摘要
目的:探讨神经阻滞治疗带状疱疹相关性疼痛(zoster-associated pain,ZAP)的疗效。方法:回顾性分析南京大学医学院附属金陵医院疼痛科2018年6月至2022年6月接受神经阻滞治疗的ZAP病人共153例,按带状疱疹病程分为急性期组(acute herpetic neuralgia,AHN)(1~30天)、亚急性期组(subacute herpetic neuralgia,SHN)(31~90天)和慢性期组(postherpetic neuralgia,PHN)(>90天)。所有病人均行2次神经阻滞治疗,每次间隔7天。记录病人入院时、出院时、出院后1个月和3个月疼痛视觉模拟评分法(visual analogue scale,VAS)评分、口服药用量、匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)、病人满意度评分(likert scale)和药物不良反应。结果:三组病人出院时各项评分均较入院时明显改善(P<0.05),1个月和3个月时AHN组和SHN组普瑞巴林用量较出院时降低(P<0.05),阿片类药物用量AHN组在第3个月时较入院时和出院时显著降低(P<0.001),AHN组有30%的病人在出院后3个月内完全停药,SHN组有8%,PHN组仅有3%。AHN组VAS评分、PQSI评分和Likert评分均较SHN组和PHN组有显著改善,且药物不良反应发生率更低。结论:ZAP病人越早行神经阻滞治疗,病人疼痛缓解有效率越高,疼痛缓解越持久,口服药疗程越短。
Objective:To explore the efficacy of nerve block in the treatment of zoster-associated pain(ZAP).Methods:A total of 153 ZAP patients who received nerve block therapy in the Pain Department of Jinling Hospital affiliated to Medical College of Nanjing University from June 2018 to June 2022 were analyzed retrospectively.According to the course of herpes zoster,they were divided into acute group(acute herpetic neuralgia,AHN)(1-30 days),subacute group(subacute herpetic neuralgia,SHN)(31-90 days)and chronic group(postherpetic neuralgia,PHN)(more than 90 days).All patients were treated with nerve block twice with an interval of 7 days.The visual analogue scale(VAS),oral drug dosage,Pittsburgh sleep quality index(PSQI),patient satisfaction score(likert scale)and adverse reactions were recorded before admission,at discharge,1 month and 3 months after discharge.Results:The scores of patients in the three groups at discharge were significantly better than those at admission(P<0.05).The dosage of pregabalin in AHN group and SHN group at 1 month and 3 months was lower than that at discharge(P<0.05).The dosage of opioids in AHN group was significantly lower than that at admission and discharge(P<0.001).30%of patients in AHN group stopped taking drugs completely within 3 months after discharge,8%in the SHN group,Only 3%in PHN group.The scores of VAS,PQSI and Likert in AHN group were significantly better than those in SHN group and PHN group,and the incidence of adverse drug reactions was lower.Conclusion:The earlier the patients with ZAP were treated with nerve block,the higher the effective rate of pain relief,the longer the pain relief,and the shorter the course of oral medication.
作者
章阳
郝冲
曾永芬
陈浩飞
贾宏彬
金毅
ZHANG Yang;HAO Chong;ZENG Yongfen;CHEN Haofei;JIA Hongbin;JIN Yi(Anesthesia college,Xuzhou Medical University,Xuzhou 221004,China;Pain Department of Jinling Hospital Affiliated to Medical College of Nanjing University,Nanjing 210002,China)
出处
《中国疼痛医学杂志》
CAS
CSCD
北大核心
2023年第1期32-37,共6页
Chinese Journal of Pain Medicine
基金
江苏省重点研发项目(BE2018669)。
