首都医科大学学报 ›› 2008, Vol. 29 ›› Issue (5): 646-649.

• 临床研究 • 上一篇    下一篇

庆大霉素与复方倍他米松治疗原发性三叉神经痛的早期疗效对比研究

王纲, 王保国   

  1. 首都医科大学附属北京天坛医院麻醉科
  • 收稿日期:2007-08-27 修回日期:1900-01-01 出版日期:2008-10-24 发布日期:2008-10-24

Comparative Studies on Gentamicin and Compound Betamethasone for the Treatment of Primary Trigeminal Neuralgia

Wang Gang, Wang Baoguo   

  1. Department of Anesthesiology, Beijing Tiantan Hospital, Capital Medical University
  • Received:2007-08-27 Revised:1900-01-01 Online:2008-10-24 Published:2008-10-24

摘要: 目的 比较庆大霉素与复方倍他米松用于原发性三叉神经痛的治疗效果.方法 将40例经卡马西平等药物治疗无效或者难以耐受其不良反应的原发性三叉神经痛患者分为2组,分别用庆大霉素和复方倍他米松进行三叉神经外周支阻滞.疼痛强度评分采用视觉模拟评分法(visualanalogue scale,VAS)评定病人的疼痛程度和治疗效果.分别记录治疗前、治疗后1周、2周、3周、4周、5周的每次注射前、治疗结束后1月、2月、3月的疼痛强度评分,并记录治疗期间出现的不良反应.结果 庆大霉素组和复方倍他米松组治疗后的VAS评分与治疗前相比均降低,在治疗后的前2周,庆大霉素组的VAS评分高于复方倍他米松组,差异有统计学意义(P<0.01),在随后的治疗期间,两组的VAS评分差异无统计学意义.结论 采用庆大霉素以小剂量、分次局部注射方式,进行神经阻滞治疗三叉神经痛,可以避免使用激素引起的不良反应,且具有不良反应小,可多次重复的优点,对于有激素使用禁忌的原发性三叉神经痛患者,应用庆大霉素进行神经阻滞治疗是理想的替代用药选择.

关键词: 原发性三叉神经痛, 庆大霉素, 复方倍他米松, 神经阻滞

Abstract: Objective To compare the therapeutic effects and adverse events of gentamicin and betamethasone on primary trigeminal neuralgia.Methods Forty patients with primary trigeminal neuralgia were allocated into two groups to receive a peripheral nerve block with lidocaine combined with gentamicin or betamethasone,respectively,once a week for 5 weeks.Their pain intensity were assessed using visual analogue scale(VAS)before treatment and once a week just prior to every treat.We continued to make such assessments every month until 3 months after treatment.Their pain relief rate and the occurrence of adverse events were also evaluated.Results The VASvalue of patients in gentamicin group and betamethasone group decreased significantly after treatment.Compared with the betamethasone the decreases in VASvalue induced by gentamicin were lower during the first 2 weeks,but there were no significant differences between these two groups at other observing points.In addition,no severe adverse events was observed in patients with either drug at the dosage we used.Conclusion Gentamicin is the optimal choice for patients with primary trigeminal neuralgia cases that can not be treated by corticosteroids.

Key words: primary trigeminal neuralgia, gentamicin, betamethasone, nerve block

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