摘要
特发性三叉神经痛(TN)是一种常见的神经系统疾病,主要特征为无明确病因情况下出现的面部三叉神经分布区域的阵发性剧烈疼痛,疼痛的诱因和类型复杂多样,严重影响患者的生活质量。常规一线药物(如卡马西平)常因疗效不足或难以耐受的副作用限制使用,且部分患者拒绝手术治疗。本文报道了1例患有特发性TN伴焦虑症状的中年男性患者,经普瑞巴林联合小剂量度洛西汀治疗后,焦虑症状改善并且疼痛发作频率和强度逐渐控制;其特异性在于结合两种不同机制的药物,旨在协同镇痛并且改善长期疼痛给患者带来的情绪问题。本病例关注普瑞巴林联合小剂量度洛西汀的治疗效果,提示了度洛西汀作为抗抑郁药,在治疗特发性TN等神经病理性疼痛方面有着显著效果,可能是治疗难治性或并不能耐受一线药物的特发性TN患者的替代方案,为临床医师提供安全有效的治疗选择方法。
Trigeminal neuralgia(TN)is a common neurological disorder,the main characterized by paroxysmal severe pain in the distribution area of the trigeminal nerve in the face without a clear etiology,with a variety of triggers and types of pain,which seriously affects the quality of life of patients.Conventional first-line drugs(Carbamazepine)were often limited in use due to insufficient efficacy or intolerable side effects,and some patients refuse surgical treatment.This article reported a case of a middle-aged male patient with idiopathic TN with anxiety symptoms,who was treated with Pregabalin in combination with low-dose Duloxetine,resulting in improvement of anxiety symptoms and gradual control of the frequency and intensity of pain episodes.The specificity of this case lies in the combination of two drugs with different mechanisms aimed at synergizing analgesia and improving the emotional problems associated with chronic pain.This case focuses on the therapeutic effect of Pregabalin in combination with low-dose Duloxetine,suggesting that Duloxetine,as an antidepressant,has significant efficacy in the treatment of neuropathic pain,such as idiopathic TN,and may be an alternative for the treatment of patients with idiopathic TN who are refractory to treatment or who cannot tolerate first-line medications,providing clinicians with safe and effective therapeutic options.
作者
滕雅馨
徐子淇
尹彦方
赵晓勇
TENG Yaxin;XU Ziqi;YIN Yanfang;ZHAO Xiaoyong(School of Anesthesiology,Shandong Second Medical University,Shandong Province,Weifang 261053,China;Department of Pain Medicine,Affiliated Hospital of Shandong Second Medical University,Shandong Province,Weifang 261042,China;Department of Anesthesiology,Shandong Cancer Hospital,Shandong Province,Jinan 250117,China)
出处
《中国医药导报》
2025年第20期187-190,共4页
China Medical Herald
基金
中国博士后科学基金项目(2024T170529)
山东省博士后创新项目(SDCX-ZG-202400048)。
