无损伤性治疗三叉神经痛的临床研究

The clinical study of noninvasive injections in the treatment of trigeminal neuralgia

目的观察倍他米松加利多卡因治疗原发性三叉神经痛的临床疗效。方法88例原发性三叉神经痛患者随机分为两组，规察组给予复方倍他米松加2％利多卡因（n=56），根据疼痛范围进行相应神经支局部注射；对照组按传统治疗方法给予抗癫痫药卡马西平（n=32）。应用视觉模拟评分法（VAS）评价2组治疗后疼痛的改善情况。结果观察组在第2周末治疗优良率为87.5％，有效率为98.2％，优良率显著高于对照组（28.1％.P〈0.01）。3个月末观察组治疗优良率为75％，有效率为98.2％，均显著高于对照组的18.7％、68.7％（P〈0.01，P〈0.05）。观察组中44例病程1年以下患者经2-3次治疗后效果显著（有效率为100％），12例病程〉1年者（6年2例）有效率为91.7％，显示病程与治疗效果有明显关系。结论复方倍他米松加2％利多卡因用于治疗三叉神经痛简单易行，疗效显著，对早中期三叉神经痛患者有非常好的疗效。

Objective To evaluate the clinical therapeutic effect of nerve branch injection with compound Betamethasone/Lidocaine in patients with idiopathic trigeminal neuralgia. Methods 58 patients with idiopathic trigeminal neuralgia were randomly divided into two groups. Patients in observation group （n=56） were treated with nerve branch injection of compound Betamethasone plus Lidocaine. Patients in control group （n=32） were treated with oral administration of Carbamazepine. The symptoms and signs of pain and numbness were evaluated by vision ambiguity scales （VAS） before and after treatment. Results In week two and three month after treatment excellence rates of pain alleviation were 87.5% ,75% in observation group, and 28.1% ,18.7% in control group. There was significant difference between the two groups （P 〈0.01）. The total effective rate were 98.2%,98.2% in observation group and 81.2% ,68.7% in control group,the significant difference （P 〈 0.05） was seen after treated 13 weeks. 44 patients in observation group whose course of disease was shorter than one year, had excellent response （total effective rate was 100%）. 91.7% total effective rate was shown on 12 patients whose course of disease was longer than one year （two were six years）. Conclusions The results suggest that nerve branch injection with compound Betamethasone/Lidocaine is an effective and safe method in treatment of senile idiopathic trigeminal neuralgia. It is easy to repeat and can provide immediate pain relief of early and intermediate stage.