微球囊压迫与口服卡马西平治疗三叉神经痛的效果及安全性比较

Comparison on the efficacy and safety of microballoon compression and carbama-zepine in the treatment of trigeminal neuralgia

目的比较微球囊压迫与卡马西平治疗三叉神经痛的效果及安全性。方法选取收治的120例原发性三叉神经痛患者,用随机数字表法均分为微球囊压迫组和药物治疗组,每组60例。微球囊压迫组采用经皮穿刺微球囊神经节压迫治疗,药物治疗组口服卡马西平治疗。比较2组治疗结束后的临床疗效、治疗前后的疼痛视觉模拟评分(visual analogue scale,VAS)和生活质量综合评定问卷-74(general quality of life inventory-74,GQOL-74)评分、治疗前后血清炎症因子[白细胞介素-1β(interleukin-1β,IL-1β)、白细胞介素-6(interleukin-6,IL-6)及肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)]的水平。比较2组不良反应的发生情况。结果微球囊压迫组的治疗总有效率高于药物治疗组(91.67%vs.75.00%,P<0.05)。治疗后,微球囊压迫组患者各时间点的VAS均低于药物治疗组,GQOL-74评分均高于药物治疗组(P<0.05)。与治疗前比较,2组患者血清IL-1β、IL-6、TNF-α的水平均明显降低(P<0.05),但2组比较差异无统计学意义(P>0.05)。微球囊压迫组术后不良反应的发生率为6.67%,显著低于药物治疗组(20.00%)(P<0.05)。结论微球囊压迫与口服卡马西平均对三叉神经痛有明显效果,且均能降低患者血清炎症因子的水平、缓解患者的疼痛症状,但与口服卡马西平比较,微球囊压迫的疗效更好,且安全性更高。

Objective To compare and analyze the efficacy and safety of microballoon compression and carbamazepine in the treatment of trigeminal neuralgia.Methods A total of 120 patients with primary trigeminal neuralgia admitted to the hospital.Accor-ding to random number table method,they were divided into microballoon compression group and drug treatment group,60 cases in each group.The microballoon compression group was treated with percutaneous microballoon ganglion compression,while the drug treatment group was treated with oral carbamazepine.The clinical curative effect after treatment,the scores of visual analogue scale(VAS)and general quality of life inventory-74(GQOL-74),and the levels of serum inflammatory factors[interleukin-1β(IL-1β),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)]before and after treatment were compared between the 2 groups.The occurrence of postoperative complications in microballoon compression group and the occurrence of adverse reactions in drug treatment group were statistically analyzed.Results The total response rate after treatment in microballoon compression group was higher than that in drug treatment group(91.67%vs.75.00%,P<0.05).After treatment,the VAS in microballoon compression group were lower than those in drug treatment group,but the GQOL-74 scores were higher than those in drug treatment group(P<0.05).After treatment,the levels of serum IL-1β,IL-6 and TNF-αin both groups were significantly decreased(P<0.05),but there was no significant difference between the 2 groups(P>0.05).The incidence of postoperative complications in microballoon compression group was significantly lower than that in drug treatment group(6.67%vs.20.00%)(P<0.05).Conclusion Both microballoon compression and drug treatment have significant curative effect on trigeminal neuralgia,which can reduce the levels of serum inflammatory factors and relieve pain of patients.However,compared with drug treatment,microba-lloon compression can significantly improve the curative effect and improve the quality of life,with high safety.