中国实用口腔科杂志

中国实用口腔科杂志 ›› 2010, Vol. 3 ›› Issue (05): 290-291.

• 论著 • 上一篇    下一篇

局部封闭联合卡马西平治疗原发性三叉神经痛临床观察

  

  1. 中山大学光华口腔医学院附属口腔医院口腔颌面外科，广州  510055
  • 收稿日期:2010-03-31 修回日期:2010-04-24 出版日期:2010-05-15 发布日期:2010-06-01

  • Received:2010-03-31 Revised:2010-04-24 Online:2010-05-15 Published:2010-06-01

摘要：

目的    评价局部封闭联合卡马西平治疗原发性三叉神经痛的临床效果。方法    选择2006年9月至2009年3月中山大学附属口腔医院收治的52例原发性三叉神经痛患者，其中男14例，女38例，年龄46～67岁，平均58岁。按随机分配原则分为试验组（局部封闭+卡马西平）和对照组（卡马西平）。试验组患者采用地塞米松1 mg、维生素B1 100 mg、维生素B12 1 mg和2％利多卡因1mL混合液行局部封闭，每周2次，共4周，同时口服卡马西平；对照组单纯口服卡马西平。采用疼痛视觉模拟评分法（VAS）对疼痛进行评估，并比较治疗前后的效果。结果    治疗后1个月和12个月时试验组的优良率（92.31%和69.23%）与对照组（57.69%和38.46%）比较差异均有统计学意义（P < 0.05）。治疗后1个月试验组和对照组VAS值均显著下降，且组间差异有统计学意义（P < 0.05）；12个月后两组VAS值均增高，且差异仍有统计学意义（P < 0.05）。结论    局部封闭联合卡马西平治疗原发性三叉神经痛是一种非常有效和安全的方法。

关键词: 三叉神经痛, 地塞米松, 维生素B1, 维生素B12, 卡马西平, 封闭治疗

Abstract:

Objective    To assess the experiment effects of local blockade combined with carbamazapine in the treatment for patients with primary trigeminal neuralgia. Methods    From September 2006 to March 2009，52 cases （14 males and 38 females，aged from 46 to 67 with the mean of 58 years），diagnosed as primary trigeminal neuralgia in Hospital of Stomatology，Sun Yat-Sen University，were divided into two groups randomly. Experiment group was locally blocked with solution of 2% lidocaine 1mL，dexamethasone 1 mg，Vitamin B1 100mg and Vitamin B12 1mg，twice a week， for 4 weeks，and carbamazepine was given orally. In control group，carbamazepine was given orally only. The intensity of pain was evaluated by means of the Visual Analogue Scale （VAS）. Results    After 1 month the excellence rate was 92.31% in experiment group and 57.69% in control group and after 12 months the excellence rate was 69.23% and 38.46% respectively. Experiment group was more effective， the dosage of carbamazepine was lower and the adverse effect was less. Conclusion    The local blockade combined with carbamazapine is an effective method to manage trigeminal neuralgia.

Key words: trigeminal neuralgia；dexamethasone；vitamin B1；vitamin B12；carbamazepine；blockade therapy