颈2、3脊神经后内侧支阻滞联合牛痘疫苗接种家兔炎症皮肤提取物注射液治疗颈源性头痛临床观察  

Effectiveness of nerve stimulator guided cervical 2 and 3 spinal nerve block of the posterior⁃medial branch combined with ex⁃tracts from rabbit skin inflamed by vaccinia virus for injection for cervicogenic headache

作　　者：祝建斌 申文 陈博 杨少昆 朱学林 Zhu Jianbin;Shen Wen;Chen Bo;Yang Shaokun;Zhu Xuelin(School of Anesthesiology,Xuzhou Medical University,Xuzhou 221004,China;Department of Pain,Affiliated Hospital of Xuzhou Medi-cal University,Xuzhou 221006,China;Department of Pain,Eastern Hospital of Wenling,Wenling 317525,China)

机构地区：[1]徐州医科大学麻醉学院,221004 [2]徐州医科大学附属医院疼痛科,221006 [3]温岭东方医院疼痛科,317525

出　　处：《国际麻醉学与复苏杂志》2021年第11期1166-1169,共4页International Journal of Anesthesiology and Resuscitation

基　　金：温岭市科技局计划项目(2016C311143)。

摘　　要：目的探讨神经刺激仪引导下C_(2)、C_(3)脊神经后内侧支阻滞联合牛痘疫苗接种家兔炎症皮肤提取物注射液治疗颈源性头痛的临床疗效。方法选择诊断为颈源性头痛的患者60例,按照随机数字表法分为联合治疗组和对照组,每组30例。两组患者均行神经刺激仪引导下C_(2)、C_(3)脊神经后内侧支阻滞治疗,联合治疗组在此基础上同时配合牛痘疫苗接种家兔炎症皮肤提取物注射液肌内注射。在治疗前和治疗后1 d、7 d、14 d、1个月、3个月分别采用VAS疼痛评分评定患者的疼痛程度,VAS加权计算法评定疼痛缓解程度。结果两组患者年龄、性别比、病程比较,差异无统计学意义(P>0.05)。治疗后7 d、14 d、1个月和3个月,联合治疗组[(2.3±1.1)分、(1.5±0.6)分、(1.3±0.5)分、(2.1±1.2)分]VAS疼痛评分明显低于对照组[(3.5±1.2)分、(3.8±1.1)分、(4.0±1.5)分、(4.3±1.7)分](P<0.05)。治疗后7 d、14 d、1个月和3个月,联合治疗组(80%、92%、94%、88%)总有效率高于对照组(65%、58%、55%、50%)(P<0.05)。结论神经刺激仪引导下C_(2)、C_(3)脊神经后内侧支阻滞联合牛痘疫苗接种家兔炎症皮肤提取物注射液治疗颈源性头痛作用持久稳定,疗效确切。Objective To evaluate the clinical effectiveness of nerve stimulator guided cervical 2 and 3 spinal nerve block of the posteriormedial branch combined with extracts from rabbit skin inflamed by vaccinia virus for injection on patients with cervicogenic headache.Methods A total of 60 patients who were diagnosed with cervical headache were enrolled.According to the random number table method,they were divided into two groups(n=30):a combined treatment group and a control group.Both groups underwent C_(2) and C_(3) dorsal medial branch block under the guidance of nerve stimulator,where the combined treatment group was intramuscularly injected with extracts from rabbit skin inflamed by vaccinia virus.Their Visual Analogue Scale(VAS)score was assessed before treatment and 1,7,14 d,1 month and 3 months after treatment.The VAS weighted calculation was used to evaluate the degree of pain relief in the two groups.Results There was no statistical difference in age,sex ratio,and course of disease between the two groups(P>0.05).Then,7,14 d,1 month and 3 months after treatment,the combined treatment group(2.3±1.1,1.5±0.6,1.3±0.5,2.1±1.2)showed significantly lower VAS scores than the control group(3.5±1.2,3.8±1.1,4.0±1.5,4.3±1.7)(P<0.05).Also,7,14 d,1 month and 3 months after treatment,the total effective rate was remarkably higher in the combined treatment group(80%,92%,94%,88%)than that of the control group(65%,58%,55%,50%)(P<0.05).Conclusions Nerve stimulator guided cervical 2 and 3 spinal nerve block of the posteriormedial branch combined with extracts from rabbit skin inflamed by vaccinia virus for injection can provide lasting and satisfactory effects on patients with cervical headache.

关 键 词：颈源性头痛 神经刺激仪 脊神经阻滞 牛痘疫苗接种家兔炎症皮肤提取物注射液 

分 类 号：R681.55[医药卫生—骨科学]