带状疱疹后神经痛综合治疗策略的临床研究

Clinical research of comprehensive strategies in treatment of post-herpetic neuralgia

目的探讨综合治疗策略对病程较长的难治性PNH带状疱疹后神经痛的疗效。方法33名临床诊断为难治性带状疱疹后神经痛的患者随机分为3组,每组11例。I组为单纯药物治疗组,II组为神经阻滞配合超激光治疗组,III组为椎间孔神经根阻滞联合药物及超激光照射综合治疗组,疗程为25d。分别于治疗前、治疗后5、10、15、20和25d进行VAPS及VASS评分,对患者治疗后25d进行疗效评价和汉密顿抑郁量表(HAMD)心理测验。结果与I组、II组比较,III组治疗后5、10、15、20和25d时VAPS评分明显降低(P<0.01),VASS评分明显增高(P<0.01);治疗后25d,III组总有效率和显效率均明显高于I组及II组(P<0.01),HAMD量表总分低于I组及II组(P<0.01)。结论椎间孔神经根阻滞联合药物及超激光照射是治疗病程较长带状疱疹后神经痛安全有效的方法。

To investigate the effect of comprehensive strategies in the treatment of post-herpetic neuralgia (PHN) with disease period more than 3 months. 33 patients with PHN were randomly assigned to three groups (11 patients in each group): medication(group I),nerve blocking combined with laser(group II), comprehensive treatment involving medication and nerve blocking combined with laser (group III).25 days was a period of treatment. Visual analogue scale was utilized to assess the degree of pain and the quality of sleep at pre-treatment and post-treatment 5, 10, 15, 20, 25 d respectively. And Hamilton depression scale(HAMD) was used to evaluate the psychological state before and after treatment. There were significant difference between group I and group II (P<0.05) and between group II and group III (P<0.01) in VAS pain scores. VAS sleep scores and HAMD scores in group III were higher than that of the other two groups (P <0.01). [Conclusions] Comprehensive treatment involving medication and nerve blocking combined with laser is an effective method in management of pain resulting from PHN, furthermore, it can also improve the quality of sleep and relieve the symptom of depression.