普瑞巴林联合椎旁神经阻滞治疗带状疱疹后遗肋间神经痛的临床研究

摘要

Objective To observe the clinical efficacy of pregabalin combined with paravertebral nerve block on postherpetic intercostal neuralgia. Methods Sixty - six patients with postherpetic intercostal neuralgia were randomly divided into three groups: pregabalin group ( A) , simple paravertebral nerve block group (B) and pregabalin combined with paravertebral nerve block group ( C ) ( n = 22 in each group). 1,3,6 and 9 weeks after treatment, the visual analog scale (VAS) and sleep quality score ( QS) were evaluated and adverse reactions were recorded. Results The treatment in A group could effectively relieve pain and promote the improvement of the quality of sleep, but it showed a slow onset, large demand of drug and many adverse expnts. It showed a rapid onset in B group, but the treatment lacked the start improvements in pain and sleep. There were significant differences between the score of VAS and QS before treatment and that after treatment in C group ( P < 0. 05). The score of VAS and QS of C group decreased more significantly after treatment than those of A and B group (P<0.05). Treatments in all group showed a small number of adverse reactions, which was least in C group. Conclusion The clinical efficacy of pregabalin combined with paravertebral nerve block for the treatment of postherpetic intercostal neuralgia is safe and reliable, which is superior to simple pregabalin or paravertebral nerve block and shows fewer adverse reactions. It is worthy of clinical practice.%目的 观察普瑞巴林联合椎旁神经阻滞治疗带状疱疹后遗肋间神经痛的临床疗效.方法 将临床确诊为带状疱疹后遗肋间神经痛的66例病人随机分为3组,A组(口服普瑞巴林)22例、B组(单纯椎旁神经阻滞)22例、C组(椎旁神经阻滞联合口服普瑞巴林)22例.在治疗后1、3、6、9周时,采用疼痛视觉模拟评分法(VAS)和睡眠质量评分法(QS)综合评定治疗结果,同时观察不良反应.结果 A组按照给药方案治疗能有效缓解疼痛和促进睡眠质量的改善,但起效缓慢、药物用量大,不良反应多；B组起效快,但起始对疼痛和睡眠的改善还欠缺；C组治疗后的效果与治疗前相比VAS评分和QS评分均明显下降(P＜0.05),并优于A和B组(P＜0.05)；3组都有少量的不良反应,其中C组的不良反应最少.结论 普瑞巴林联合椎旁神经阻滞治疗带状疱疹后遗肋间神经痛安全可靠,其疗效比单纯口服普林巴林或椎旁神经阻滞优越,且不良反应少,值得临床推广.