甲强龙联合咪达唑仑治疗腰骶部带状疱疹后神经痛38例临床研究

Analysis on Clinical Efficacy of Methylprednisolone Combined with Midazolam in Treatment of Lumbosacral Postherpetic Neuralgia in 38 Cases

目的观察甲强龙联合咪达唑仑治疗腰骶部带状疱疹神经痛(PHN)的临床疗效。方法选择2012年1月至2013年12月接受治疗的腰骶部PHN患者114例,随机分为甲强龙组、咪达唑仑组与联合组,每组38例。甲强龙组硬膜外给予甲强龙、0.9%氯化钠注射液治疗;咪达唑仑组硬膜外给予0.9%氯化钠注射液联合鞘内给予咪达唑仑治疗;联合组硬膜外给予甲强龙联合鞘内给予咪达唑仑治疗。结果 3组患者治疗后疼痛视觉模拟评分(VAS)以及睡眠质量评分均明显改善,联合组患者治疗后28,56,84 d的VAS以及睡眠质量得分均显著优于甲强龙组、咪达唑仑组(P均<0.05)。3组患者不良反应发生率比较无统计学差异(P>0.05)。结论甲强龙联合咪达唑仑治疗腰骶部PHN的长期镇痛效果良好,不良反应发生率低,安全有效,值得临床应用。

Objective To observe the clinical efficacy of methylprednisolone combined with midazolam in the treatment of lumbosacral postherpetic neuralgia（ PHN）. Methods 114 patients with lumbosacral PHN treated in our hospital from January 2012 to December2013 were selected and randomly divided into the methylprednisolone group,midazolam group and combination group,38 cases in each group. The methylprednisolone group was given methylprednisolone and 0. 9% Na Cl solution by epidural injection; the midazolam group was given 0. 9% Na Cl solution by epidural injection combined with midazolam by intrathecal injection; the combination group was given methylprednisolone by epidural injection combined with midazolam by intrathecal injection. Results The VAS and sleep quality scores after treatment in the three groups were significantly improved, the VAS and sleep quality scores on 28,56,84 d after treatment in the combination group were significantly superior to those in the methylprednisolone group and the midazolam group with statistically significant difference（ P〈0. 05）. There were no statistically significant differences in the occurrence situation of adverse reactions among the three groups（ P〉0. 05）. Conclusion Methylprednisolone combined with midazolam in treating lumbosacral PHN has long term analgesic effect and low occurrence rate of adverse reactions with safety and effectiveness and is worthy of clinical application.