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目的:观察神经阻滞联合加巴喷丁治疗原发性三叉神经痛的效果。方法:选择原发性三叉神经痛89例,随机分为卡马西平组(C组)30例,加巴喷丁组(G组)30例和神经阻滞联合加巴喷丁组(NG组)29例。C组采用卡马西平治疗;G组采用加巴喷丁治疗;NG组采用神经阻滞联合加巴喷丁治疗。比较3组治疗前、治疗后第1天、第3天、第7天、第14天、第21天的疼痛数字(NRS评分,治疗前、治疗3周后疼痛发作频次和匹兹堡睡眠质量指数(PSQI)评分,治疗7天后疼痛缓解率及不良反应发生情况等。结果治疗前3组NRS分值差异不显著(P>0.05);治疗后3组第1天、第3天、第7天、第14天、第21天的NRS分值,均显著或非常显著低于治疗前(P<0.05,P<0.01);NG组治疗后第1天、第3天、第7天、第14天的NRS分值,均显著低于C组或G组相同时间节点(P<0.05);C、G两组比较,不同时间节点NRS分值差异不显著(P>0.05)。治疗前3组疼痛发作频次和PSQI分值均差异不显著(P>0.05);治疗后3组疼痛发作频次和PSQI分值,均显著或非常显著低于治疗前(P<0.05,P<0.01);NG组治疗后疼痛发作频次和PSQI分值,均显著低于C组或G组相同时间节点(P<0.05);C、G两组比较,疼痛发作频次和PSQI分值差异不显著(P>0.05)治疗7天后,NG组疼痛缓解率显著高于C组和G组(P<0.05)。C、G组疼痛缓解率差不显著(P>0.05)。G组和NG组不良反应发生率均非常显著低于C组(P<0.01),G组和NG组不良反应发生率差异不显著(P>0.05)。结论:神经阻滞联合加巴喷丁治疗原发性三叉神痛效果优于单用加巴喷丁或卡马西平。
Objective: To observe the effect of nerve block combined with gabapentin in the treatment of primary trigeminal neuralgia. Methods: A total of 89 patients with primary trigeminal neuralgia were randomly divided into carbamazepine group (30 cases), gabapentin group (30 cases) and nerve block combined with gabapentin group (n = 29). Group C was treated with carbamazepine; Group G was treated with gabapentin; Group NG was treated with nerve block plus gabapentin. The pain scores of the three groups before treatment, on day 1, 3, 7, 14 and 21 were compared (NRS score, pain frequency 3 weeks after treatment and Pittsburgh sleep quality index PSQI score, the pain relief rate and the incidence of adverse reactions after 7 days of treatment.Results There was no significant difference in the NRS score between the three groups before treatment (P> 0.05); after treatment, the first day, the third day, the seventh day, The scores of NRS on day 14 and day 21 were significantly or very significantly lower than those before treatment (P <0.05, P <0.01); on day 1, day 3, day 7, day 14 (P <0.05) .NRS scores at different time points in groups C and G were not significantly different (P> 0.05), and the scores of NRS in the three groups before treatment were significantly lower than those in group C or G (P <0.05). The pain frequency and PSQI scores of the three groups after treatment were significantly or very significantly lower than those before treatment (P <0.05, P <0.01); NG treatment Postoperative pain frequency and PSQI score were significantly lower than those in group C or group G at the same time point (P <0.05). There was no significant difference between the frequency of PSQI score and PSI score in C and G groups (P> 0.05) After 7 days, the pain relief rate of NG group (P0.05) .The pain relief rate in C and G groups was not significantly different (P0.05) .The adverse reaction rate in G and NG groups was significantly lower than that in C group (P0.01) ), There was no significant difference in the incidence of adverse reactions between G group and NG group (P> 0.05) .Conclusion: Nerve block combined with gabapentin is superior to gabapentin or carbamazepine in the treatment of primary trigeminal pain.