经皮内加关节突滑膜感受器通路给药治疗带状疱疹后神经痛的研究  

Therapeutic efficacy of intradermal injection with receptor passway of facet joints synovium injection on post herpetic neuralgia

作　　者：耿祝生[1] 章云海[1] 崔吉正[1] 

机构地区：[1]连云港市第一人民医院麻醉科,江苏连云港222002

出　　处：《江苏大学学报（医学版）》2011年第6期519-522,共4页Journal of Jiangsu University：Medicine Edition

基　　金：国家自然科学基金资助项目(30271260);江苏高校省级重点实验室第三批对外开放基金资助项目(K2093);江苏省科技厅指导计划项目(BS2002305);连云港市科技发展项目(SH0408;SH0507;SH0905)

摘　　要：目的:分析经皮内与皮内加关节突滑膜两种给药方法治疗带状疱疹后神经痛(post herpetic neuralgia,PHN)的疗效。方法:将80例颈、胸、腰段的PHN患者随机分为皮内加关节突滑膜组(双途径给药组)和皮内组。双途径给药组皮内给药配方:甲泼尼龙40 mg+左氧氟沙星0.1 g+1%罗哌卡因5 ml+亚甲蓝注射液10 mg+0.9%氯化钠注射液,稀释至20 ml;关节突滑膜给药配方:复方倍他米松5 mg+左氧氟沙星0.1 g+1%罗哌卡因5 m1+亚甲蓝注射液10 mg+0.9%氯化钠注射液,稀释至20 ml,再加入透明质酸钠20 mg。1次/周,1～3次为1个疗程。皮内组用药配方同双途径给药组的皮内给药配方,1次/周,1～5次为1个疗程。结果:回访3个月的疗效,双途径给药组优32例(82%),皮内组优19例(53%),差异有统计学意义(P<0.01);双途径给药组治疗次数为1.62次,明显低于皮内组(3次,P<0.01);两组优良率均为100%,疗效无统计学差异,两组满意度均为优。1～3年后回访70例,均无复发,两组满意度均为优。结论:双途径给药组治疗次数低于皮内组。Objective： To investigate the therapeutic efficacy of intradermal injection with receptor passway of facet joints synovium injection on post herpetic neuralgia（PHN）.Methods： Eighty patients with cervical thoracic and lumber PHN were randomly divided into 2 groups.Intradermal injection（methylprednisolone 40 mg＋levofloxacin 0.1 g＋1% ropivacaine 5 ml＋methylthioninium 10 mg＋0.9% sodium chloride metered to 20 ml）with receptor passway of facet joints synovium injection（compound betamethasone 5 mg＋Levofloxacin 0.1 g＋1% ropivacaine 5 ml＋methylthioninium 10 mg＋0.9% sodium chloride metered to 20 ml＋sodium hyaluronate 20 mg） was used in A group,one administration each week and 1-3 adminitrations constituting one course.Intradermal injection was only used in B group,one administration each week and 1-5 adminitrations constituting one course.Results： After 3 months of follow-up,the therapeutic efficacy of A group（82%） was improved significantly compared to that of B group（53%）.Treatment number in A group（1.62） was decreased significantly compared to that of B group.The good rate and the satisfaction degree of A group were the same as B group.After 1-3 years of follow-up,70 patients had no recurrence,but the outcomes were no increased.The satisfaction degree was both excellent in A group and B group.Conclusion： The therapeutic efficacy of A group was superior to that of B group.Treatment numbers were less in A group.

关 键 词：皮内 关节突 滑膜 PHN 亚甲蓝 

分 类 号：R614.3[医药卫生—麻醉学]