甲钴胺联合卡马西平治疗三叉神经痛的效果观察

目的 探讨甲钴胺联合卡马西平治疗三叉神经痛的临床疗效.方法 选取2011年3月至2012年3月解放军第一一三医院收治的180例原发性三叉神经痛患者,采用随机数字表法分为研究组和对照组,每组90例.对照组患者服用卡马西平片（0.1g/次,2次/d）;研究组在对照组的基础上加服甲钴胺片（0.5 mg/次,3次/d）.2组均1个月为1个疗程,共2个疗程.通过对比2组患者治疗2、4、8周的疼痛视觉模拟评分（VAS）、疼痛缓解程度及治疗后生活质量评分来评价临床疗效,并比较2组的不良反应发生情况.结果 研究组和对照组患者治疗后2、4、8周VAS差异均有统计学意义[研究组：（4.0±1.8）、（2.4±0.7）、（1.0±1.1）分,对照组：（4.3±1.7）、（3.1±0.8）、（1.8±0.9）分,均P＜0.05].研究组和对照组疼痛完全缓解率分别为68.9％（62/90）和54.4％（49/90）,组间差异有统计学意义（P＜0.05）.研究组患者在睡眠质量、生活质量、食欲、兴趣爱好等方面评分均明显低于对照组,差异均有统计学意义[（2.1±0.3）分比（4.3±0.9）分、（2.7±0.9）分比（7.1±1.4）分、（2.4±0.2）分比（6.3±0.6）分、（2.9±0.5）分比（6.9±1.1）分]（均P ＜0.05）.研究组与对照组不良反应发生率的差异无统计学意义[2.2％（2/90）比8.9％（8/90）,P＞0.05].结论 甲钴胺联合卡马西平治疗三叉神经痛可明显缓解患者的疼痛症状,改善患者的生活质量.

Clinical observation of mecobalamin combined with carbamazepine in treatment of trigeminal neuralgia

Objective To investigate the clinical efficacy of mecobalamin combined with carbamazepine in treatment of trigeminal neuralgia.Methods A total of 180 patients with trigeminal neuralgia from No.113 Hospital of People＇s Liberation Army were gathered from March 2011 to March 2012.They were randomly divided into control group and study group.The control group received carbamazepine （0.1 g,bid.） and the study group received mecobalamin （0.5 mg,tid.） on the basis of the control group.The visual analogue scale（VAS） score and quality of life scores,pain relief and other adverse reactions were compared after two weeks,four weeks and eight weeks,respectively.Results The VAS scores were significantly different in the two groups after 2,4 and 8 weeks [study group：（4.0±1.8） scores,（2.4±0.7） scores,（1.0±1.1） scores; control group：（4.3±1.7） scores,（3.1 ±0.8） scores,（1.8 ±0.9） scores] （all P 〈 0.05）.The cases with complete remission in study group[68.9% （62/90）]were significantly higher than those in the control group[54.4% （49/90）] （P 〈0.05）.The scores of sleep,life,appetite and interest in study group [（2.1 ± 0.3） scores,（2.7 ± 0.9） scores,（2.4 ± 0.2） scores,（2.9 ± 0.5） scores] were significantly lower than those in the control group [（4.3 ± 0.9） scores,（7.1 ± 1.4） scores,（6.3 ±0.6） scores,（6.9 ± 1.1） scores] （all P 〈 0.05）.The adverse effects rates were no significantly different in the two groups[2.2% （2/90） vs 8.9% （8/90）,P 〉0.05].Conclusion Mecobalamin combined with carbamazepine for the treatment of trigeminal neuralgia can relieve pain significantly and improve the quality of life.