卡马西平联合脉冲射频治疗三叉神经痛患者的疗效及对患者氧化应激、炎症因子、微量元素和免疫功能的影响

Efficacy of carbamazepine combined with pulsed radiofrequency therapy for patients with trigeminal neuralgia and its effects on patients′oxidative stress,inflammatory factors,trace elements and immune function

目的探讨卡马西平联合脉冲射频治疗三叉神经痛患者的疗效及对患者氧化应激、炎症因子、微量元素和免疫功能的影响。方法选取106例三叉神经痛患者,按照随机数字表法分为脉冲射频组和联合治疗组,各53例。脉冲射频组采用脉冲射频治疗,联合治疗组采用卡马西平联合脉冲射频治疗。比较两组患者治疗前后的疼痛视觉模拟量表(VAS)评分、生活质量评分、氧化应激指标[一氧化氮、谷胱甘肽过氧化物酶(GSH-Px)、超氧化物歧化酶(SOD)]、炎症因子[白细胞介素(IL)-6、IL-1β、肿瘤坏死因子α(TNF-α)]水平、微量元素(锌、铁、镁、钙)、免疫细胞(CD3+T淋巴细胞、CD4+T淋巴细胞、CD8+T淋巴细胞)水平,并观察治疗期间的不良反应发生情况及治疗20 d后的治疗效果。结果治疗后,联合治疗组的疼痛VAS评分及血清一氧化氮、IL-6、IL-1β、TNF-α、钙水平,以及CD8+T淋巴细胞、CD3+T淋巴细胞水平低于脉冲射频组,生活质量评分及血清SOD、GSH-Px、锌、铁、镁水平,以及CD4+T淋巴细胞水平均高于脉冲射频组,且联合治疗组治疗总有效率高于脉冲射频组(均P<0.05);治疗期间,两组患者不良反应发生率差异无统计学意义(P>0.05)。结论相较于单一的脉冲射频,卡马西平联合脉冲射频治疗三叉神经痛短期疗效更显著,更能缓解患者疼痛,降低患者炎症反应及氧化应激水平,改善患者免疫功能及生活质量,不良反应较少。

Objective To investigate the efficacy of carbamazepine combined with pulsed radiofrequency therapy for patients with trigeminal neuralgia and its effects on patients′oxidative stress,inflammatory factors,trace elements and immune functions.Methods A total of 106 patients with trigeminal neuralgia enrolled were divided into pulse radiofrequency group and combined treatment group according to the random number table method,with 53 cases in each group.The pulse radiofrequency group received pulse radiofrequency therapy,and the combined treatment group received carbamazepine combined with pulse radiofrequency therapy.The related indices of the patients before and after treatment were compared between the two groups,including the Visual Analogue Scale(VAS)pain score,quality of life score,oxidative stress indices(nitric oxide,glutathione peroxidase[GSH-Px],superoxide dismutase[SOD]),inflammatory factors(interleukin[IL]-6,IL-1β,tumor necrosis factorα[TNF-α])levels,trace elements(zinc,iron,magnesium,calcium),and immunocytes(CD3+T lymphocytes,CD4+T lymphocytes,CD8+T lymphocytes)levels.And the occurrence of treatment-emergent adverse reactions and the therapeutic effects after 20 days of treatment were observed.Results After treatment,the combined treatment group yielded lower VAS pain score and serum levels of nitric oxide,IL-6,IL-1β,TNF-αand calcium,decreased levels of CD8+T lymphocytes and CD3+T lymphocytes,a higher score of quality of life,elevated serum SOD,GSH-Px,zinc,iron and magnesium levels,and a higher level of CD4+T lymphocytes as compared with the pulse radiofrequency group;moreover,the total effective rate for treatment in the combined treatment group was higher than that in the pulse radiofrequency group(all P<0.05).There was no statistically significant difference in the incidence rate of adverse reactions between the two groups during treatment(P>0.05).Conclusion Compared with single pulse radiofrequency therapy,carbamazepine combined with pulse radiofrequency therapy has more remarkable short-term efficacy for trigeminal neuralgia,which can alleviate patients′pain preferably,reduce patients′inflammatory response and oxidative stress levels,improve patients′immune functions and quality of life,having fewer adverse reactions.