摘要
目的观察神经阻滞药物配方中是否使用糖皮质激素对治疗带状疱疹疼痛疗效的影响。方法选择带状疱疹疼痛患者60例，病程〈3个月，数字评分法（NRS）评分≥6，采用随机数字表法分为激素组和无激素组，每组30例，两组在常规治疗同时行责任神经阻滞及皮损区浸润治疗：颈椎、胸椎、腰椎椎旁神经阻滞；无激素组分别用浓度为0．4％、0．4％、0．8％N多卡因5ml；激素组在上述配方的基础上加人地塞米松3mg，比较两组治疗前、后的NRS评分以及两组优效、良效例数及治疗次数的差异。结果两组患者治疗结束后、随访半年及1年时NRS评分均显著下降，无激素组患者NRS评分由治疗前（7．2±1．1）下降为疗程结束后（1．8±1．2）、随访半年时（2．0±1．5）和随访1年时的（1．7±1．3）；激素组由治疗前（7．5±1．4）降为治疗结束后（2．0±1．4）、随访半年时（1．8±1．3）以及随访1年时（1．9±1．2）。NRS评分在各时间点两组间比较差异无统计学意义。两组患者优效、良效例数及治疗次数比较差异无统计学意义。结论神经阻滞在治疗带状疱疹疼痛时，是否使用糖皮质激素对治疗效果无显著性影响。
Objective To assess the efficacy of nerve block with or without glucocorticoid in the management of herpes zoster neuralgia. Methods Sixty patients with herpes zoster were randomly divided into hormone group and hormone free group, 30 cases in each group. The course of disease was within 3 months and the numerical rating scale （NRS） was≥6. At the same time of conventional therapy, all the patients were treated with nerve block. The cervical, thoracic, lumbar paravertebral nerve blocks were performed by injecting lidocaine 5 ml of the concentrations of 0.4%, 0.4%, 0.8% respectively in hormone free group, while adding dexamethasone 3 mg to the above formula in hormone group. The NRS, cases of excellent and good effect, and treatment times in the two groups were compared. Results NRS was significantly decreased in the two groups after the end of the treatment, followed up for six months and for 1 year. After the treatment, NRS reduced from （7.2±1.1） to （1.8±1.2） in hormone free group, from （7.5±1.4） to （2.0±1.4） in hormone group （P〈0.05）. By followed up for half a year and 1 year, NRS decreased to （2.0± 1.5） and （1.7±1.3） in hormone free group, （1.8± 1.3） and （1.9± 1.2） in hormone group respectively. There were no significant differences for NRS of each time point, cases of excellent and good effect, and treatment times between the two groups. Conclusion Glucocorticoid does not promote the efficacy of nerve block in the treatment of herpes zoster neuralgia.
出处
《实用疼痛学杂志》
2017年第6期421-424,共4页
Pain Clinic Journal
