加巴喷丁联合神经妥乐平神经阻滞治疗带状疱疹后神经痛的疗效观察

Therapeutic efficacy of gabapentin combined with nerver block in the patients with postherpetic neuralgia

目的:观察口服加巴喷丁联合神经妥乐平神经阻滞治疗带状疱疹后神经痛的疗效。方法:98例带状疱疹后神经痛患者随机分为A、B 2组,A组采用加巴喷丁加神经妥乐平神经阻滞(神经妥乐平3.6IU+维生素B12针1.0mg+2%利多卡因针5mL,用生理盐水稀释至20mL)。B组采用口服加巴喷丁加复方倍他米松神经阻滞(复方倍他米松3.5mg+维生素B12针1.0mg+2%利多卡因针5mL,用生理盐水稀释至20mL)分别行各疱疹分布区的神经干、神经根及皮下注射。以视觉模拟评分法(VAS)和疗效评定评价治疗效果。结果:两组治疗后与治疗前比较以及治疗后两组间比较,VAS评分均明显降低(P<0.01);两组患者的显效率分别为93.87%,75.51%(P<0.05)。结论:加巴喷丁联合神经妥乐平神经阻滞治疗带状疱疹后神经痛疗效确切而且安全。

OBJECTIVE To observe the efficacy of gabapentin combined with neurotropin or compound betamethasone block in treatment of postherpetic neuralgia. METHODS Ninety eight patients with postherpetic neuralgia were divided into observation group and control group at random, then the observation group was treated with gabapentin combined with neurotropin block of never trunk, never root and skin lesion area＇s branch （neurotropin 3. 6 IU ＋ Vitamin Bl2 1.0 mg＋ 2% lidocaine 5 mL, diluted to 20 ml. with 0. 9% sodium chloride） ; the control group was received compound betamethasone block of never trunk, never root and skin lesion area＇s branch （compound betamethasone 3.5 mg ＋ Vitamin B12 1.0 mg ＋ 2% lidoeaine 5 mL,diluted to 20 mL with 11. 9% sodium chloride）. The clinical effect was evaluated before and after treatment by visual analogue scale （VAS） and therapeutic evaluation. RESULTS The VAS of each group decreased obviously after treatment compared with the VAS before treatment （P〈0.01 ）. the VAS of observation group was lower than that of control group after the treatment（P〈0. 01 ）. And the excellence rate of observation group and control group was 93. 87% and 75.51% respectively. and there was large imparity between these two groups （P〈0. 05）. CONCLUSION The strategy of injecting gahapentin combined with neurotropin block was effective and safe in treatment of patients with postherpetic neuralgia.