脉络宁复合液经两种神经阻滞方法治疗带状疱疹后神经痛

TREATMENT OF POSTHERPETIC NEURALGIA WITH MAILUONING COMPOUND LIQUID BY TWO NERVE BLOCK METHODS

目的:观察脉络宁复合液硬膜外神经阻滞治疗带状疱疹后神经痛(Postherpetic Neuralgia,PHN)的临床效果.方法:选取68例颈、胸、腰段PHN病人为研究对象,单盲随机分为观察组和对照组,每组34例.观察组采用脉络宁复合液硬膜外神经阻滞;对照组采用脉络宁复合液后支神经阻滞.两组病人每周治疗一次,疗程6周,3个月后随访.观察治疗前后视觉模拟评分(visual analogue scale,VAS)、汉密尔顿抑郁量表(Hamilton Depression Scale,HAMD)评估,VAS加权值VAS-WV作为疼痛治疗有效率指标,评定治疗总有效率.结果:治疗6周后,两组病人VAS评分治疗后与治疗前比较有明显降低,差异有统计学意义P<0.05,治疗后观察组与对照组比较改善更为显著,差异有统计学意义P<0.05;HAMD评分两组病人治疗后与治疗前比较显著降低P<0.05,治疗后观察组各项指标评分均低于对照组P<0.05;观察组的总有效率为88.24%,明显高于对照组的70.59%,两者具有显著的统计学差异P<0.05.结论:脉络宁复合液治疗PHN取得满意的临床效果,硬膜外神经阻滞效果更好,明显优于后支神经阻滞.对不适于糖皮质激素治疗的病人,亦可选择脉络宁复合液进行治疗,值得在临床上推广应用.

Objective:To observe the clinical efficacy of epidural nerve block with Mailuoning compound liquid (MCL) for postherpetic neuralgia (PHN). Methods:Sixty-eight patients with cervical, thoracic and lumbar PHN were randomly divided into observation group (n = 34) and control group (n = 34). The observation group was treated with epidural nerve block of MCL. The control group was treated with posterior branch nerve block of MCL. Patients in both groups were treated once a week for 6 weeks and followed up after 3 months. Visual analogue score (VAS) and score of Hamilton Depression scale (HAMD) were observed before and after treatment. VAS weighted value (VAS-WV) was used to evaluate the total effective rate of treatment. Results:After 6 weeks of treatment, the VAS scores of the two groups were significantly lower than those before treatment (P < 0.05), and the improvement of the observation group was more significant than that of the control group (P < 0.05). The HAMD scores of the two groups after treatment were significantly lower than those before treatment (P < 0.05), and all the indexes of the observation group after treatment were lower than those of the control group (P < 0.05). The total effective rate of the observation group was 88.24%, which was significantly higher than that of the control group 70.59%(P < 0.05). Conclusion:The treatment to PHN with MCL is effective, and epidural nerve block is better than posterior branch nerve block. The patients who are not suitable for glucocorticoid therapy can also be treated with MCL, which is worth to popularize in clinic.