星状神经节阻滞联合加巴喷丁治疗头面部带状疱疹后神经痛的疗效观察

Efficacy of Stellate Ganglion Block Combined with Gabapendin for the Treatment of Craniofacial Postherpetic Neuralgia

目的观察星状神经节阻滞联合加巴喷丁治疗头面部带状疱疹后神经痛的临床疗效。方法选择头面部带状疱疹后皮损已痊愈、自然病程超过1个月的神经痛患者60例。随机分成加巴喷丁组(GBP组,n=30)和星状神经节阻滞联合加巴喷丁组(SGB-G组,n=30),GBP组予以加巴喷丁及其他补救用药治疗,SGB-G组在GBP组基础上,每日行星状神经节阻滞治疗,观察治疗前和治疗后第3、7、14、21和28日的视觉模拟评分(VAS)、生活质量评分(QOL)、治疗有效率、麻木及痛觉过敏改善状况及补救镇痛药剂量的使用量及不良反应。结果治疗后第3、7、14、21和28日,2组VAS评分、QOL评分较治疗前均有改善(P<0.05),且SGB-G组效果更显著(P<0.05);SGB-G组镇痛效率(90%)高于GBP组(56.7%),差异有统计学意义(P<0.05);随着时间延长,麻木、痛觉过敏的改善情况越来越明显(P<0.05),SGB-G组更为显著(P<0.05);SGB-G组补救辅助镇痛药用量较GBP明显减少,不良反应少。结论星状神经节阻滞联合加巴喷丁治疗头面部带状疱疹后神经痛疗效优于单用加巴喷丁,是一种治疗头面部带状疱疹后神经痛的安全有效的方法。

Objective To observe the efficacy of stellate ganglion block combined with gabapendin for the treatment of craniofacial posthetpetic neuralgia. Methods Sixty patients with craniofacial postherpetic neuralgia whose skin lesions were heal and natural course more than 1 month, were selected for the study and then randomly divided into 2 groups： the gabapendin group （group GBP, n =30）, the steHate ganglion block com- bined with gabapendin group （group SGB-G, n =30）. Group GBP received gabapendin and other remedy drugs. Group SGB-G combined stellate ganglion block everyday with the same administration of gabapentin as group GBP. The visual analogue scale （VAS）, the quality of life （QOL）, the effective rate of pain relieving, the improvement of numb and hyperpathia, and administration of remedy drug and side effects were evaluated before and after the treatment on day 3,7, 14,21 and 28. Results The VAS were significantly declined and the QOL were significantly improved in both groups after the treatment （ P 〈 0.05 ）, and the declination was more significant in group SGB- G than in group GBP （ P 〈 0.05 ） .The effective rate was 90% in group SGB-G, while 56.7% in group GBP （ P 〈 0.05 ）. The numb and hyperpathia was significantly improved in both groups （P 〈0.05 ）, and the improvement was more significant in group SGB-G than in group GBP （P 〈 0.05）. The administration of remedy drug were lower and side effects were less in group SGB-G. Conclusion Stellate ganglion block combined with gabapendin is a safe and effective treatment for craniofacial posther- petic neuralgia, which is more effective than single administration of gabapendin.