三种方法治疗带状疱疹后遗神经痛的疗效比较

The Observation of theTreatment Effects of Three Approaches for Postherpetic Neuralgia

目的观察牛痘疫苗致炎兔皮提取物静脉点滴与复方倍他米松(得宝松)椎旁神经阻滞和多柔比星椎旁神经根毁损对带状疱疹后遗神经痛(PHN)的治疗效果。方法将360例PHN患者随机分为三组,每组120例。A组:牛痘疫苗致炎兔皮提取物静脉点滴治疗;B组:局麻药联合牛痘疫苗致炎兔皮提取物和复方倍他米松椎旁神经阻滞治疗;C组:多柔比星椎旁神经根毁损治疗。观察治疗前后不同时期疼痛程度变化,以视觉模拟评分(VAS)评定治疗效果。结果三组治疗后较治疗前VAS评分均有明显降低(P<0.05),且B,C两组VAS评分明显低于A组(P<0.05),C组VAS评分明显低于A,B两组(P<0.05)。结论多柔比星椎旁神经毁损治疗能迅速缓解或解除带状疱疹后遗神经痛,疗效明显优于单纯使用牛痘疫苗致炎兔皮提取物和联合用药椎旁神经阻滞。

Objective To investigate the tre＇atment effects on the patients who are suffering from postherpetic neuralgia（PHN） by drugs administration. Treatments consisted of cowpex vaccine-induced in rabbit skin extract intravenous viral injection;compound betamethasone by paravertebral nerve block and doxoru- bicin by paravertbral nerve root damage. Methods 360 case of PHN were randomly divided into threegroups, each group had 120 cases.Group A was treated with cowpox vaccine-induced inflammation in rabbit skin extract by intravenous. Group B was treated with local anesthetics allied cowpox vaccine-induced in- flammation in rabbit skin extract and compound betamethasone by paravertebral nerve block. Group C wastreated with doxorubicin by paravertebral nerve root damage. Observing the changes of pain in different pe- riods before and after treatment. The treatment effect were evaluated by visual analog scale （VAS）. Results Compared treatment with before ,VAS were significantly lower（P〈 0.05）in three groups than before, group B and C were significantly lower than group A（P〈 0.05）, group C were significantly lower than group A and B（P 〈 0.05）. Conclusion The postherpetic neuralgia （PHN） were rapidly remission or remove with doxoru- bicin by paravertebral nerve damage, which effects significantly better than the cowpox vaccine-induced in- flammation in rabbit skin extract only and combination drugs administration by parevertebral nerve block.