摘要
目的探讨重复椎旁神经阻滞联合药物治疗急性、亚急性带状疱疹相关性疼痛的临床效果。方法选取2017年5月至2019年4月在清华大学附属北京清华长庚医院疼痛门诊就诊的50例急性、亚急性带状疱疹相关性疼痛患者为研究对象,依据治疗方法不同分为药物组和椎旁组,各25例。药物组采用口服加巴喷丁治疗;椎旁组采用口服加巴喷丁+超声引导下重复椎旁神经阻滞和治疗。比较两组患者治疗后1 d、3个月、6个月的疼痛视觉模拟评分(VAS)、睡眠质量评分(QS)、VAS加权值及不良反应发生情况。结果VAS评分的时点间与组间存在交互作用(P<0.01),与治疗前相比,两组治疗后1 d、3个月、6个月的VAS评分均明显降低(P<0.05);与药物组相比,治疗后3个月、6个月时椎旁组VAS评分明显降低(P<0.05)。QS评分的时点间与组间存在交互作用(P<0.01),与治疗前相比,两组治疗后1 d、3个月、6个月的QS评分均明显升高(P<0.05);与药物组相比,治疗后3个月、6个月时椎旁组QS评分明显升高(P<0.05)。两组治疗后1 d的VAS加权值比较差异无统计学意义(P>0.05),治疗后3个月、6个月,椎旁组VAS加权值明显高于药物组(P<0.05)。两组均未出现血肿和穿刺部位感染,两组头晕、恶心、嗜睡发生率比较差异均无统计学意义(P>0.05)。结论超声引导下重复椎旁神经阻滞联合口服药物治疗急性、亚急性带状疱疹的疗效较好,且患者带状疱疹相关性疼痛、睡眠明显改善。
Objective To investigate the clinical effect of repeated paravertebral nerve block combined with drugs in the treatment of acute and subacute herpes zoster related pain.Methods A total of 50 patients with acute or subacute herpes zoster related pain treated in the pain clinic of Beijing Tsinghua Changgung Hospital Affiliated to Tsinghua University from May 2017 to Apr.2019 were included.They were randomly divided into a drug group and a paravertebral group according to different treatment methods,with 25 cases in each group.The drug group was treated with oral gabapentin;the paravertebral group was treated with oral gabapentin and repeated paravertebral nerve block under ultrasound guidance.The visual analogue scale(VAS),sleep quality score(QS),VAS weighted value and adverse reactions at 1 day,3 months and 6 months after treatment were compared between the two groups.Results There was interaction in VAS score between time points and groups(P<0.01).Compared with before treatment,the VAS score of the two groups decreased significantly at 1 day,3 months and 6 months after treatment(P<0.05);compared with the drug group,the VAS score of the paravertebral group decreased significantly at 3 and 6 months after treatment(P<0.05).There was interaction in QS score between time points and groups(P<0.01).Compared with before treatment,the QS scores of the two groups increased significantly at 1 day,3 months and 6 months after treatment(P<0.05);compared with the drug group,the QS score of paravertebral group increased significantly at 3 and 6 months after treatment(P<0.05).There was no significant difference in VAS weighted value between the two groups at 1 day after treatment(P>0.05),and at 3 and 6 months after treatment,VAS weighted value in the paravertebral group was significantly higher than that in the drug group(P<0.05).There was no hematoma and puncture site infection in both groups.There were no significant differences in the incidences of dizziness,nausea and sleepiness between the two groups(P>0.05).Conclusion Repeated paravertebral nerve block under ultrasound guidance combined with oral medication is effective in the treatment of acute and subacute herpes zoster,and the pain related to herpes zoster and sleep are significantly improved.
作者
刘芳
白志勇
LIU Fang;BAI Zhiyong(Department of Pain Medicine,Tsinghua University,Beijing 102218,China;Department of Ultrasound,Beijing Tsinghua Changgung Hospital/School of Clinical Medicine,Tsinghua University,Beijing 102218,China)
出处
《医学综述》
CAS
2021年第19期3924-3928,共5页
Medical Recapitulate
基金
北京市医院管理中心“培育计划”西医项目(PX2020040)。
关键词
带状疱疹
神经痛
重复椎旁阻滞
Zoster
Neuralgia
Repeated paravertebral block
