局部与椎旁阻滞和电刺激综合治疗带状疱疹后神经痛

目的 观察局部浸润、椎旁阻滞与经皮神经电刺激治疗带状疱疹后神经痛的效果。方法 选择40例顽固性带状疱疹后神经痛的患者，随机分为观察组和对照组，每组20例。观察组治疗方法为：皮损区用0.2％布比卡因、泼尼松龙、弥可保浸润，同时椎旁阻滞与经皮神经电刺激；对照组采用局部浸润及椎旁阻滞。以视觉模拟评分（VAS）和睡眠质量评分（SQS）评定治疗效果。结果 治疗后1、2、3周两组VAS和SQS评分均明显下降（JD〈0．01），观察组治疗后VAS和SQS下降幅度显著大于对照组（P〈0．05或P〈0．01）。两组治疗有效率均为100％，但观察组显效率为80％，显著高于对照组60％（P〈0．05）。结论 两种治疗方法对带状疱疹后神经痛均有显著疗效，但局部浸润、椎旁阻滞与经皮神经电刺激疗法对缓解带状疱疹后神经痛及改善睡眠质量的效果均优于神经阻滞疗法。

Efficacy of local infiltration and paravertebral nerve block combined with HANS transcutaneous electric nerve stimulation on postherpetic neuralgia

] Objective To observe the efficacy of local infiltration, paravertebral nerve block combined with HANS transcutaneous electric nerve stimulation on postherpetic neuralgia. Methods Forty patients suffering intractable PHN were randomly divided into two groups: the control group was treated with local infiltration with solution containing 0.2% bupivicaine, prednisolone, mecobamine and paravertebral nerve block; while the study group treated with the same method plus HANS transcutaneous electric nerve stimulation. Visual analogue scale (VAS) and sleep quality scale(SQS) were evaluated. Results All the scores of VAS and SQS decreased significantly after treatment comparing with before the treatement (P<0.01) in both groups, and study group was better than controll group (P<0.05 or P<0.01). For pain relief, the excellent rate of study group was significantly higher than that of control group (P<0.05 or P<0.01). Conclusion Local infiltration with paravertebral nerve block is efficient for PHN, combinned with HANS transcutaneous electric nerve stimulation the treatment results, including pain relief, sleep quality and the excellent rate can be improved.