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神经阻滞治疗对带状疱疹神经痛的影响

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带状疱疹的发病率呈逐年上升趋势,带状疱疹后神经(postherpetic neuralgia,PHN)发生率随年龄增长而增加,随着人口老龄化,普通药物治疗在合并基础疾病的老龄患者往往效果不佳.基于倾向性评分匹配理论,通过建立预防PHN的多变量模型,对江苏省中医院就诊急性期带状疱疹神经痛患者进行了回顾性的临床疗效差异性分析.研究结果表明:在治疗后6个月,早期神经阻滞组的数字评分和PHN发生率均低于非神经阻滞治疗组(P<0.05),而完全缓解率均明显高于非神经阻滞治疗组(P<0.05).利用多因素回归方法对396例带状疱疹神经痛(zoster related neuralgia,ZRN)病人统计发现,早期神经阻滞是PHN发生率的保护因素,对于中度至重度疼痛的ZRN病人,早期神经阻滞治疗能够取得良好长期疗效,并可能预防急性带状疱疹神经痛向慢性疼痛转变.研究结果对提高ZRN临床疗效和预防PHN具有一定的参考价值.
Effect of Nerve Block Therapy on Herpes Zoster Neuralgia
The incidence of shingles is on the rise year by year,and the incidence of PHN(postherpetic neuralgia)increases with age.With the aging of the population,ordinary drug treatment is often ineffective in elderly patients with underlying diseases.Based on the propensity score matching theory,a multivariate model was established to prevent PHN in patients with acute herpes zoster neuralgia treated at Jiangsu Provincial Traditional Chinese Medicine Hospital,and a retrospective clinical efficacy difference analysis was conducted.The research results show that at 6 months after treatment,the digital score and incidence of PHN in the early nerve block group are lower than those in the non nerve block treatment group(P<0.05),while the complete remission rate is significantly higher than that in the non nerve block treatment group(P<0.05).Using multivariate regression analysis,it is found that early nerve block is a protective factor for the incidence of PHN in 396 patients with ZRN(zoster related neuralgia).For ZRN patients with moderate to severe pain,early nerve block treatment can achieve good long-term efficacy and may prevent the transition from acute herpes zoster neuralgia to chronic pain.The research results have certain reference value for improving the clinical efficacy of ZRN and preventing PHN.

herpetic neuralgianerve blockearly treatmentclinical efficacy

黄岚、邹蓉、郑曼、田伟千、胡虹钰、汤洋

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南京中医药大学附属江苏省中医院麻醉科,南京 210000

带状疱疹神经痛 神经阻滞 早期治疗 临床疗效

2024

科学技术与工程
中国技术经济学会

科学技术与工程

CSTPCD北大核心
影响因子:0.338
ISSN:1671-1815
年,卷(期):2024.24(34)