阿霉素椎旁注射对带状疱疹后神经痛患者疼痛程度及血清疼痛递质、细胞因子的影响

Effect of Paravertebral Injection of adriamycin on pain degree,serum pain transmitters and cytokines in patients with postherpetic neuralgia

目的研究阿霉素椎旁注射对带状疱疹后神经痛患者疼痛程度及血清疼痛递质、细胞因子的影响。方法选择2018年5月~2020年1月期间口服及外用镇痛药物治疗无效的60例带状疱疹后遗神经痛患者,采用随机数表分为接受阿霉素椎旁注射的观察组、椎旁神经阻滞的对照组。治疗前后采用视觉模拟评分(VAS)评价疼痛程度,采集血清并测定疼痛递质、细胞因子。结果治疗后1周、1个月及3个月时,观察组的VAS评分低于对照组(P<0.05);治疗后1周,观察组患者的血清P物质(SP)、神经肽Y(NPY)、5-羟色胺(5-HT)、血清降钙素基因相关肽(CGRP)、前列腺素E2(PGE2)、肿瘤坏死因子-α(TNF-α)、高迁移率族蛋白B1(HMGB1)、白细胞介素-2(IL-2)、白细胞介素-8(IL-8)、白细胞介素-26(IL-26)含量均低于对照组(P<0.05)。结论阿霉素椎旁注射能够较椎旁阻滞更为有效地减轻带状疱疹后神经痛患者的疼痛程度并减少疼痛递质、炎性细胞因子的分泌。

Objective To study the effect of Paravertebral Injection of adriamycin on pain degree,serum pain transmitters and cytokines in patients with postherpetic neuralgia.Methods 60 cases of postherpetic neuralgia patients with no response to oral or external analgesics from May 2018 to January 2020 were randomly divided into observation group receiving paravertebral injection of adriamycin and control group receiving paravertebral nerve block.Before and after treatment,visual analogue scale(VAS)was used to evaluate the degree of pain and serum samples were collected,pain transmitters and cytokines were measured.Results The VAS score of the observation group was lower than that of the control group at 1 week,1 month and 3 months after treatment(P<0.05);serum substance P(SP),neuropeptide Y(NPY),5-hydroxytryptamine(5-HT),serum calcitonin gene-related peptide(CGRP),prostaglandin E2(PGE2),tumor necrosis factor-α(TNF-α),high mobility group protein B1(HMGB1),interleukin-2(IL-2),interleukin-8(IL-8),interleukin-26(IL-26)contents of observation group were significantly lower than those of the control group at 1 week after treatment(P<0.05).Conclusion Paravertebral injection of adriamycin is more effective than paravertebral block in relieving pain and reducing the secretion of pain transmitters and inflammatory cytokines in patients with postherpetic neuralgia.