无损伤性治疗原发性三叉神经痛的临床观察

Clinical study of noninvasive treatment for primary trigeminal neuralgia

目的评价局部封闭联合卡马西平治疗原发性三叉神经痛的临床效果。方法选择2005年9月—2011年6月本院口腔科收治的60例原发性三叉神经痛患者,其中男26例,女34例,年龄30～70岁。采取随机数字表方法分为试验组和对照组1(局部封闭)、对照组2。试验组采用地塞米松1 mg、维生素B1100 mg、维生素B121 mg和2%利多卡因1 ml混合液行局部封闭,2次/周,共4周,同时口服卡马西平;对照组1单纯局部封闭,对照组2单纯口服卡马西平。采用疼痛视觉模拟评分法(VAS)对疼痛进行评估,并比较治疗前后的疗效。结果治疗后1个月和6个月时试验组的优良率(95.00%和80.00%)与对照组1(50%和45%)、对照组2(50%和45%)比较,差异均有统计学意义(P<0.05)。治疗后1个月试验组和对照组VAS值均显著下降,且组间差异有统计学意义(P<0.05);6个月后三组VAS值均增高,且差异仍有统计学意义(P<0.05)。结论局部封闭联合卡马西平治疗原发性三叉神经痛是一种有效和安全的方法。

Objective To assess the clinical effects of local blockade combined with Carbamazepine in the treatment for patients with primary trigeminal neuralgia. Methods From September 2005 to June 2011,60 cases（26 males and 34 females,aged from 30 to 70）,in our hospital were divided into three groups by random number table method.Experiment group was treated by local blocked with solution of 2% Lidocaine 1mL,Dexamethasone 1 mg,vitamin B1 100mg and vitamin B12 1mg,twice a week,for 4 weeks,and Carbamazepine was given orally.In control group Ⅰ,given locally blocked only,and the other control group Ⅱ,Carbamazepine was given orally only.The intensity of pain was evaluated by means of the Visual Analogue Scale（VAS） and the effects before and after treatment were compared. Results After 1 month and 6 months,the excellence rate in experiment group were 95.00% and 80.00%,compared with control group Ⅰ（50% and 45%） and control group Ⅱ（50% and 45%）,the difference has statistical significance（P0.05）.After 1 month,the VAS level in all groups were significantly decreased,the difference between groups has statistical significance（P0.05）;after 6 months,the VAS level in all groups were increased,the difference between groups has statistical significance（P0.05）. Conclusion The local blockade combined with Carbamazepine is an effective method to treat trigeminal neuralgia.