神经阻滞联合口服药物治疗带状疱疹后遗神经痛临床观察

Effects of Nerve Block Combined with Oral Administration Drugs on Postherpetic Neuralgia

目的比较单纯口服药物和联合神经阻滞两种方法治疗带状疱疹后遗肋间神经痛(PHN)的效果。方法40例病程超过6个月的PHN患者,分成两组,每组各20例。A组口服卡马西平、多塞平、双氯芬酸钠、B族维生素,B组在口服上述药物的基础上应用醋酸曲安奈德、弥可保、0.4%利多卡因行肋间神经阻滞。比较两组患者治疗前、治疗后3周和治疗后6个月的视觉模拟评分(VAS)。结果B组患者在治疗后3周和6个月VAS均较治疗前明显降低(P<0.01),A组在治疗后3周VAS低于治疗前,6个月后与治疗前无显著性差异。组间比较:B组治疗后3周和6个月VAS均明显低于A组(P<0.01)。结论神经阻滞联合口服药物治疗顽固PHN止痛作用强,疗效持久。

Objective To evaluate the efficacy of nerve block combined with oral administration drugs on postherpetic neuralgia （PHN）. Methods 40 patients were assigned into 2 groups： group A （n：20） accepted carbamazepine, doxepin, diclofenac sodium, and vitamin B compound; while group B （n=20） combined with intercostal nerve block. The pain was assessed with visual analogue scale （VAS） before, 3 weeks and 6 months after treatment. Results The scores of VAS decreased significantly after treatment corn pared with the baseline in groups 13 （P〈0.01）, but only 3 weeks after treatment in group A, and it decreased more in group B than in group A （P〈0.01） at any time after treatment. Conclusion Nerve block combined with oral administration drugs is effective on PHN.