电流感觉阈值测定对三叉神经痛患者感觉定量评估作用

Effect of current perception threshold measurement on sensory quantitative evaluation of trigeminal neuralgia patients

目的探讨电流感觉阈值(CPT)测定对三叉神经痛患者感觉定量的评估作用。方法选择2017年1月—2018年10月江西省人民医院神经内科住院部或门诊临床确诊为原发性三叉神经痛下颌支受累的患者26例,所有患者均常规给予营养神经的药物治疗。在治疗前、治疗后7、14 d对患者进行CPT测定和简化麦吉尔(McGill)疼痛问卷评分表(SF-MPQ)测评,比较CPT和SF-MPQ疼痛评分,评价CPT在三叉神经痛患者治疗前后的感觉功能中的应用价值。结果治疗前用5、250 Hz刺激,患侧CPT高于健侧,差异均有统计学意义(均P<0.05),而用2000 Hz刺激,两侧CPT比较,差异无统计学意义(P>0.05)。患侧治疗后7、14 d CPT与治疗前比较,5、250 Hz刺激下的CPT均有所下降,差异均有统计学意义(均P<0.05),而2000 Hz刺激下患侧治疗后7、14 d CPT与治疗前比较,差异无统计学意义(P>0.05)。治疗后7、14 d SF-MPQ疼痛评分低于治疗前,差异均有统计学意义(均P<0.05)。Pearson相关分析显示,治疗前,治疗后7、14 d的SF-MPQ疼痛评分与患侧下颌支5 Hz刺激下CPT呈正相关(r=0.656、0.418、0.697,P<0.05)。结论CPT可量化地检测三叉神经痛患者治疗前后的感觉功能,客观地评估治疗前后病情程度及治疗效果。

Objective To evaluate the effect of current perception threshold(CPT)measurement on sensory quantification in patients with trigeminal neuralgia.Methods From January 2017 to October 2018,26 patients with primary trigeminal neuralgia involving the mandibular branches were selected from the Inpatient Department of Neurology or Outpatient Department of Jiangxi Provincial People′s Hospital.All patients were routinely treated with nutritive nerve drugs.The CPT and the simplified McGill pain questionnaire(SF-MPQ)were measured before,7 and 14 days after treatment,and the CPT and SF-MPQ pain score were compared to evaluate the application value of CPT in the sensory function of patients with trigeminal neuralgia before and after treatment.Results Before treatment,when stimulated by 5 and 250 Hz,CPT on the affected side was higher than that on the healthy side,with statistically significant differences(all P<0.05);while when stimulated by 2000 Hz,CPT on both sides showed no statistically significant difference(P>0.05).CPT at 7 and 14 days after treatment on the affected side decreased under 5 and 250 Hz stimulation compared with before treatment,and the differences were statistically significant(all P<0.05),while CPT on the affected side at 7 and 14 days after treatment under 2000 Hz stimulation was not statistically significant compared with that before treatment(P>0.05).The pain score of SF-MPQ at 7 and 14 days after treatment was lower than that before treatment,and the differences were statistically significant(all P<0.05).Pearson correlation analysis showed that SF-MPQ pain score at 7 and 14 days after treatment was positively correlated with CPT under 5 Hz stimulation of the affected mandibular branches(r=0.656,0.418,0.697,P<0.05).Conclusion CPT can quantitatively detect the sensory function of patients with trigeminal neuralgia before and after treatment,and objectively evaluate the severity of the condition before and after treatment and the therapeutic effect.