高压氧综合治疗老年患者带状疱疹后遗神经痛46例疗效观察  

Clinical effect of hyperbaric oxygen therapy on 46 cases of postherpetic neuralgia in elderly patients

作　　者：李爱芝[1] 杨卉[2] 张媛 徐伟伟 Li Aizhi;Yang Hui;Zhang Yuan;Xu Weiwei(Department of Anesthesiology,Yantai Yuhuangding Hospital,Yantai 264000,China;Department of Pharmacy,Yantaishan Mountain Hospital of Yantai City,Yantai 264000,China;Department of Dermatology,No.970 Hospital of PLA,Yantai 264000,China)

机构地区：[1]烟台毓璜顶医院麻醉科,烟台264000 [2]烟台市烟台山医院药剂科,烟台264000 [3]联勤保障部队第九七○医院皮肤科,烟台264000

出　　处：《中华航海医学与高气压医学杂志》2022年第4期538-541,554,共5页Chinese Journal of Nautical Medicine and Hyperbaric Medicine

摘　　要：目的:探讨高压氧(HBO)综合治疗老年带状疱疹后遗神经痛(PHN)患者的临床疗效及其作用机制。方法:选取2019年7月至2021年7月毓璜顶医院皮肤科收治的92例老年PHN患者作为研究对象,采用随机数字表法分为观察组(n=46例)和对照组(n=46例)。对照组在常规治疗的基础上予以盐酸羟考酮缓释片和普瑞巴林治疗;观察组在对照组治疗的基础上予以HBO治疗。采用数字疼痛评分(NRS)法评估患者疼痛的改善情况,并对治疗效果进行评估;采用简明疼痛评估量表(BPI)评估治疗前后患者的生活质量;采用酶联免疫法检测血清5-羟色胺(5-HT)和降钙素基因相关肽(CGRP)等疼痛因子水平。结果:观察组治疗4个疗程后总有效率(95.65%)明显高于对照组(80.43%),差异有统计学意义(χ2=4.432,P=0.036)。观察组患者治疗7、14、21、28 d的NRS评分均明显低于对照组(P<0.05)。观察组患者治疗后日常生活、情绪、活动能力、工作、与他人交往、睡眠、享受生活及BPI总评分均明显低于对照组(P<0.05)。观察组治疗14、28 d后,血清5-HT和CGRP水平均明显低于对照组(P<0.01)。结论:在普瑞巴林和盐酸羟考酮缓释片治疗的基础上联合HBO治疗老年患者PHN,能够缓解患者疼痛,提高其生活质量,可推广应用。Objective To investigate the clinical efficacy and mechanism of hyperbaric oxygen(HBO)in the treatment of elderly patients with postherpetic neuralgia(PHN).Methods A total of 92 elderly PHN patients treated in the Department of Anesthesiology of Yantai Yuhuangding Hospital from July 2019 to July 2021 were selected as research subjects.They were randomly divided into two groups:observation group(n=46)and control group(n=46).The control group was given oxycodone hydrochloride controlled-release tablets and pregabalin on the basis of conventional treatment.The observation group was given HBO on the basis of the treatment in the control group.The pain numerical rating scale(NRS)was used to evaluate the improvement of pain and the therapeutic effect.The brief pain inventory(BPI)scale was used to evaluate the quality of life of patients before and after treatment.The enzyme-linked immunosorbent assay was used to detect the levels of serum pain factors,such as 5-hydroxytryptamine(5-HT)and calcitonin gene-related peptide(CGRP).Results After four courses of treatment,the total effective rate of the observation group(95.65%)was significantly higher than that of the control group(80.43%),with statistically significant difference(χ2=4.432,P=0.036).The NRS scores of the observation group on day 7,14,21,and 28 of the treatment were significantly lower than those of the control group(P<0.05).The item scores of general activity,mood,walking ability,normal work,relations with other people,sleep,and enjoyment of life and the total score of BPI in the observation group were significantly lower than those in the control group(P<0.05).The levels of serum 5-HT and CGRP on day 14 and 28 of the treatment in the observation group were significantly lower than those in the control group(P<0.01).Conclusion On the basis of pregabalin and oxycodone hydrochloride controlled-release tablets,adding HBO to the treatment of PHN in elderly patients can achieve good clinical efficacy by alleviating the pain and improving the quality of life,which

关 键 词：高压氧 老年患者 带状疱疹后遗神经痛 普瑞巴林 盐酸羟考酮 

分 类 号：R752.12[医药卫生—皮肤病学与性病学]