不同剂量复方倍他米松皮内阻滞治疗带状疱疹后神经痛的临床研究

Clinical Study of Intradermal Block Treatment for Post-herpetic Neuralgia Using Different Dose of Compound Betamethasone

目的探讨不同剂量复方倍他米松用于皮内阻滞治疗带状疱疹后神经痛(PHN)的安全性和有效性。方法将2013年6月-2014年12月收治的符合要求的老年PHN患者96例,随机均分为生理盐水对照组(C组)、复方倍他米松0.5 m L组(B0.5组)和复方倍他米松1.0 m L组(B1.0组)。C组镇痛液配方:2%利多卡因5 m L+生理盐水配成20 m L溶液;B0.5、B1.0组配方分别是在C组配方中加入0.5、1.0 m L的复方倍他米松。同组患者于治疗的第1、8、15天皮内注射1次相同配方的镇痛液。所有患者治疗过程口服相同药物。记录患者治疗前、出院时、出院后3个月视觉模拟评分(VAS)、睡眠质量评分(QS)和治疗期间的不良反应。结果 C组1例、B1.0组2例患者退出研究。出院时和出院后3个月时,3组患者VAS、QS均较治疗前明显改善,差异有统计学意义(P<0.05);B0.5、B1.0组VAS、QS较C组明显改善,差异有统计学意义(P<0.05);B0.5、B1.0组间VAS和QS差异无统计学意义(P>0.05)。结论皮内阻滞治疗PHN的20 m L镇痛液中加入0.5或1.0 m L复方倍他米松可明显减轻患者疼痛程度、改善患者睡眠质量;皮内阻滞治疗PHN的20 m L镇痛液中加入复方倍他米松0.5 m L较1.0 m L更合理。

Objective To compare the ef ect of dif erent doses of compound betamethasone intradermal block on post-herpetic neuralgia（PHN） in elderly patients.Methods Between June 2013 and December 2014,96 elderly patients who matched the criteria of PHN were chosen and randomly divided into saline control group（group C）,compound betamethasone 0.5 m L group（group B0.5） and compound betamethasone 1.0 m L group（group B1.0）.For the control group,20 m L analgesic saline liquid including 5 m L of 2% lidocaine was used.And 0.5 and 1.0 m L compound betamethasone was added into the solution of group C to get the solution for group B0.5 and group B1.0,respectively.The patients got intracutaneous injection once in the af ected area on the day 1,8,and 15 respectively,and patients in the same group were injected the same solution of analgesic liquid.All the patients took the same medicine during treatment.Their visual analog scale（VAS） scores,quality of sleep（QS） scores and adverse events before treatment（T0）,at discharging from the hospital（T1）,and three months after discharging（T2） were carefully noted and analyzed.Results The VAS and QS scores of the three groups at T1 and T2 improved signii cantly compared with those at T0（P〈 0.05）.The VAS and QS scores of group B0.5 and group B1.0 improved signii cantly more compared with group C（P〉0.05）,and the dif erence of VAS and QS scores between group B0.5 and group B1.0 was not statistically insignii cant（P〈 0.05）.Conclusions Adding 0.5 m L or 1 m L of compound betamethasone to the 20 m L analgesic liquid for intradermal block treatment on PHN can obviously release patients＇ pain and improve their sleep quality.Compared with 1 m L,adding 0.5 m L compound betamethasone to the 20 m L analgesic liquid for intradermal block treatment on PHN is a more ideal dose.