奥卡西平联合神经阻滞治疗原发性三叉神经痛的随机对照试验  

RANDOMIZED CONTROLLED TRIAL OF OXCARBAZEPINE COMBINED WITH NERVE BLOCK IN TREATMENT OF PRIMARY TRIGEMINAL NEURALGIA

作　　者：苏芳[1,2] 盖成林[2] 袁源[3] 张倩[1] 

机构地区：[1]中国医科大学口腔医学院麻醉科,沈阳110002 [2]解放军第230医院麻醉科,丹东118000 [3]锦州市中心医院药剂科,锦州121000

出　　处：《中国疼痛医学杂志》2013年第2期82-86,共5页Chinese Journal of Pain Medicine

摘　　要：目的:评估奥卡西平联合神经阻滞是否可以提高治疗原发性三叉神经痛的临床效果。方法:选择原发性三叉神经痛患者60例,随机分为3组:奥卡西平治疗组(O组)、神经阻滞组(B组)和奥卡西平联合神经阻滞组(OB组)。采用视觉模拟评分(visual analogue scale,VAS)评估3组患者治疗前及治疗后第1、2、4周的疼痛分值以及睡眠、生活质量、MPQ总评分、患者自我评价等指标,同时观察患者的不良反应。结果:O组患者口服奥卡西平起效缓慢,但能有效缓解疼痛,治疗后第4周与治疗前VAS疼痛评分比较差异有显著性(P<0.01);B组治疗后第1、2、4周疼痛缓解效果与O组比较,差异有显著性(P<0.05);B组治疗后第4周与治疗前VAS疼痛评分比较有显著性差异(P<0.01);OB组奥卡西平联合神经阻滞组患者,治疗后第4周与治疗前VAS疼痛评分比较差异有显著性(P<0.01);且OB组较其他两组治疗后各时间点疼痛评分统计学差异显著(P<0.05)。患者评价显示OB组较其他两组总体效果更让人满意(P<0.05)。3组均有不良反应发生,其中O组不良反应发生例数最多;OB组不良反应发生例数最少,差异有显著性(P<0.05)。结论:奥卡西平联合神经阻滞治疗原发性三叉神经痛有效且安全;其疗效优于单独服药和单独神经阻滞治疗。Objective： To study the efficacy of Oxcarbazepine combined with nerve block in the treatment of primary trigeminal neuralgia. Methods： Sixty primary trigeminal neuralgia patients were randomly divided into three groups： group O （Oxcarbazepine）, group B （nerve block） and group OB （Oxcarbazepine combined with nerve block）. We evaluated the degree of the patients＇ pain of pre-therapy and post-therapy after the first week, the second week and the fourth week by visual analogue scale （VAS）. Results： The pain of group O relieve slowly, while have an effective relief after therapy; and there was a significant difference between the VAS of before treatment and the 4 weeks after treatment （24.5 ± 2.7 vs 85.5 ± 6.7, P 〈 0.01）. Comparing with group O, group B had a significant pain relief on the 1st week, 2nd week and 4th week separately; and there was a significant difference between the VAS of the fourth week after treatment and before treatment （18.7 ± 3.5 vs 83.3 ± 7.5, P 〈 0.01）. There was a significant difference between the VAS of the fourth week after therapy and pre-therapy in group OB （8.8± 2.7 vs 86.1 ±7.5, P 〈 0.01）. Group OB has a significant difference with the other groups at every point in time. Group OB has better efficacy than the other two groups （P 〈 0.01）. All three groups had some adverse side effects, especially in the group O when the patients getting large dose of drugs. Group OB had the least adverse side effects among them. Conclusion： oxcarbazepine combined with nerve block is effective and safe, and it＇s efficacy is the best among the three group.

关 键 词：奥卡西平 神经阻滞 原发性三叉神经痛 随机对照试验 

分 类 号：R745.11[医药卫生—神经病学与精神病学]