超声引导星状神经节阻滞联合度洛西汀治疗伴有失眠的颈源性头痛患者的疗效分析

Effect Analysis of Ultrasound-guided Stellate Ganglion Block Combined with Duloxetine in the Treatment of Cervicogenic Headache Patients with Insomnia

目的:探讨超声引导星状神经节阻滞联合度洛西汀治疗伴有失眠的颈源性头痛(CEH)的疗效。方法:选取2018年1月至2019年5月北京市房山区第一医院疼痛科收治的伴有失眠的颈源性头痛患者80例作为研究对象,按照随机数字表法分为对照组和观察组,每组40例。2组均接受超声引导星状神经节阻滞,1次/周,共4次。观察组除星状神经节阻滞外,加口服度洛西汀。治疗前、治疗4周后采用视觉模拟评分法(Visual Analogue Scale,VAS)和临床疗效评估判定疼痛治疗效果,睡眠质量(Sleep Quality,QS)评分判定失眠是否改善,同时观察不良反应。结果:治疗前VAS评分2组间比较,差异无统计学意义(P>0.05),治疗后2组VAS评分较治疗前均明显降低,差异有统计学意义(P<0.05),2组间临床疗效评估,差异有统计学意义(P<0.05),2组间QS比较,差异有统计学意义(P<0.001),2组均无严重不良反应。结论:超声引导星状神经节阻滞联合度洛西汀可以有效减轻疼痛,改善失眠,联合治疗效果更佳,且未见明显不良反应。

Objective:To explore the clinical efficacy of ultrasound-guided stellate ganglion block combined with duloxetine in the treatment of cervicogenic headache(CEH).Methods:80 patients with cervicogenic headache who were admitted to the pain department of our hospital from January 2018 to May 2019 were randomly divided into the control group and the observation group.Both groups underwent ultrasound-guided stellate ganglion block.1 time per week,and 4 times in total.In addition to stellate ganglion block,the observation group was given Duloxetine orally.Before and after treatment,visual analog scale(VAS)and clinical efficacy evaluation were used to determine the effect of pain treatment,sleep quality(QS)score to determine whether insomnia was improved,and adverse reactions were observed.Results:VAS score before treatment showed no significant difference between the two groups,and VAS score after treatment was significantly lower than that before treatment(P<0.05).Clinical efficacy evaluation showed significant difference between the two groups(P<0.05),sleep quality(QS)showed significant difference between the two groups(P<0.001),and no serious adverse reactions were found between the two groups.Conclusion:Ultrasound-guided stellate ganglion block combined with duloxetine can effectively reduce pain and improve insomnia,and the combined treatment has a better effect without obvious adverse reactions.