摘要
目的:探究A型肉毒毒素(BTX-A)治疗带状疱疹后遗神经痛(PHN)的疗效及其对血浆β-内啡肽、P物质的影响。方法:将60例PHN患者按不同治疗方式分为对照组和观察组,每组各30例。对照组口服加巴喷丁进行常规治疗,观察组在对照组的基础上进行A型肉毒毒素注射治疗。观察两组临床疗效,对比两组治疗前(T_(0))和治疗后[3 d(T_(1))、4周(T_(2))、8周(T_(3))]视觉疼痛模拟评分(VAS)、匹兹堡睡眠质量指数(PSQI)评分、疼痛相关物质[血浆β-内啡肽(β-EP)、血清P物质(SP)]、炎性因子[血清肿瘤坏死因子-α(TNF-α)、血清白介素-6(IL-6)]水平,记录不良反应发生情况。结果:观察组总有效率为93.33%,高于对照组的73.33%(P<0.05);观察组T_(2)、T_(3)的VAS评分、PSQI评分均低于对照组(P<0.05);观察组T_(2)、T_(3)血清SP水平、TNF-α水平、IL-6水平均低于对照组(P<0.05),血浆β-EP水平高于对照组(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:BTX-A治疗PHN具有较好疗效,可有效缓解疼痛,可能与BTX-A调节机体疼痛相关物质水平、减轻神经炎症有关。
Objective:To explore the efficacy of botulinum toxin type A(BTX-A)in the treatment of postherpetic neuralgia(PHN)and its influence on plasmaβ-endorphin and substance P.Methods:60 patients with PHN were selected and divided into control group and observation group according to different treatment methods,with 30 cases in each group.The control group was treated with oral gabapentin,and the observation group was treated with botulinum toxin type A injection on the basis of the control group.The clinical efficacy of the two groups was observed,and the visual pain simulation score(VAS),Pittsburgh sleep quality index(PSQI)score,pain-related substances[plasmaβ-endorphin(β-EP),serum substance P(SP)],inflammatory factors[serum tumor necrosis factor(TNF-α),serum interleukin-6(IL-6)]levels at different time points[before treatment(T_(0)),3 days after treatment(T_(1)),4 weeks after treatment(T_(2)),and 8 weeks after treatment(T_(3))]were compared.The occurrence of adverse reactions was recorded.Results:The total effective rate of the observation group was 93.33%,which was higher than 73.33%of the control group(P<0.05).The VAS score and PSQI score of T_(2) and T_(3) in the observation group were lower than those in the control group(P<0.05).The levels of serum SP,TNF-αand IL-6 in the observation group at T_(2) and T_(3) were lower than those in the control group(P<0.05),and the plasmaβ-EP level was higher than that in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:BTX-A has good curative effect in the treatment of PHN,which can effectively relieve pain,which may be related to BTX-A regulating the level of pain-related substances and reducing neuroinflammation.
作者
许小蕊
赵洋洋
马文宇
XU Xiao-rui;ZHAO Yang-yang;MA Wen-yu(Department of Aesthetic Medicine,Affiliated Hospital of Qinghai University,Xining 810000,Qinghai,China;Department of Dermatology,Affiliated Hospital of Qinghai University,Xining 810000,Qinghai,China)
出处
《川北医学院学报》
CAS
2021年第12期1588-1592,共5页
Journal of North Sichuan Medical College
基金
青海大学附属医院中青年科研基金立项项目(ASRF-2019-YB-11)。
