硬膜外神经阻滞联合药物用于带状疱疹后神经痛治疗的临床观察

Clinical observation of epidural nerve block combined with medication in post-herpetic neuralgia

目的评价连续硬膜外神经阻滞联合药物用于带状疱疹后神经痛(PHN)的效果。方法60例临床诊断为PHN的患者随机分为2组:Ⅰ组(n=30)为药物治疗组,Ⅱ组(n=30)为连续硬膜外神经阻滞联合药物综合治疗组,疗程4周。分别于治疗前,治疗后1、2、3和4周进行视觉模拟评分(VAS)及匹兹堡睡眠质量指数(PSQI)评定,并对患者的疗效进行评价。结果与治疗前比较,两组患者1周后VAS、PSQI评分明显降低(P<0.01),与Ⅰ组比较,Ⅱ组治疗后1、2、3和4周时VAS、PSQI评分明显降低,总有效率升高(P<0.01)。结论连续硬膜外神经阻滞联合药物是治疗PHN安全有效的方法。

Objective To assess the efficacy of continuous epidural nerve block combined with medication in post-herpetic neuralgia（PHN）.Methods 60 patients clinically diagnosed as having PHN were randomly assigned into 2 groups： group Ⅰ（n=30） received routine medication and group Ⅱ（n=30） received continuous epidural nerve block combined with medication for 4 weeks.The clinical effect was evaluated before and every week after treatment by visual analogue scale（VAS） and Pittsburgh sleep quality index（PSQI）.Results Compared to before treatment both group Ⅰand group Ⅱ showed a lower level of VAS and lower PSQI at 1st,2nd,3rd and 4th week of treatment（P0.01）.Compared with group Ⅰ,group Ⅱ had lower VAS and lower PSQI.The treatment efficacy of group Ⅱ was significantly higher（P0.01）.Conclusion Continuous epidural nerve block combined with medication is an efficient and safe way in the treatment of post-herpetic neuralgia.