臭氧大自血联合神经阻滞疗法治疗带状疱疹后神经痛的研究

Study on Treatment of Postherpetic Neuralgia with Ozone Large Self-bloodcombined with Nerve Block Therapy

目的观察臭氧大自血联合神经沮滞治疗带状疱疹后遗神经痛(PHN)的临床疗效和安全性。方法将60例PHN患者随机分为三组。A组:给予口服加巴喷丁900mg/d(4周);B组:给予超声引导下神经阻滞治疗,2次/周(2周),并口服加巴喷丁900mg/d(4周);C组给予超声引导下神经阻滞治疗,2次/周(2周),口服加巴喷丁900mg/d(4周),臭氧大自血治疗(1次/d,连续10d)。比较单纯药物治疗与联合神经阻滞治疗,及配合臭氧大自血治疗后疼痛缓解程度(VAS评分)、情绪评分(emotional scale,ES)、爆发痛次数。结果三组患者治疗后的各个时间点与治疗前相比VAS评分、ES评分及爆发痛次数均明显降低。三组患者相比较,A组患者疗效最差,治疗后28d,VAS评分(3.51±0.79)分,ES评分(1.35±0.75)分,爆发痛次数(0.80±0.77)次。C组患者疗效最佳,治疗后28d爆发痛发生(0.05±0.22)次,VAS评分(0.48±0.39)分,ES评分(0.40±0.50)分,患者情绪良好,应答自如,面容安静。结论药物联合神经阻滞及臭氧大自血治疗PHN疗效更好,能显著改善患者生活质量。

Objective To observe the efficacy and safety of ozone large self-bloodcombined withnerve block in the treatment of postherpetic neuralgia（ PHN）.Methods 60 patients with PHN were randomly divided into three groups.Group A： oral gabapentin 900 mg/d（ 4 weeks）; Group B： nerve block guided by ultrasound twice a week（ 2 weeks） and oral gabapentin 900 mg/d（ 4 weeks）; Group C： nerve block guided by ultrasound twice a week（ 2 weeks）,oral gabapentin 900 mg/d（ 4 weeks）,and Ozone self-blood therapy（ once a day,for 10 days）.After treatment with simple drug therapy,combined nerve block therapy,and combined ozone large self-blood therapy,the degree of pain relief（ VAS score）,emotional scale（ ES） and the frequency of pain outbreak were compared.Results After treatment,compared with before treatment,the VAS score,the ES score and the frequency of pain outbreak in the three groups were significantly decreased at each time point.During the three groups,the curative effect of group A was the worst： after 28 days of treatment,the VAS scorewas was（ 3. 51± 0. 79）,the ES score was（ 1. 35± 0. 75）,and the times of pain outbreak were（ 0. 80±0. 77）; Group C had the best curative effect： after 28 days of treatment,there was almost no outbreak of pain and the VAS score was（ 0. 48 ± 0. 39）,patients in good mood,free response and quiet face. Conclusion Drugs combined with nerve block and ozone large self-blood therapy are more effective in the treatment of PHN,which can significantly improve the quality of life of patients.