摘要
目的:探讨A型肉毒毒素对带状疱疹后遗神经痛患者疼痛程度及神经递质表达的影响。方法:选取2018年12月-2019年12月寿光市中医医院临床收治的带状疱疹后遗神经痛患者144例为研究对象,采用随机数字表法将患者分成对照组(曲安奈德治疗)和研究组(A型肉毒毒素治疗),每组72例。对两组治疗前后的疼痛视觉模拟(VAS)评分、神经病理疼痛评分(NPS)、疼痛发作频率、疼痛发作持续时间、血清P物质(血清SP)和神经激肽-1(NK-1)、血清炎症因子[白细胞介素-2(IL-2)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)]及临床综合疗效进行观察和比较。结果:研究组治疗后1、6个月VAS和NPS评分、疼痛发作频率和发作持续时间均低于对照组,差异均有统计学意义(P<0.05)。研究组治疗后1、6个月血清SP和NK-1均低于对照组,差异均有统计学意义(P<0.05)。研究组治疗后1、6个月血清IL-2均高于对照组,IL-6和IL-10水平均低于对照组,差异均有统计学意义(P<0.05)。研究组临床治疗总有效率为95.83%,显著高于对照组的75.00%,且差异有统计学意义(P<0.05)。结论:A型肉毒毒素治疗带状疱疹后遗神经痛能通过降低血清SP和NK-1水平和改善局部炎症反应有效改善患者临床疼痛症状,提升临床综合疗效,是临床治疗带状疱疹后遗神经痛的可靠方案之一。
Objective:To investigate the effect of type A botulinum toxin on pain degree and neurotransmitter expression in patients with postherpetic neuralgia.Method:From December 2018 to December 2019,144 patients with postherpetic neuralgia treated in Shouguang Hospital of Traditional Chinese Medicine were selected as the research objects,the patients were randomly divided into the control group(treated with Triamcinolone Acetonide)and the study group(treated with type A botulinum toxin),72 cases in each group.The visual analogue scale(VAS),neuropathological pain scale(NPS),frequency of pain attack,duration of pain attack,serum substance P(serum SP),neurokinin-1(NK-1),serum inflammatory factors[interleukin-2(IL-2),interleukin-6(IL-6)and interleukin-10(IL-10)]at 1 and 6 months after treatment and clinical comprehensive efficacy of two groups were observed and compared.Result:The VAS and NPS scores and frequency and duration of pain attack in the study group at 1 and 6 months after treatment were lower than those in the control group,the differences were statistically significant(P<0.05).The serum SP and NK-1 in the study group at 1 and 6 months after treatment were lower than those in the control group,the differences were statistically significant(P<0.05).The levels of serum IL-2 in the study group at 1 and 6 months after treatment were higher than those in the control group,the levels of IL-6 and IL-10 were lower than those in the control group,the differences were statistically significant(P<0.05).The total effective rate of clinical treatment in the study group was 95.83%,which was significantly higher than 75.00% in the control group,the difference was statistically significant(P<0.05).Conclusion:Type A botulinum toxin in the treatment of postherpetic neuralgia can effectively improve the clinical pain symptoms and clinical comprehensive curative effect by reducing the serum SP and NK-1 and improving the local inflammatory response,it is one of the reliable schemes for the clinical treatment of postherpetic neuralgia
作者
杨艳萍
徐金辉
YANG Yanping;XU Jinhui(Shouguang Hospital of Traditional Chinese Medicine,Shandong Province,Shouguang 262700,China;不详)
出处
《中国医学创新》
CAS
2022年第10期62-66,共5页
Medical Innovation of China
