摘要
目的:评估加巴喷丁联合星状神经节超激光照射治疗头面部带状疱疹后神经痛的疗效。方法:60例病人随机分A、B、C 3组,进行为期21 d的治疗。A组单服加巴喷丁900 mg/d;B组除服药外,联合星状神经节阻滞每周2次;C组联合超激光星状神经节照射,每周5次。分析各组治疗前和治疗后第3、7、14、21天病人疼痛视觉模拟评分(VAS)的变化,比较每组病人的补救用药、不良反应的发生率以及治疗结束时的总有效率。结果:3组病人治疗后第3天与治疗前相比VAS明显降低(A组:t=13.1,P<0.01;B组:t=5.2,P<0.01;C组:t=18.5,P<0.01),治疗第3、7天B组VAS明显低于A、C组(第3天:F=4.1,P=0.02;第7天:F=4.4,P=0.02),第14、21天,B组和C组VAS显著低于A组(第14天:F=5.0,P=0.01;第21天:F=3.9,P=0.02)。治疗后第3天,A、B、C 3组补救用药率分别为40%、5%和15%(X2=7.5,P=0.027),之后无统计学差异。治疗结束时,各组总有效率没有差异,但完全缓解率B、C组明显优于A组(X2=11.6,P=0.04),不良反应发生率B组高达30%,C组仅为15%。结论:加巴喷丁联合星状神经节超激光照射的疗效优于单用加巴喷丁治疗,治疗2周后疗效和加巴喷丁联合星状神经节阻滞相似,是一种治疗头面部带状疱疹后神经痛安全、无创和有效的方法。
Objective To evaluate the effect of gabapendin combined with super lizer irradiation on stellate ganglion for the treatment of craniofacial postherpetic neuralgia.Methods Sixty patients were randomly divided into 3 groups and received 21-day treatment： the gabapendin group（group A,n=20）,the gabapendin combined with stellate ganglion block group（group B,n=20）,the gabapendin combined with super lizer irradiation on stellate ganglion group（group C,n=20）.The visual analogue scale（VAS）,effective rate of pain relieving,administration of remedy drug and side effects were observed before and 3、7、14、21 days after treatment.Results The VAS values in all groups decreased significantly on the 3rd day after treatment（P〈0.01）.The VAS values in Group B were significantly lower than group A and C on the 3rd and 7th day after treatment（3rd day： P=0.02;7th day： P=0.02）.The VAS values in group A were higher than group B and C on 14th day and 21st day（14th day： P=0.01;21st day： P=0.02）.On the 3rd day after treatment,the rates of remedy drug administration in group A,B and C were 40%,5% and 15%,respectively（P=0.027）.At the end of the treatment,the effective rates of pain relieving in 3 groups were similar but the complete pain relieving rates in group B and C were significantly higher than group A（P=0.04）.Side effect rate of group B was 30% and higher than 15% of Group C.Conclusions Gabapendin combined with super lizer irradiation on stellate ganglion is more effective than single administration of gabapendin for the treatment of craniofacial postherpetic neuralgia.Although super lizer irradiation could not have immediate curative effect like nerve block,it is a safe,noninvasive and effective treatment for craniofacial postherpetic neuralgia.
出处
《外科理论与实践》
2011年第6期581-584,共4页
Journal of Surgery Concepts & Practice
