星状神经节阻滞联合普瑞巴林治疗头面部急性带状疱疹的临床研究

Clinical study of stellate ganglion block combined with pregabalin in the treatment of craniofacial acute herpes zoster

目的 探讨星状神经节阻滞联合普瑞巴林治疗头面部急性带状疱疹(HZ)的疗效、安全性及对带状疱疹后遗神经痛(PHN)的预防作用。方法 将68例患者随机分为普瑞巴林组(P组)和星状神经节阻滞联合普瑞巴林组(S组),各34例。P组患者给予普瑞巴林及其他补救药物治疗;S组患者在P组治疗方案的基础上,用0.2%罗哌卡因4ml行患侧星状神经节阻滞(SGB)。所有患者均行抗病毒治疗。观察治疗前后疱疹特征、视觉模拟评分(VAS)、匹兹堡睡眠质量指数(PSQI)变化,统计镇痛药物使用量,记录治疗后PHN发生率及不良反应发生情况。结果 在疱疹特征方面,与P组相比,S组的止疱时间、结痂时间、皮损愈合时间明显缩短(P<0.05);在镇痛效果方面,与P组相比,S组VAS评分及镇痛药物使用量均显著降低(P<0.05);在睡眠质量方面,与P组相比,S组PSQI评分降低(P<0.05);在PHN发生率方面,与P组相比,S组在1个月、3个月、6个月随访时发生率明显降低(P<0.05);在安全性方面,两组患者在研究期间均无明显不良反应发生。结论 星状神经节阻滞联合普瑞巴林治疗头面部急性带状疱疹较单独使用普瑞巴林相比,在疱疹愈合、镇痛效果、睡眠质量提高、镇痛药物使用量减少方面均有较大优势。

Objective To investigate the efficacy,safety and preventive effect on postherpetic neuralgia(PHN)of stellate ganglion block(SGB)combined with pregabalin in the treatment of craniofacial acute herpes zoster.Methods Sixty-eight patients were randomly divided into two groups.Group P(n=34)accepted pregabalin and other remedial drugs.Group S were treated with 4ml of 0.2%ropivacaine to perform SGB on the affected side based on the group P.All patients were treated with antiviral therapy.The characteristics of herpes,visual analog score(VAS)and Pittsburgh sleep quality index(PSQI)were observed before and after treatment.The dosage of analgesic drugs,the incidence of PHN and adverse reactions were recorded.Results Compared with group P,the blister stopping time,scab forming time and skin wound healing time in group S were shorter(P<0.05).VAS and the dosage of analgesic drugs in group S were lower than that in group P(P<0.05).Compared with group P,PSQI score in group S decreased.Patients were followed up at 1 month,3 months and 6 months,the incidence of PHN in group S was significantly lower than that in group P(P<0.05).No serious adverse reactions occurred in two groups during the study.Conclusion The efficacy of stellate ganglion block combined with pregabalin in the treatment of craniofacial acute herpes zoster in patients is better than pregabalin alone.