A型肉毒素治疗带状疱疹后遗神经痛的临床观察

Clinical Observation on Botulinum Toxin in the Treatment of Postherpetic Neuralgia

目的:观察A型肉毒素皮内注射治疗带状疱疹后遗神经痛(Postherpetic Neuralgia,PHN)的临床效果。方法:选择76例胸背部带状疱疹后神经痛患者,采用乒乓球抽签法随机分为观察组与对照组,每组38例患者。在口服药物治疗的基础上,观察组与对照组的局部疼痛敏感点分别皮内注射A型肉毒素与生理盐水。比较两组治疗前与治疗后第1、7、30、60天的视觉模拟评分量表(Visual Analogue Scale,VAS)及睡眠质量评分量表(Quality of Sleep,QS)评分的变化。结果:两组患者治疗后第1、7、30、60天的VAS及QS评分均明显低于治疗前(P<0.05),观察组患者治疗后第1、7、30、60天的VAS及QS评分结果明显低于对照组(P<0.05)。两组均未见明显的治疗相关并发症。结论:A型肉毒素皮内注射疗法可以显著减轻PHN患者的疼痛及改善睡眠质量。

Objective： To observe the clinical effect ofbotulinum toxin type A intradermal injection in the treatment of Postherpetic Neuralgia （PHN） of patients with herpes zoster. Methods： 76 cases of thoracic back postherpetic neuralgia patients with table tennis were randomly divided into the observation group and the control group with 38 patients in each group. On the basis of oral drug treatment, observation group and control group were intradermally injected with botulinum toxin type A and saline respectively. The visual ana- logue scale （Visual, Analogue, Scale, VAS） and the sleep quality scale （Quality, Sleep, QS） were evaluated before treatment on the 1st, 7th, 30th and 60th day after treatment. Results： The VAS and QS scores of both groups on the 1st, 7th, 30th and 60th day after treatment were significantly lower than those before treamaent （P〈0.05）, the VAS and QS scores of observation group were obviously lower than those of the control group （P〈0.05）. No serious adverse reactions was observed in both groups. Conclusion： Intradermal injection of botulinum toxin A can significantly alleviate the pain and improve the quality of sleep in patients with PHN.