普瑞巴林联合神经阻滞在老年人头面颈部带状疱疹后神经痛中的应用

目的观察不同剂量普瑞巴林联合神经阻滞治疗老年人头面部带状疱疹后神经痛的有效性和安全性。方法头面部带状疱疹后神经痛老年患者54例,随机分为低剂量组和高剂量组。高剂量组采用三叉神经分支阻滞和皮损区皮内注射治疗每星期一次,治疗1个月,并从治疗开始时口服普瑞巴林300 mg/d,bid直至第10周,低剂量组采用相同的神经阻滞疗法并从治疗开始时口服普瑞巴林150 mg/d,bid直至第10周。用视觉模拟评分(visual analoguescale,VAS)和睡眠质量评分(quality of sleep,QS)评价治疗效果,并观察治疗后的不良反应。结果与治疗前比较,两组治疗后第1～10w,VAS和QS评分均显著下降(P<0.05);与低剂量组相比,高剂量组治疗后第5w和第4w开始VAS评分和QS评分分别降低,且差异有统计学意义(P<0.05);两组患者治疗后10周,不良反应无明显差别。结论普瑞巴林300 mg/d联合神经阻滞可迅速缓解老年头面部带状疱疹后神经痛,改善睡眠质量,且无明显不良反应,值得临床推广。

Application of Pregabalin Combined with Nerve Block in the Treatment of Strip Spore Rash Postherpetic Neuralgia in Head,Face and Neck of the Elderly

Objective To observe the effect of different doses of pregabalin combined with nerve block in the treatment of elderly head and face postherpetic neuralgia.Method 54 elderly head and face postherpetic neuralgia patients were divided into low dose group and high dose group.High-dose group were treated with trigeminal nerve block and intradermal injection in the lesion area once a week for 1 month and combined with oral pregabalin 300 mg one day,2 times a day until the 10th week;the low dose group used the same nerve block treatment with high dose group but oral pregabalin 150 mg one day,2 times a day until the 10th week.Visual analog scale(VAS) and sleep quality score(QS) were evaluated and adverse reactions were observed after treatment.Results Compared with pre-treatment,VAS and QS were significantly decreased from 1 week to 10 weeks after treatment.Compared with low dose group,the VAS and QS decreased 5 weeks and 4 weeks after treatment respectively in the high group.The adeverse effect of the two groups had no significant difference.Conclusion Pregabalin 300 mg one day with nerve block can quickly relieve elderly head and face postherpetic neuralgia and improve sleep quality,with no obvious adverse effects and is worthy of promotion.