Abstract：Objective To compare the clinical efficacy and safety of Duloxetine Hydrochloride and Amitriptyline in patients with herpes zoster neuralgia. Methods A total of 120 patients with herpes zoster neuralgia admitted to the Department of Pain Medicine, Nanjing Drum Tower Hospital Affiliated Nanjing University Medical College from January to August 2022 were selected, they were divided into Amitriptyline group (60 cases, Amitriptyline combined with Pregabalin orally) and Duloxetine group (60 cases, Duloxetine Hydrochloride combined with Pregabalin orally) by random number table method. Visual analogue scale (VAS) scores were compared between two groups before treatment and at 7, 14 d, and 28 d after treatment; Hamilton depression scale 17 (HAMD-17) scores was compared between two groups before treatment and at 14 d and 28 d after treatment; Pittsburgh sleep quality index (PSQI) scores were compared between two groups before treatment and at 28 d after treatment; the dosage of Pregabalin at 28 d after treatment was compared between two groups; the occurrence of adverse reactions at 28 d after treatment was recorded in both groups. Results Two cases in Amitriptyline group and one case in Duloxetine group could not be effectively eliminated due to adjustment of dosage. The overall analysis showed that there were statistically significant differences in the time, inter-group, and interaction of VAS scores between two groups (P＜0.05). Further pairwise comparison, intra-group comparison: VAS scores of two groups at 7, 14 d, and 28 d after treatment were lower than those before treatment, and the differences were statistically significant (P＜0.05). Comparison between groups: VAS scores at 7, 14 d, and 28 d after treatment of Duloxetine group were lower than those of Amitriptyline group, and the differences were statistically significant (P＜0.05). Overall analysis showed that there was no significant difference in HAMD-17 score between two groups (P＞0.05). There were significant differences in HAMD-17 score time and interaction between two groups (P＜0.05). Further pairwise comparison, intra-group comparison: HAMD-17 scores at 14 d and 28 d after treatment of two groups were lower than those before treatment, and the differences were statistically significant (P＜0.05). Comparison between groups: there was no significant difference in HAMD-17 scores at 14 d and 28 d after treatment between two groups (P＞0.05). Before treatment, there was no significant difference in PSQI score between two groups (P＞0.05). At 28 d after treatment, PSQI scores in two groups were lower than those before treatment, and Duloxetine group was lower than Amitriptyline group, and the differences were statistically significant (P＜0.05). There was no significant difference in dosage of Pregabalin between two groups (P＞0.05). The incidence of dry mouth in Duloxetine group was lower than that in Amitriptyline group, and the difference was statistically significant(P＜0.05); there were no significant differences in the incidence of nausea, dizziness, lethargy, and palpitation between two groups (P＞0.05). Conclusion Duloxetine Hydrochloride combined with Pregabalin in the treatment of herpes zoster neuralgia has more accurate effect and higher safety, can effectively relieve pain and improve life quality, and is worthy of clinical application.
李小倩 李静 马超 黄莹. 盐酸度洛西汀和阿米替林对带状疱疹性神经痛患者的临床疗效及安全性[J]. 中国医药导报, 2023, 20(34): 124-128.
LI Xiaoqian LI Jing MA Chao HUANG Ying. Clinical efficacy and safety of Duloxetine Hydrochloride and Amitriptyline in patients with herpes zoster neuralgia. 中国医药导报, 2023, 20(34): 124-128.
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