【摘要】：目的:本文主要觀察并探討神經(jīng)阻滯聯(lián)合干擾電療法治療帶狀皰疹后遺肋間神經(jīng)痛(postherpetic intercostal neuralgia,PHN)的有效性及安全性。方法:選擇我院疼痛門診收治的PHN患者60例,隨機(jī)分為A(對照組)、B(治療組),每組30例。A組行口服普瑞巴林加相應(yīng)部位的肋間神經(jīng)阻滯治療;B組在同樣藥物的基礎(chǔ)上作相應(yīng)肋間神經(jīng)阻滯聯(lián)合干擾電療法。分別于治療前、治療后1周、治療后8周觀察并記錄兩組患者的視覺模擬評分(VAS)、睡眠質(zhì)量評分(QS)以及不良反應(yīng)的發(fā)生情況。兩組患者的近期和遠(yuǎn)期療效可通過兩種評分來綜合比較。結(jié)果:兩組患者在性別、年齡、病程、治療前VAS評分及QS評分等一般資料的比較上,差異無統(tǒng)計(jì)學(xué)意義(P0.05),具有可比性。與治療前比較,治療后1周和治療后8周兩組患者的VAS及QS評分均有所降低,且治療后1周及治療后8周B組的VAS及QS評分均明顯低于A組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。遠(yuǎn)期(8周后)綜合療效比較中可以得出,兩組患者的治療總有效率均為100%,A組顯效率為70%(21/30),B組顯效率為93%(28/30)。與B組相比,A組顯效率明顯降低,差異有統(tǒng)計(jì)學(xué)意義(χ2=1.92 P0.05)。兩組患者不良反應(yīng)的記錄中,A組有3例患者,B組有2例患者肋間神經(jīng)阻滯后出現(xiàn)頭暈癥狀,休息數(shù)分鐘后緩解,無感染、呼吸困難、血?dú)庑氐陌l(fā)生。兩組患者在干擾電治療中均無皮膚刺激反應(yīng)和皮膚燒灼等不良反應(yīng)的發(fā)生。結(jié)論:神經(jīng)阻滯聯(lián)合干擾電療法能更有效的緩解或解除PHN患者的痛苦,效果更為持久,精神狀態(tài)也能很好的改善,生活質(zhì)量也有很大的提高,臨床上值得推薦應(yīng)用。
[Abstract]:Objective: to investigate the efficacy and safety of nerve block combined with interference electrotherapy in the treatment of intercostal neuralgia after herpes zoster. Methods: sixty patients with PHN were selected from pain outpatient department in our hospital. Group A (control group, 30 cases) were randomly divided into two groups: group A (group A) and group B (group B) were given intercostal nerve block combined with intercostal nerve block on the basis of the same drug. Visual analogue score (VAS),) sleep quality score (QS) and adverse reaction (ADR) were observed and recorded before treatment 1 week after treatment and 8 weeks after treatment. The short-term and long-term outcomes of the two groups can be comprehensively compared by two scores. Results: there was no significant difference in sex, age, course of disease, VAS score and QS score between the two groups (P0.05). The scores of VAS and QS in group B were significantly lower than those in group A 1 week after treatment and 8 weeks after treatment, and the scores of VAS and QS in group B were significantly lower than those in group A at 1 week and 8 weeks after treatment (P0.05). The long-term (8 weeks later) comprehensive efficacy comparison showed that the total effective rate of both groups was 70% in group A (93%) in group 21 / 30), B (28 / 30). Compared with group B, the effective rate of group A was significantly lower than that of group B (蠂 2 1.92 P 0.05). There were 3 cases in group A and 2 cases in group B with dizziness after intercostal nerve block. The symptoms were relieved after a few minutes rest, no infection, dyspnea and hemopneumothorax occurred. There were no adverse reactions such as skin irritation and skin cauterization in both groups. Conclusion: nerve block combined with interference therapy can alleviate or relieve the pain of PHN more effectively, the effect is more lasting, the mental state can also be improved, and the quality of life is also greatly improved, which is worthy of clinical recommendation.
【學(xué)位授予單位】：蚌埠醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R614

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