they were higher than those in cetirizine group [(33±8)% and (56±14)%, withq values respectively 4.70 and 3.82,P values below 0.05]. The remission rate of pruritus of patients in placebo group on PTD 3 and 28 was 0, which was lower than that of the other 2 groups each (withq values from 3.94 to 6.76,P values below 0.05). During the course of treatment, 5 patients in gabapentin group suffered from adverse effects including mild–to–moderate drowsiness and dizziness, but they disappeared one week later. No adverse effects were observed in patients of the other two groups. Conclusions For patients with deep partial–thickness burn, gabapentin can effectively alleviate scar itching after wound healing with safety.-
Key words:
- Burns /
- Cicatrix /
- Pruritus /
- Gabapentin
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