皮内注射联合口服药物治疗胸背部带状疱疹后神经痛的临床观察

CLINICAL OBSERVATION ON INTRADERMAL INJECTION COMBINED ORAL MEDICATION FOR TREATMENT OF THORACIC AND DORSAL POSTHERPETIC NEURALGIA

目的:观察皮内注射联合口服药物治疗胸背部带状疱疹后神经痛的临床疗效和安全性。方法:60例确诊为胸背部带状疱疹后神经痛的患者,采用数字表法随机均分为两组,对照组(n=30):口服加巴喷丁、神经妥乐平和盐酸曲马多;观察组(n=30):在口服药物的基础上联合疼痛区域的皮内注射治疗。观察治疗前及治疗后不同时期(治疗后7 d、14 d和28 d)疼痛程度和睡眠质量的变化。采用视觉模拟评分(visual analogue scale,VAS)及睡眠质量(quality of sleep,QS)综合评定治疗效果,并记录并发症和不良反应的发生率。结果:两组治疗后各时期VAS评分均较治疗前明显降低,睡眠质量评分均较治疗前明显增加(P<0.01);观察组在治疗后各时期VAS评分较对照组同期明显降低,睡眠质量评分较对照组同期明显升高(P<0.01)。观察组在治疗后24 h内未出现局部血肿。两组患者在口服药物后出现程度不等的不良反应,患者均可耐受。结论:皮内注射联合口服药物治疗胸背部带状疱疹后神经痛效果好,可以迅速缓解疼痛症状、改善患者睡眠质量,且安全性良好。

Objective： To investigate the efficacy and safety of intradermal injection combined with oral medication to alleviate the thoracic and dorsal postherpetic neuralgia（PHN）. Methods： 60 patients with PHN were randomly divided into two groups（each n =30） according to digital table. Patients in the control group received oral medication（gabapetin, neurotropin, tramadol hydrochloride）, whereas those in the observation group were treated with oral medication combined with intradermal injection. Changes in pain degree and sleep quality were observed before treatment and at different time points after treatment（7 d, 14 d and 28 d）. The VAS and the scores of quality of sleep were selected to evaluate the curative efficacy, and the complications and adverse reactions were recorded. Results： The VAS in both groups were all decreased significantly at different time points after treatment compared with pre-treatment（P〈0.01）, and the sleep quality scores were increased significantly at different time points after treatment compared with pretreatment（P〈0.01）. The VAS of observation group were decreased significantly after treatment compared with control group（P〈0.01）, the sleep quality scores of observation group were increased significantly after treatment compared with control group（P〈0.01）. No hematoma was found within 24 h after treatment in observation group. The patients in both groups developed some mild adverse reactions after oral drug treatment, and can tolerate them well. Conclusion： Intradermal injection with oral medication can rapidly alleviate the thoracic and dorsal PHN safely and enhance the quality of sleep.