消痰通络凝胶联合加巴喷丁、甲钴胺治疗带状疱疹后神经痛的临床观察

Clinical observation on Xiaotan Tongluo Gel together with gabapentin and methylcobalamin in the treatment of postherpetic neuralgia

目的观察消痰通络凝胶联合加巴喷丁、甲钴胺治疗带状疱疹后神经痛(PHN)的临床疗效。方法将125例PHN患者随机分为治疗组(65例)和对照组(60例)。两组均给予加巴喷丁胶囊、甲钴胺片口服,在此基础上,治疗组加用消痰通络凝胶局部涂擦,对照组加用安慰剂凝胶,14 d为1个疗程,连续治疗2个疗程。观察临床疗效,比较疼痛视觉模拟评分(VAS)、匹茨堡睡眠质量指数量表(PSQI)评分、血清P物质(SP)水平的变化情况。结果(1)治疗14 d时,治疗组、对照组总有效率分别为70.77%、53.33%,治疗组临床疗效优于对照组(P<0.05);治疗后,治疗组、对照组总有效率分别为89.23%、70.00%,治疗组临床疗效优于对照组(P<0.01)。(2)治疗14 d、治疗后与治疗前组内比较,两组VAS评分、PSQI评分、血清SP水平降低(P<0.01);治疗14 d、治疗后组间比较,治疗组VAS评分、PSQI评分、SP水平低于对照组(P<0.05,P<0.01)。结论与单纯采用加巴喷丁、甲钴胺相比,加用消痰通络凝胶治疗PHN疗效满意,能更好地改善疼痛症状,提高患者的生活质量。

Objective To investigate the clinical efficacy of Xiaotan Tongluo Gel combined with gabapentin capsules and methylcobalamin tablets in treating postherpetic neuralgia(PHN).Methods Totally 125 patients with PHN were randomly divided into a treatment group(n=65)and a control group(n=60).Both groups were administered with gabapentin capsules and mecobalamin tablets orally.Additionally,the treatment group was provided with Xiaotan Tongluo Gel for external application while the control group was provided with placebo gel.Both groups were treated continuously for 2 courses with 14 days in each course.The clinical efficacy was observed,and the changes of Visual Analogue Scale(VAS)score,Pittsburgh Sleep Quality Index(PSQI)score and serum substance P(SP)level were compared.Results(1)The total effective rate was 70.77%in the treatment group and 53.33%in the control group after 14 days of treatment,and the clinical efficacy of the treatment group was better than that of the control group(P<0.05).After 28 days of treatment,the total effective rate was 89.23%in the treatment group and 70.00%in the control group,and the clinical efficacy of the treatment group was better than that of the control group(P<0.01).(2)The VAS score,PSQI score,and serum SP level decreased in both groups after 14 days and 28 days of treatment compared with those before treatment(P<0.01).The VAS score,PSQI score and SP level in the treatment group were lower than those in the control group after 14 days and 28 days of treatment,respectively(P<0.05,P<0.01).Conclusion Compared with the clinical efficacy of gabapentin capsules and methylcobalamin tablets,the application of Xiaotan Tongluo gel together with gabapentin and methylcobalamin has achieved more satisfactory results in the treatment of PHN,which could better alleviate pain and improve patients’quality of life.