复方倍他米松神经阻滞治疗胸背部带状疱疹后神经痛的疗效

目的探讨复方倍他米松神经阻滞治疗胸背部带状疱疹后神经痛（PHN）的疗效。方法选择胸背部带状疱疹后神经痛40例。随机分为研究组和对照组，分别采用复方倍他米松和曲安奈德合并维生素B12行肋间神经阻滞。在第1周-第4周、第8周测定视觉模拟评分（VAS）和睡眠质量评分（QS）综合评定治疗结果。结果与治疗前比较，研究组治疗后各时段的VAS评分明显下降，差异均有统计学意义（1分别=19．80、25．58、33．96、39．82、37．86，P均〈0．05）；与对照组比较。研究组治疗后各时段的VAS评分明显下降，差异均有统计学意义（t分别=9．31j3．04、7．53、4．89、2．85，P均〈0．05）。研究组治疗后QS评分与治疗前比较，差异有统计学意义（t分别=12．06、19．88、21．94、31．72、35-36，P均〈0．05），与对照组比较。研究组治疗后QS评分明显下降，差异有统计学意义（t分别=5．11、7．25、11．90、8．49、6．86。P均〈0．05）。研究组治疗后显效率为85％，与对照组比较。差异有统计学意义（x^2=4．02，P〈0．05）。结论复方倍他米松合并维生素B12行肋间神经阻滞治疗胸背部PHN具有起效快、发挥作用时间长等特点，从而达到更好的止痛效果，改善患者的生活质量。

Therapeutic effect of compound betamethasone on nerve block in relieving thorax-back postherpetic neuralgia

Objective To investigate the efficacy of compound betamethasone in the treatment of thorax -back postherpetic neuralgia （PHN）. Method Forty patients with thorax -back post herpetic neuralgia were divided into two groups randomly. The study group received intercostal nerve block with compound betamethasone and vitamin B12 and the control group received nerve block with triamcinolone acetonide and vitamin B12. The effects were evaluated according to visual analogue scale （VAS）and quality of sleep （QS） in the first to the forth week and the eighth . Results In the study group, VAS after treatment decreased markedly compared with that before treatment （ t = 19.80,25.58,33.96,39.82,37.86, P〈0.05）,and decreased significantly when compared with the control group （ t = 9.31,3.04,7.53,4.89,2.85 , P〈0.05 ） ; Qs decreased markedly compared with that before treatment （t= 12.06,19.88,21.94,31.72,35.36 , P〈0.05 ）,and decreased significantly when compared with the control group （t=5.11,7.25,11.90,8.49,6.86,P〈0.05）.The excellence rate was 85% in the study group. Compared with the control group, the difference had statistic significance（x^2=4.02,P〈0.05）. Conclusions Intercostal nerve block with compound betamethasone and vitamin B12 in relieving thorax -back PHN can provide fast and effective analgesia and improve the life of patients.