A型肉毒毒素联合甲钴胺治疗三叉神经痛临床观察  

Clinical observation of type A botulinum toxin combined with mecobalamine in treatment of trigeminal neuralgia

作　　者：刘君[1] 汪建云 张宁[1] 刘焕 巩诗彤 安晓雷[1] LIU Jun;WANG Jianyun;ZHANG Ning;LIU Huan;GONG Shitong;AN Xiaolei(Xuzhou Central Hospital,Xuzhou 221009,China)

机构地区：[1]徐州市中心医院,江苏徐州221009

出　　处：《中国实用神经疾病杂志》2025年第3期356-359,共4页Chinese Journal of Practical Nervous Diseases

基　　金：徐州市科技局基金项目(编号:KC22175)。

摘　　要：目的评估A型肉毒毒素(BTX-A)联合甲钴胺治疗三叉神经痛的临床效果及其对患者心理情绪的影响。方法纳入徐州市中心医院2021-01—2023-12收治的40例三叉神经痛患者为观察对象,随机分成对照组和观察组,每组20例。对照组予以A型肉毒素注射治疗,观察组予以A型肉毒素和甲钴胺联合治疗。2组均在治疗2、4、12周后观察疗效,采用视觉模拟评分量表(VAS评分)对2组患者进行评估,应用汉密尔顿焦虑量表(HAMA)和匹兹堡睡眠质量指数(PSQI)对患者治疗后第12周的焦虑和睡眠情况进行评估。结果观察组和对照组治疗前VAS评分差异无统计学意义(P>0.05),治疗后2、4、12周2组VAS评分均低于治疗前(P<0.05),观察组明显低于对照组,差异有统计学意义(P<0.05),2组VAS评分变化趋势也存在统计学差异(P<0.05)。观察组治疗后2、4、12周的有效率高于对照组,差异有统计学意义(P<0.05)。治疗12周,2组HAMA和PSQI评分均下降(P<0.05),与治疗前相比差异均有统计学意义(P<0.05)。观察组治疗后12周HAMA及PSQI评分较对照组更低,差异有统计学意义(P<0.05)。结论A型肉毒素联合甲钴胺治疗三叉神经痛患者疗效确切,能减轻焦虑及睡眠状况,改善心理情绪。Objective To evaluate the clinical effect of botulinum toxin type A combined with mecobalamin in the treatment of trigeminal neuralgia,and explore its effect on the psychological mood.Methods Forty patients with trigeminal neuralgia admitted to Xuzhou Central Hospital from January 2021 to December 2023 were included as the observation objects,and were randomly divided into the control group and the observation group,with 20 cases in each group.The control group was treated with type A botulinum toxin injection,and the observation group was treated by type A botulinum toxin combined with mecobalamin.The effects of the two groups were observed after 2,4 and 12 weeks of treatment.The visual analogue scale(VAS)was used after treatment,and the effective rate was compared.Hamilton anxiety scale(HAMA)and Pittsburgh sleep quality index(PSQI)were used to evaluate the patients’anxiety and sleep at the 12th week after treatment.Results There was no significant difference on VAS score between the observation group and the control group before treatment(P>0.05),at 2,4 and 12 weeks after treatment,the VAS scores of the two groups were lower than those before treatment(P<0.05).VAS score of the observation group was significantly lower than that of the control group,the difference was statistically significant(P<0.05).The change trend of VAS score between the two groups also had statistical different(P<0.05).The effective rates of the observation group at 2,4 and 12 weeks after treatment were higher than those of the control group,the differences were statistically significant(P<0.05).After 12 weeks of treatment,HAMA and PSQI scores decreased in both groups(P<0.05).Compared with those before treatment,these changes were statistically significant(P<0.05).The HAMA and PSQI scores of the experimental group were lower than those of the control group at 12 weeks after treatment,the difference was statistically significant(P<0.05).Conclusion Botulinum toxin type A combined with mecobalamin has positive clinical effect in the treatme

关 键 词：三叉神经痛 A型肉毒素 甲钴胺 心理情绪 焦虑 睡眠状况 

分 类 号：R745.11[医药卫生—神经病学与精神病学]