舒芬太尼联合甲强龙鞘内注射治疗下肢带状疱疹后神经痛的疗效观察

Clinical observation on intrathecal sufentanil combined with methylprednisolone in the treatment of lumbasacralpostherpetic neuralgia

目的观察舒芬太尼联合甲强龙鞘内注射治疗带状疱疹后神经痛的疗效和安全性。方法 60例带状疱疹后神经痛病人随机数字表法均分为两组:舒芬太尼复合甲强龙组(MS组)鞘内注射舒芬太尼5μg复合甲强龙10 mg混合液5 mL,甲强龙组(M组)鞘内注射甲强龙10 mg/5 mL,观察两组病人治疗前、治疗后1、2、4、12周疼痛评分、睡眠质量评分以及爆发痛的补救镇痛药物用量,并记录两组病人住院期间的不良反应。结果与治疗前相比,两组病人治疗后1、2、4、12周疼痛视觉模拟评分(VAS评分)均降低,睡眠质量评分升高(P<0.05);与M组比较,MS组病人治疗后4、12周疼痛VAS评分显著降低,睡眠质量评分显著升高(P<0.05);MS组病人治疗后1、2、4、12周补救药物用量明显小于M组(P>0.05);两组病人治疗后不良反应差异无统计学意义(P>0.05)。结论舒芬太尼复合甲强龙鞘内注射治疗带状疱疹后神经痛长期疗效好,是一种安全有效的治疗方法。

Objective To observe the effect of intrathecal sufentanil combined with methylprednisolone in the treatment of lumbasacral-postherpetic neuralgia. Methods Sixty patients with postherpetic neuralgia were randomized into sufentanil combined with methylpred-nisolone group （group MS, 30 cases） and methylprednisolone group （group M,30 cases）. Group MS was given sufentanil 5 ｜jig plus methylprednisolone 10 mg mixture 5 mL while group M was given methylprednisolone 10 mg/5 mL. Changes in pain degree and sleep quality and remedies dosage of outbreak pain were observed before treatment and at different time points after treatment（the 1,2,4 and 12 week） ,and adverse reactions were recorded. Results Compared with before treatment,theVAS score of group MS decreased signifi-cantly at different time points after treatment （P 〈 0 . 05） while the sleep quality score was increased significantly （ P 〈 0. 05 ） . Com-pared with group M,theVAS score of group MS decreased significantly and sleep quality score increased significantly at 4,12 week after treatment （P 〈0. 0 5 ） . The remedies dosage of outbreak pain in group MS was significantly less than group M at different time points af-ter treatment （P 〈0. 05） . The incidences of adverse reactions were not different between two groups （P 〉 0. 05 ） . Conclusions In-trathecal injection of sufentanil combined with methylprednisolone in the treatment of lumbasacralpostherpetic neuralgia is a safe and ef-fective clinical treatment.