POST HERPETIC NEURALGIA/AMITRYPTILINE VS MORPHINE IN PATIENT MANAGEMENT

带状疱疹后神经痛/阿米替林与吗啡在患者管理中的比较

• 批准号: 6218286
• 负责人: SRINIVASA N. RAJA
• 金额: $ 0.23万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1998
• 资助国家: 美国
• 起止时间: 1998-12-01 至 1999-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6218286
• 关键词: amitriptyline; analgesia; chronic pain; clinical research; clinical trials; comorbidity; depression; drug screening /evaluation; genital herpes; human subject; human therapy evaluation; interview; medical complication; morphine; outcomes research; pain threshold; patient care management; sensory mechanism; shingles; skin hypersensitivity

The purpose of this research is to determine the effectiveness of two medications, tricyclic antidepressants (TCA) and opioids, compared to a placebo in the treatment of Post-Herpetic Neuralgia. The specific aims are to compare the effects of opioids and TCA against placebo on pain, altered skin sensitivity, and affective and cognitive function. In addition, the study will determine if the therapy with opioids or TCA affects cognitive function that may limit their usefulness in the treatment of PHN. We have studied the relationships between ongoing pain, alterations in thermal sensibility, and allodynia to mechanical and thermal stimuli of patients with PHN to determine the role of peripheral and/or central mechanisms in PHN. Ongoing pain ratings were obtained using a verbal score (0-10). Sensory tests were performed within the affected site, and the corresponding, contralateral, normal site. The area of mechanical allodynia was mapped with a cotton swab and pain evoked by mechanical stimuli (soft hair brush, brass probe, von Frey hairs) was rated on a verbal scale of 0-10. Thermal thresholds to warm, cold, heat pain, and cold pain were determined using a Peltier device and a modified Marstock technique. Measures of cognitive function included the Digit symbol test, Digit Span, a digit cancellation test, the grooved pegboard, and a measure of verbal learning.

本研究的目的是确定三环类抗抑郁药 (TCA) 和阿片类药物这两种药物与安慰剂在治疗带状疱疹后神经痛方面的有效性。 具体目的是比较阿片类药物和 TCA 与安慰剂对疼痛、皮肤敏感性改变以及情感和认知功能的影响。 此外，该研究还将确定阿片类药物或 TCA 治疗是否会影响认知功能，从而可能限制它们在 PHN 治疗中的作用。我们研究了 PHN 患者持续疼痛、热敏感性改变以及对机械和热刺激的异常性疼痛之间的关系，以确定 PHN 中外周和/或中枢机制的作用。 使用言语评分（0-10）获得持续疼痛评级。 在受影响部位和相应的对侧正常部位进行感官测试。 用棉签绘制机械异常性疼痛的区域，并按 0-10 的语言等级对机械刺激（软毛刷、黄铜探针、冯弗雷毛）引起的疼痛进行评分。 使用 Peltier 装置和改良的 Marstock 技术确定热痛、冷痛、热痛和冷痛的热阈值。 认知功能的测量包括数字符号测试、数字跨度、数字取消测试、凹槽钉板和言语学习测量。