穴位注射盐酸利多卡因治疗原发性三叉神经痛的临床观察

发布时间：2018-02-24 14:29

本文关键词： 三叉神经痛穴位注射盐酸利多卡因卡马西平　出处：《南京中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:探讨盐酸利多卡因穴位注射治疗原发性三叉神经痛的疗效。方法:将符合纳入标准患者60例随机分配,其中治疗组(穴位注射组)30例,对照组(药物治疗组)30例。治疗组采用盐酸利多卡因进行穴位注射(第1支疼痛:鱼腰;第2支疼痛:四白;第3支疼痛:下关),隔日1次,7次为一疗程,连续2个疗程,疗程间隔2天。对照组卡马西平口服,每天2次,首次口服0.1克,后每日递加0.1克,直到面痛等症状消失,但每日最大量不能超于1.0克,以后根据其疼痛的程度和次数调整药量,确定最低有效维持量,连续治疗4周。两组于治疗前、治疗2周、4周及治疗结束3月后分别记录纳入者视觉模拟评分、中医症候积分,分别评定近期与远期疗效。结果:1.近期效果:2周后,总有效率治疗组(96.67%)与对照组(90.00%)无显著性差异(P0.05);4周后,总有效率治疗组(100.00%)明显高于对照组(90.00%),两组差异明显(P0.05)。两组患者无论在治疗2周后还是4周后的视觉模拟评分均呈下降趋势,有统计学差异(P0.01),但两组间患者治疗2周后的VAS评分无统计学差异(P0.05),治疗4周后,两组患者间的VAS评分存在统计学差异(P0.01);两组患者中医症状积分在治疗后均呈下降趋势,有统计学差异(P0.05)。2.远期治疗效果:治疗组总有效率(100.00%)明显高于对照组(90.00%),存在统计学差异(P0.01);两组患者VAS评分较治疗前均有统计学差异(P0.05);两组间的VAS评分亦有统计学差异(p0.01)。中医症状评分,两组较治疗前均有统计学差异(P0.05),但两组间在治疗3个月后无统计学差异(p0.05)。结论:盐酸利多卡因穴位注射对原发性三叉神经痛症状改善优于单纯口服卡马西平。
[Abstract]:Objective: to investigate the efficacy of lidocaine hydrochloride point injection in the treatment of primary trigeminal neuralgia. Control group (drug treatment group, n = 30). The treatment group was injected with lidocaine hydrochloride for acupoint injection (the first pain: fish waist; the second branch pain: four white; the third branch pain: Xiaguan Pao, 7 times a second day as a course of treatment, 2 consecutive courses of treatment, The control group took carbamazepine twice a day for the first time, then added 0.1 g daily, until the symptoms such as facial pain disappeared, but the maximum dose of carbamazepine could not exceed 1.0 g per day. According to the degree and times of pain, the lowest effective maintenance dose was determined, and the continuous treatment was 4 weeks. The visual analogue score and TCM symptom score were recorded in the two groups before treatment, 2 weeks and 4 weeks before treatment and after March, respectively. Results: there was no significant difference in the total effective rate between the treatment group (96.67g) and the control group (90.005 weeks after 2 weeks). The total effective rate in the treatment group was significantly higher than that in the control group, and the difference between the two groups was significant (P 0.05). The visual analogue scores of the two groups showed a downward trend both after 2 weeks of treatment and 4 weeks after treatment. There was significant difference in VAS scores between the two groups after 2 weeks of treatment, but there was no significant difference in the VAS scores between the two groups after 2 weeks of treatment. After 4 weeks of treatment, there was a statistical difference in the VAS scores between the two groups (P 0.01), and the scores of TCM symptoms in the two groups showed a downward trend after treatment. The long-term therapeutic effect: the total effective rate in the treatment group was 100.00g) significantly higher than that in the control group (P 0.01); the VAS scores of the two groups were significantly different from those before treatment (P0.05A); the VAS scores of the two groups were also statistically poor. Chinese medicine symptom score, There was significant difference between the two groups before and after treatment, but there was no significant difference between the two groups after 3 months of treatment. Conclusion: the improvement of the symptoms of primary trigeminal neuralgia by acupoint injection of lidocaine hydrochloride is superior to that of carbamazepine alone.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R745.11

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