超声引导下椎旁阻滞联合中药治疗带状疱疹后神经痛  

Ultrasound-guided thoracic paravertebral block combined with traditional Chinese medicine for the treatment of postherpetic neuralgia

作　　者：赵峰[1] 季淑娟[1] 李莎[1] 徐钢[1] 姚凤珍[1] 黄礼兵[1] 季方兵[1] ZHAO Feng;JI Shu-juan;LI Sha;XU Gang;YAO Feng-zhen;HUANG Li-bing;JI Fang-bing(Department of Anesthesiology,Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing,Jiangsu 210029,China)

机构地区：[1]南京中医药大学附属医院麻醉科,江苏南京210029

出　　处：《中国临床研究》2022年第5期694-697,共4页Chinese Journal of Clinical Research

基　　金：江苏省中医院科研项目(Y17052)。

摘　　要：目的观察对带状疱疹后神经痛采用超声引导下椎旁阻滞联合中药治疗的临床疗效。方法选取2017年1月至2021年1月于南京中医药大学附属医院就诊的胸段带状疱疹后神经痛患者60例,随机分为观察组30例(超声引导下椎旁阻滞联合血府逐瘀汤加减口服治疗)和对照组30例(加巴喷丁胶囊口服治疗)。治疗前、治疗后1周、2周、1个月、2个月和3个月分别使用视觉模拟评分量表(VAS)和匹兹堡睡眠指数评分量表(PSQI)评估临床疗效,并记录治疗期间患者的不良反应。结果治疗后1周、2周、1个月、2个月和3个月,两组患者VAS、PSQI评分均降低,且观察组显著低于对照组(P<0.05);观察组眩晕、嗜睡等不良反应发生率低于对照组(P<0.01)。观察组总有效率(96.7%vs 73.3%,P<0.01)和显效率(90.0%vs 56.7%,P<0.05)均高于对照组,差异有统计学意义。结论超声引导下椎旁阻滞联合中药治疗带状疱疹后神经痛起效快,镇痛效果显著,副作用小,中西医结合效果显著。Objective To investigate the clinical efficacy of ultrasound-guided paravertebral block combined traditional Chinese medicine in patients with postherpetic neuralgia.Methods A total of 60 patients with thoracic postherpetic neuralgia who were treated in the Affiliated Hospital of Nanjing University of Traditional Chinese Medicine from January 2017 to January 2021 were selected and randomly divided into observation group(n=30,ultrasound-guided paravertebral block combined with Xuefu Zhuyu Decoction)and control group(n=30,oral treatment with Gabapentin Capsules).Before treatment,1 week,2 weeks,1 month,2 months and 3 months after treatment,the visual analog scale(VAS)and Pittsburgh Sleep Index(PSQI)were used to evaluate the clinical efficacy,and the adverse reactions of patients during treatment was recorded.Results One week,2 weeks,1 month,2 months and 3 months after treatment,the VAS and PSQI scores of the two groups were decreased,and the observation group was significantly lower than the control group(P<0.05).The incidence of dizziness,drowsiness and other adverse reactions in the observation group was lower than that in the control group(P<0.01).The total effective rate(96.7%vs 73.3%,P<0.01)and markedly effective rate(90.0%vs 56.7%,P<0.05)of the observation group were higher than those of the control group,and the difference was statistically significant.Conclusion Ultrasound-guided paravertebral block combined with traditional Chinese medicine in the treatment of postherpetic neuralgia has a rapid onset,significant analgesic effect,and small side effects.

关 键 词：带状疱疹后神经痛 超声引导下椎旁阻滞 血府逐瘀汤 加巴喷丁 

分 类 号：R614.4[医药卫生—麻醉学]