中西医结合治疗原发性三叉神经痛50例临床观察

目的观察愈痛散配合卡马西平治疗原发性叉神经痛的临床疗效。方法将98例原发性三叉神经痛患者随机分为2组。治疗组50例子愈痛散加卡马西平治疗,对照组48例子卡马西平治疗。2组均20d为1个疗程,1个疗程后观察简化麦吉尔疼痛问卷（McGill）疼痛量表评分及肌电图瞬目反射（BR）各指标改善情况。结果2组治疗后的简化McGill疼痛量表各项评分与本组治疗前比较差异均有统计学意义（P〈0．05）。治疗组治疗后PRI感觉评分、PRI总分均低于对照组（P〈0．05）;2组治疗前后简化McGill疼痛量表各项评分的差值比较,治疗组均高于对照组（P〈0．05）。在瞬目反射方面,2组治疗前受累侧与正常侧R1时限比较差异无统计学意义（P〉0．05）,治疗后组内及组间比较差异无统计学意义（P〉0．05）,治疗前受累侧1t2较正常侧1t2延长。2组治疗后受累侧1t2较本组治疗前均明显改善（P〈0．05）,治疗组改善程度优于对照组（P〈0．05）。结论愈痛散配合卡马西平治疗三叉神经痛,从疼痛症状缓解及BR客观指标改善方面均取得了良好效果,值得临床推广。

Clinical research of treating trigeminal neuralgia with combined therapy of traditional Chinese medicine and western medicine

Objective To observe the clinical effects of Yutongsan combined with Carbamazepine on the treatment of trigeminal neuralgia. Methods 98 patients with trigeminal neuralgia were randomly divided into tow group. The patients in treatment group （ n = 50） were treated with Yutongsan combined with Carbamazepine. 48 ca- ses in control group were treated by Carbamazepine alone. The therapeutic course was 20 days in two groups. The im- provement of the pain after treatment was evaluated by McGill Pain questionaire and Blink reflex （BR） of EMG in these two group. Results PRI sensation scores and total PRI scores in treatment group were lower than those in control group （ P 〈 0.05）. And the differences between before and after treatment in aH item of McGill Pain ques- tionaire were higher than those in control group （ P 〈 0.05）. On the aspect of Blink reflex there was no difference between two groups on R1 time of affected side and the normal side before treatment （ P 〉 0.05）. And there was no difference between two groups on R1 time of affected side and the normal side after treatment （ P 〉 0.05 ）. There was no difference between before and treatment in two groups （ P 〉 0.05）. R2 of affected side before treatment was extended as compared with that after treatment. R1 and R2 of affected side after treatment were significantly improved as compared with those before treatment. The improvement of R1 and R2 in treatment group was superior to that in control group （ P 〈 0.05）. Conclusion Yutongsan combined with Carbamazepine has a good effect in pain relief and BR improvement for treating trigeminal neuralgia.