加巴喷丁联合神经阻滞治疗原发性三叉神经痛的临床观察

目的观察加巴喷丁联合神经阻滞治疗原发性三叉神经痛的临床疗效及不良反应。方法将2010年3月至2011年12月南宁市红十字会医院收治的90例原发性三叉神经痛患者按随机数字表法分为单纯加巴喷丁药物治疗组(A组)和加巴喷丁联合神经阻滞治疗组(B组),各45例,A组每天口服加巴喷丁1200 mg,连服4周;B组加巴喷丁用法与A组相同,同时每周给予神经阻滞治疗1次,连续3周。4周后观察两组的疼痛强度(PI)、疼痛缓解度(PAR)、镇痛有效率及不良反应发生情况。结果两组治疗后NRS评分明显低于治疗前(P<0.05),B组在治疗后3、7、14、21、28 d的NRS评分均明显低于A组(P<0.05);B组镇痛效率在治疗后3、7 d与A组无差别,在治疗后14、21、28 d高于A组(P<0.05);两组不良反应发生率比较差异无统计学意义(P>0.05)。结论加巴喷丁联合神经阻滞治疗原发性三叉神经痛临床效果好,不良反应少,是非手术疗法的较好选择。

Clinical Observation on Combined Gabapentin and Nerve Block in the Treatment of Primary Trigeminal Neuralgia

Objective To evaluate the efficacy and adverse reaction of combined gabapentin and nerve block in the treatment of primary trigeminal neuralgia.Methods 90 adult patients with trigeminal neuralgia were divided into gabapentin medical treatment group(A)and combined gabapentin and nerve block group(B),45 cases each group.Patients of group A were given gabapentin 1200 mg per day,treated for 4 weeks.The usage of gabapentin in group B was same as group A,and patients of group B were treated with nerve block once a week for 3 weeks.The numeric rating scales(NRS)changes,efficacy rate of relieving pain and the adverse reaction were observed after 4 weeks.Results The NRS scores of group A and group B were obviously decreased after treatment with pre-treatment(P<0.05),the NRS scores in group B were obvious lower than group A at 3,7,14,21,28 days post-treatment(P<0.05).On the efficacy rate of pain relief,there was no differences between group A and group B at 3,7 days post-treatment,but group B was obviously higher than group A at 14,21,28 days post-treatment(P<0.05).There was no differences between the two groups in the occurrence of the adverse reaction(P>0.05).Conclusion The treatment of primary trigeminal neuralgia by combined gabapentin and nerve block has better efficacy and little adverse reactions,which is a good choice for the non-surgical treatment of trigeminal neuralgia.