扳机点注射A型肉毒杆菌毒素联合活血通络胶囊治疗原发性三叉神经痛疗效及对血浆CGRP、SP、IL-6、IL-1β水平的影响  

Effect of trigger point injection of botulinum toxin type A combined with Huoxue Tongluo Capsule on the treatment of primary trigeminal neuralgia and its influence on the plasma expression of CGRP,SP,IL-6 and IL-1 beta

作　　者：曹腾腾 叶蕾[1] 郑海霞 CAO Tengteng;YE Lei;ZHENG Haixia(The First Hospital of Yulin,Yulin 718000,Shaanxi,China)

机构地区：[1]陕西省榆林市第一医院,陕西绥德718000

出　　处：《现代中西医结合杂志》2018年第30期3328-3331,3335,共5页Modern Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的观察扳机点注射A型肉毒杆菌毒素联合活血通络胶囊治疗原发性三叉神经痛(PTN)的疗效及对血浆降钙素基因相关肽(CGRP)、P物质(SP)、白细胞介素-6(IL-6)、白细胞介素-IL-1β(IL-1β)水平的影响。方法将80例PTN患者随机分为观察组(40例)及对照组(40例),2组均给予常规基础治疗,对照组在此基础上给予扳机点注射A型肉毒杆菌毒素治疗,观察组在对照组治疗基础上给予活血通络胶囊口服,2组疗程均为8周。观察2组治疗前后疼痛、麻木、睡眠质量、生活质量、咀嚼肌肌电及血浆CGRP、SP、IL-6、IL-1β水平变化情况,并记录2组不良反应发生情况。结果 2组治疗2周、4周、8周时疼痛VAS评分、麻木VAS评分、匹兹堡睡眠质量指数问卷(PSQI)评分均明显低于治疗前(P均<0. 05),生活质量评定量表(SF-36)评分均明显高于治疗前(P均<0. 05),且观察组上述评分改善情况均显著优于对照组(P均<0. 05); 2组治疗2周、4周、8周时两侧颞肌前束(TA)、咬肌(MM)的肌电峰值均显著升高(P均<0. 05),且观察组上述肌电峰值均显著高于对照组(P均<0. 05); 2组治疗2周、4周、8周时血浆CGRP、SP、IL-6、IL-1β水平均显著降低(P均<0. 05),观察组上述指标水平均明显低于对照组(P均<0. 05); 2组治疗中未发现严重不良反应。结论扳机点注射A型肉毒杆菌毒素联合活血通络胶囊能够缓解PTN患者的临床症状,提高睡眠和生活质量,改善咀嚼肌功能,可能与降低血浆CGRP、SP、IL-6、IL-1β水平有关。Objective It is to observe the effect of trigger point injection of botulinum toxin type A injection combined with Huoxue Tongluo Capsule on the treatment of primary trigeminal neuralgia （PTN） and its influence on the expression of calcitonin gene-related peptide （CGRP）, substance P （SP）, interleukin-6 （IL-6） and interleukin-1 beta （IL-1β） in plasma.Methods Eighty patients with PTN were randomly divided into the observation group （40 cases） and the control group （40 cases）. The two groups were given conventional basic treatment. The control group was treated with trigger point injection of botulinum toxin type A on this basis. The observation group was given Huoxue Tongluo Capsule based on the control group. All patients were treated for 8 weeks. The changes of pain, numbness, quality of sleep, quality of life, electromyography （EMG） of masticatory muscles and the levels of CGRP, SP, IL-6 and IL-1β in plasma were observed before and after treatment in the two groups. And the adverse reactions were recorded in the 2 groups.Results The pain VAS score, numbness VAS score and Pittsburgh Sleep Quality Index （PSQI） score of the two groups were significantly lower than those before treatment （all P 〈0.05）, the scores of life qualities scale （SF-36） were significantly higher than those before treatment （all P 〈0.05）, and the improvement of the above scores in the observation group was better than that in the control group （ P 〈0.05）. The EMG peak values of temporal anterior （TA） and masseter muscle （MM） on both sides of the two groups were significantly increased at the 2nd, 4th and 8th week after treatment （all P 〈0.05）, and all the peak values of EMG in the observation group were significantly higher than those in the control group （all P 〈0.05）. The levels of CGRP, SP, IL-6 and IL-1β in plasma of the two groups were significantly lower at the 2nd, 4th and 8th week after treatment （all P 〈0.05）, and the levels in the observation grou

关 键 词：A型肉毒杆菌毒素 活血通络胶囊 原发性三叉神经痛 降钙素基因相关肽 P物质 白细胞介素-6 白细胞介素-1Β 

分 类 号：R745.11[医药卫生—神经病学与精神病学]