连续坐骨神经阻滞联合普瑞巴林口服治疗糖尿病周围神经病变性疼痛的效果

Effect of Continuous Sciatic Nerve Block Combined with Pregabalin in the Treatment of Diabetic Peripheral Neuropathy

目的探究连续坐骨神经阻滞联合普瑞巴林口服治疗糖尿病周围神经病变性疼痛的疗效。方法该院糖尿病周围神经病变患者120例,随机分为联合组和普瑞巴林组各60例。普瑞巴林组每日口服普瑞巴林300 mg,联合组在口服普瑞巴林基础上联合0.2%罗哌卡因连续坐骨神经阻滞,疗程均为12周,记录并比较两组患者治疗期间及治疗后视觉模拟评分法(VAS)评分、24 h内睡眠时间、血浆脑钠肽(brain natriuretic peptide,BNP)水平以及其他口服镇痛药的使用情况。结果与治疗前的24 h平均疼痛程度评分及最大疼痛程度评分相比,普瑞巴林组和联合组分别于治疗5 d后及1d后显著下降,差异有统计学意义(P<0.05);联合组各时间点的24 h平均疼痛程度评分及最大疼痛程度评分均明显低于普瑞巴林组,差异有统计学意义(P<0.05)。两组患者治疗12周后24 h内睡眠时间以及血清BNP水平均有明显改善(P<0.05),联合组改善效果显著优于普瑞巴林组,差异有统计学意义(P<0.05)。两组患者治疗12周后腓总神经、腓肠神经以及感觉神经传导速度均明显提高(P<0.05),联合组改善效果显著优于普瑞巴林组,差异有统计学意义(P<0.05)。两组患者治疗12周后均停止使用其他口服镇痛药,治疗期间两组患者的不良反应发生率差异无统计学意义(P>0.05)。结论口服普瑞巴林联合连续坐骨神经阻滞治疗糖尿病周围神经病变是一种安全有效的方法。

Objective To explore the effect of continuous sciatic nerve block combined with pregabalin in the treatment of diabetic peripheral neuropathy(DPN).Methods 120 cases of diabetic peripheral neuropathy patients were selected.They were randomly divided into pregabalin group(60 cases) and combine group(60 cases).The pregabalin group was gave pregabalin 300 mg and the combine group was gave continuous sciatic nerve block on the basis of pregabalin group.The clinical effect was compared between two groups.Results The VAS scores at 2 and 4d after treatment of combine group were lower than those of pregabalin group(P<0.05);after the treatment,the sleeping time and BNP levels of combine group were higher than those of pregabalin group(P<0.05);after the treatment,the nerve conduction velocity of combine group was faster than that of pregabalin group(P<0.05);there was no significant difference between the two groups regarding the adverse effects rate(P>0.05).Conclusion Continuous sciatic nerve block combined with pregabalin is a safe and effective method regarding DPN.