胸椎旁连续输注亚甲蓝阻滞液治疗胸段带状疱疹后神经痛的疗效观察  

Clinical effects of continuous thoracic paravertebral blocks with methylthionine chloride on postherpetic neuralgia

作　　者：王明霞 张金源 廖丽君 方洪伟 余秀琴 王祥瑞 WANG Mingxia;ZHANG Jinyuan;LIAO Lijun;FANG Hongwei;YU Xiuqin;WANG Xiangrui(Department of Pain Medicine,Dongfang Hospital,Shanghai Tongji University,Shanghai 200120,China)

机构地区：[1]上海同济大学附属东方医院疼痛科,上海200210

出　　处：《中国疼痛医学杂志》2021年第8期591-595,共5页Chinese Journal of Pain Medicine

基　　金：国家自然科学基金面上项目(81971814);上海市重症医学重中之重临床重点学科(2017ZZ02017);上海市浦东临床高峰学科(PWYgf2018-05)。

摘　　要：目的:探讨胸椎旁连续输注亚甲蓝(methylene blue,MB)阻滞液对胸段带状疱疹后神经痛(postherpetic neuralgia,PHN)的疗效。方法:根据给药不同,将90例胸段带状疱疹后神经痛病人采取抽签法随机均分为亚甲蓝(MB)组、神经妥乐平(neurotropin,NTP)组和联合组。病人入院后均每日口服150 mg普瑞巴林7天后给予受累神经节段椎旁置管并连续给药。分别测评各组病人术前、术后1周、1月、3月、6月的疼痛数字评分法(numerical rating scale,NRS)评分、失眠严重程度指数(insomnia severity index,ISI)评分、健康问卷抑郁障碍量表(the patient health questionnaire-9,PHQ-9)分数。结果:治疗后各组病人NRS、ISI及PHQ-9评分均明显下降,联合组、亚甲蓝组下降幅度均高于神经妥乐平组,亚甲蓝组与联合组间比较无显著性差异。结论:胸椎旁连续输注亚甲蓝可明显提高胸段带状疱疹后神经痛的疗效、缓解病人的焦虑抑郁情绪、改善睡眠、提高病人的生活质量。Objective:To investigate the effect of continuous thoracic paravertebral nerve block by methylene blue(MB)on the treatment of postherpetic neuralgia(PHN).Methods:Ninety patients with thoracic postherpetic neuralgia were randomly and equally divided into methylene blue(MB)group,neurotropin(NTP)group,and combined group according to different medication.After admission,patients received 150 mg of pregabalin orally for 7 days,and then continuous thoracic paravertebral nerve block was performed on affected nerve segment.Numerical rating scale(NRS),insomnia severity index(ISI),and the patient health questionnaire-9(PHQ-9)score were assessed preoperatively and 1 week,1,3,and 6 months postoperatively.Results:After treatment,the NRS,ISI,and PHQ-9 score of the three groups were significantly decreased compared with those before block,and the combined group and MB group decreased significantly than NTP group.There was no significant difference between the combined group and MB group.Conclusion:Continuous thoracic paravertebral nerve block with methylene blue could significantly improve the clinical effect of postherpetic neuralgia,relieve anxiety and depression,improve sleep,and improve life quality.

关 键 词：带状疱疹后神经痛 亚甲蓝 神经阻滞 

分 类 号：R752.12[医药卫生—皮肤病学与性病学]