A型肉毒毒素复合罗哌卡因治疗三叉神经痛的疗效

目的评价A型肉毒毒素（BTX-A）复合罗哌卡因治疗特发性三叉神经痛的临床效果。 方法选取2018年12月至2019年10月在中国医科大学附属口腔医院就诊的特发性三叉神经第三支疼痛患者20例，随机数字表法分为试验组、对照组，每组10例。试验组采用BTX-A复合罗哌卡因治疗，对照组采用卡马西平治疗。两组治疗前及治疗后1 h、6 h、12 h、1周、1个月、3个月和6个月行视觉模拟量表（VAS）评分比较疼痛程度，同时统计和比较疼痛发作频率及睡眠质量，进行疗效评价。使用SPSS 20.0软件进行数据分析。 结果试验组疼痛VAS评分在治疗后1 h、1个月分别为0.4 ± 0.5和2.8 ± 3.1，分别低于对照组（1.2 ± 1.0、5.1 ± 1.4），差异均有统计学意义（t_{1 h}=-2.191，P_{1 h}= 0.047；t_1个月=-2.155，P_1个月= 0.045）；试验组治疗后1个月睡眠质量评分为7.8 ± 3.2，对照组为10.8 ± 2.4，差异有统计学意义（t=-2.395，P= 0.028）；试验组疼痛发作频率在治疗后1周、1个月、3个月均低于对照组，而在治疗后6个月高于对照组，差异均有统计学意义（t_1周=-2.900，P_1周= 0.010；t_1个月= -4.544，P_1个月= 0.001；t_3个月=-5.156，P_3个月= 0.000；t_6个月= 3.391，P_6个月= 0.003）。 结论BTX-A复合罗哌卡因可缓解特发性三叉神经痛，改善患者的睡眠状况。

Efficacy of botulinum toxin type A combined with ropivacaine in the treatment of trigeminal neuralgia

ObjectiveTo evaluate the clinical effect of botulinum toxin type A(BTX-A)combined with ropivacaine in the treatment of idiopathic trigeminal neuralgia.MethodsTwenty patients with idiopathic trigeminal neuralgia who were treated at the Stomatological Hospital of China Medical University from December 2018 to October 2019 were selected and divided into experimental group and control group by random number table method. The experimental group was treated with BTX-A combined with ropivacaine,and the control group was treated with carbamazepine. The two groups were assessed with visual analog scores(VAS)before treatment and at the 1 st hour,6 th hour,12 th hour,1 st week,1 st month,3 rd month and 6 th month after treatment to compare the degree of pain,the frequency of pain onset and sleep quality to evaluate the efficacy. SPSS 20.0 was used for statistical analysis.ResultsThe pain VAS scores of the experimental group were 0.4 ± 0.5 and 2.8 ± 3.1 at the 1 st hour and the 1 st monthafter treatment,respectively,which were lower than those in the control group(1.2 ± 1.0,5.1 ± 1.4),andthe differences were statistically significant(t1 st h=-2.191,P1 st h= 0.047;t1 st month=-2.155,P1 st month= 0.045);The sleep quality scores of the experimental group at the 1 st month after treatment were 7.8 ± 3.2,and thesleep quality scores of the control group were 10.8 ± 2.4. The sleep quality scores of the experimental groupwere lower than those of the control group at the 1 st month after treatment,which was statisticallysignificantly different(t =-2.395,P = 0.028);The frequency of pain onset of the experimental group waslower than that of the control group at the 1 st week,1 st month and 3 rd month after treatment,but higherthan that of the control group at the 6 th month after treatment,which was statistically significantly different(t1 st week=-2.900,P1 st week=0.010;t1 st month=-4.544,P1 st month=0.001;t3 rd month=-5.156,P3 rd month=0.000;t6 th month=3.391,P6 th month= 0.003).ConclusionBTX-A combined with ropivacaine can alleviate idiopathic trigeminalneuralgia and improve the quality of sleep of patients.