两种类型带状疱疹神经痛神经阻滞的疗效观察

目的评估神经阻滞疗法对两种类型带状疱疹神经痛的效果。方法带状疱疹神经痛的患者43例分为激惹触痛型组（A组）及痹痛型组（B组）。A组28例，年龄（70．7±6．2）岁；B组15例，年龄（71．1±5．3）岁。两组均采用椎旁神经阻滞加皮损区皮下浸润性注药的方法。使用药物为0．3％利多卡因50m1、曲安奈德15mg和维生素B12 1mg混合液。每周1次，4次为1疗程。结果两组患者治疗后1周及3个月的视觉模拟评分（VAs）均显著低于治疗前（P〈0．01），而A组又较B组更低（P〈0．01）；治疗后3个月优良率在A组为96．4％（27／28例），B组为73．3％（11／15例）。两组差异有统计学意义（P〈0．01）。结论使用神经阻滞疗法治疗激惹触痛型带状疱疹神经痛的疗效较痹痛型患者显著。

Effects of nerve block on two types of herpes zoster neuralgia

Objective To evaluate the effects of nerve block therapy on the treatment of two types of herpes zoster neuralgia. Method Forty-three patients diagnosed as herpes zoster neuralgia were divided into two groups. Twenty-eight patients with the type of hyperesthesia and allodynia were allocated in the group A, aged （70.7±6.2） yr; the other patients with the type of hypoesthesia and hyperpathia were in the group B, aged （71.1±5.3） yr. All of the patients were performed para- vertebral and regional infiltration blocks with a solution of 0. 3% lidocaine 50 ml, triamcinolone 15 nag and vitamin B12 1 mg, qw, and four weeks in a course of treatment. Result The visual analogue scale （VAS） was （3. 0±1.0 ） in the group A, （4.3±0.9） in the group B at one week after the treatment; and （1.8±1.2）, （3.3±1.2） at three months after the treatment respectively. The rate of excellent and good in the group A was 96.4% （27/28 cases）, and in the group B was 73.3% （11/ 15 cases） at three months after the treatment, there were significantly statistic differences（P〈0. 05） between the two groups. Conclusion The effect of nerve block therapy with the solution of lidocaine, triamcinolone acetonide and vitamin B12 to treatment of herpes zoster neuralgia is very effective, in which the type of hyperesthesia and allodynia is better than the type of hypoesthesia and hyperpathia.