亚甲蓝复合液封闭治疗对带状疱疹患者疼痛的影响研究

Study on effect of blocking treatment with methylene blue complex solution on pain of patients with herpes zoster

目的观察带状疱疹(HZ)患者采用亚甲蓝复合液皮损区皮肤全层浸润封闭注射治疗对其疼痛的影响。方法90例带状疱疹患者,根据随机非双肓法分为A、B、C组,各30例。A组仅行常规治疗,B组行常规治疗并于皮损区皮肤全层作1%利多卡因浸润封闭注射,C组行常规治疗并于皮损区用0.1%亚甲蓝复合液(内含1%利多卡因)作皮损区皮肤全层浸润封闭注射。比较三组治疗前后视觉模拟评分法(VAS)评分、治疗后疼痛缓解效果及不良反应发生情况。结果治疗后7、14、21、28、35 d,A组、B组VAS评分比较,差异无统计学意义(P>0.05);治疗后7、14、21、28、35 d,C组VAS评分分别为(2.25±0.92)、(3.17±0.88)、(3.87±0.64)、(3.46±0.77)、(4.08±0.33)分,低于A组的(9.04±0.71)、(8.23±0.61)、(6.21±0.32)、(5.38±0.11)、(5.04±0.71)分和B组的(8.98±0.88)、(8.33±0.70)、(6.41±0.38)、(5.43±0.22)、(5.11±0.65)分,差异有统计学意义(P<0.05)。A组、B组、C组疼痛缓解效果佳占比分别为53.33%、53.33%、90.00%,C组疼痛缓解效果佳占比高于A组、B组,差异有统计学意义(P<0.05)。除局部针眼处1个月内有蓝色色素沉着及1~2 d尿液呈蓝色外,全部患者均无全身不良反应。结论应用亚甲蓝复合液封闭治疗带状疱疹,可以明显缓解患者的疼痛并作用持久,后遗神经痛发生少。

Objective To observe the effect of the whole skin infiltration and injection therapy on the pain of herpes zoster(HZ)patients with methylene blue complex solution.Methods 90 patients with herpes zoster were divided into group A,group B and group C by random non-double blind method,each with 30 cases.Group A received routine treatment only.Group B received routine treatment,and the whole skin layer of the lesion was treated with 1%lidocaine infiltration and blocking injection.Group C was treated with routine treatment,and the whole skin layer of the lesion was treated with 0.1%methylene blue complex solution(containing 1%lidocaine)infiltration and blocking injection.The visual analogue scale(VAS)score before and after treatment,pain relief effect after treatment and adverse reactions were compared between the three groups.Results There was no significant difference in VAS scores between group A and group B on 7,14,21,28 and 35 d after treatment(P>0.05).On 7,14,21,28 and 35 d after treatment,VAS scores in group C were(2.25±0.92),(3.17±0.88),(3.87±0.64),(3.46±0.77)and(4.08±0.33)points,which were lower than group A[(9.04±0.71),(8.23±0.61),(6.21±0.32),(5.38±0.11)and(5.04±0.71)],and group B[(8.98±0.88),(8.33±0.70),(6.41±0.38),(5.43±0.22)and(5.11±0.65)points].The difference was statistically significant(P<0.05).The proportion of good pain relief effect in group A,group B and group C were 53.33%,53.33%and 90.00%,respectively.The proportion of good pain relief effect in group C was higher than that in group A and group B,and the difference was statistically significant(P<0.05).No systemic adverse reactions were reported in all patients except for blue pigmentation in some needle eyes within 1 month and blue urine after 1-2 d.Conclusion Blocking treatment of herpes zoster with methylene blue complex solution can significantly alleviate the pain with lasting effect,and the occurrence of postherpetic neuralgia is less.