局部针刀治疗带状疱疹后神经痛的临床疗效

摘要

Objective To observe the clinical efficacy of local needle-knife in the treatment of patients with postherpetic neuralgia.Methods Thirty patients of both sexes with postherpetic neuralgia,aged 60-71 yr,in the Department of Pain Medicine of the Second Affiliated Hospital of Harbin Medical University,were enrolled in the study from January to June 2018.The needle-knife was inserted into the pain point after determining the area of skin pain area and making local block anesthesia.The corresponding area of subcutaneous and superficial fascia were cutted and loosened by needle-knife with a radial fan-shaped method.Visual analogue scale (VAS) and the efficacy were evaluated at 30 days after the end of the treatment according to the excellent,good and inefficiency.Results VAS was significantly lower at 30 days after the treatment (1.7±1.1) than that before the treatment (7.1±0.8),with statistically significant difference (P＜0.05).For the clinical efficacy,19 cases were excellent,10 cases good and 1 case ineffective.The total effective rate was 97％ (29/30 cases).Conclusion Loosening the subcutaneous and superficial fascia with local needle-knife can effectively reduce the VAS in patients with postherpetic neuralgia.%目的 观察局部针刀治疗带状疱疹后神经痛的临床疗效.方法 收集2018年1月至6月在哈尔滨医科大学附属第二医院疼痛科住院的带状疱疹后神经痛患者30例,性别不限,年龄60～ 71岁,检定皮肤疼痛区域范围并体表标记,根据疼痛区域定位针刀进针点,局部阻滞麻醉后,对相应区域皮下及浅筋膜层进行针刀放射状扇形切割松解,相同区域每5日重复1次,4次为1个疗程.疼痛程度采用视觉模拟评分法(VAS),疗效评价按照优效、良效、无效评价疗程结束后30 d时的疗效.结果 疗程结束后30 d时VAS评分(1.7±1.1)明显优于治疗前(7.1±0.8),差异有统计学意义(P＜0.05).疗程结束后30 d时优效19例、良效10例、无效1例,总有效率为97％(29/30例).结论 带状疱疹后神经痛患者采用局部针刀松解治疗可以降低局部疼痛VAS评分,对带状疱疹后神经痛治疗有效.