星状神经节阻滞联合度洛西汀治疗交感神经型颈椎病的临床观察

Clinical observation on treating sympathetic cervical spondylosis by stellate ganglion block combined with dutoxetine

目的:观察星状神经节阻滞联合度洛西汀治疗交感神经型颈椎病病人的临床疗效,为交感神经型颈椎病的治疗提供新的理论依据。方法:将90例临床诊断为交感神经型颈椎病的病人按随机数字表法分为治疗组、对照组和安慰剂组,每组30例,治疗组采用星状神经节阻滞联合度洛西汀治疗,对照组单纯采用星状神经节阻滞治疗,安慰剂组采用星状神经节阻滞+口服淀粉片治疗,8周为1个疗程。评价治疗前、8周治疗结束时及治疗结束后4周三组病人视觉模拟评分法(visual analogue scale,VAS)评分、生活质量健康生活简表(the medical outcomes study 36-item short-form health survey,SF-36)评分、焦虑自评量表(self-rating anxiety scale,SAS)和抑郁自评量表(self-rating depression scale,SDS)评分及匹兹堡睡眠指数(Pittsburgh sleep quality index,PSQI)评分变化情况。结果:经8周治疗后,三组病人疼痛VAS评分及SF-36评分、SAS和SDS评分及睡眠质量PSQI评分均较治疗前明显改善,且治疗组优于对照组和安慰剂组(P<0.05)。结论:星状神经节阻滞联合度洛西汀口服在改善交感神经型颈椎病病人疼痛、生活质量及心慌、头晕等方面优于单纯星状神经节阻滞治疗,且无明显不良反应,值得临床推广应用。

Objective:To observe the clinical efficacy of stellate ganglion block combined with duloxetine in the treatment of patients with sympathetic cervical spondylosis to provide a new theoretical basis for the treatment of sympathetic cervical spondylosis.Methods:Ninety patients clinically diagnosed with sympathetic cervical spondylosis were divided into a treatment group,a control group and a placebo group according to a random number table,with 30 cases in each group.The treatment group was treated with stellate ganglion block combined with duloxetine,the control group was treated with stellate ganglion block alone,and the placebo group was treated with stellate ganglion block+oral starch tablets.The treatment course lasted for 8 weeks.Changes in visual analogue scale(VAS),quality of life the medical outcomes study 36-item short-form health survey(SF-36)score,self-rating anxiety scale(SAS),self-rating depression scale(SDS),and Pittsburgh sleep quality index(PSQI)were evaluated before treatment,after 8-week treatment course,and 4 weeks after treatment.Results:After the 8-week treatment,the pain VAS scores,SF-36 scores,SAS,and SDS scores and sleep quality PSQI scores of patients in all three groups were significantly improved compared with those before treatment,and the improvement of the treatment group was superior to the control and placebo groups(P<0.05).Conclusion:Stellate ganglion block combined with duloxetine is superior to stellate ganglion block treatment alone in reducing pain,improving quality of life,panic,and dizziness in patients with sympathetic cervical spondylosis,with no obvious adverse effects,and is worthy of clinical promotion and application.