CAJ | 학술논문

目的：研究威伐光照射联合胸椎旁阻滞治疗胸背部带状疱疹后神经痛的效果。方法胸背部带状疱疹后神经痛患者60例，随机分为两组：胸椎旁阻滞组(a组，n=30)，威伐光照射联合胸椎旁阻滞组(B组，n=30)。两组患者所用消炎镇痛药物均为：复方倍他米松、盐酸利多卡因、盐酸罗哌卡因、甲钴胺每周1次，共3次。分别记录两组患者治疗前后的视觉模拟评分(visual analogue scale,Vas)值，匹兹堡睡眠质量指数(pittsburge sleep quality index,PsQi)值，是否存在痛觉超敏以及治疗过程中和治疗后的不良反应。结果与治疗前比较，两组患者治疗后Vas值和PsQi均显著降低(P<0.05)；三次治疗后威伐光照射联合胸椎旁阻滞组(B组)的Vas评分及PsQi均较胸椎旁阻滞组(a组)低(P<0.05)；两组患者痛觉超敏均显著改善(a组85%，B组85.71%),两组患者治疗中和治疗后均未出现明显不良反应。结论威伐光照射联合胸椎旁阻滞治疗胸背部带疱疹后神经痛疗效确切，安全可行，值得疼痛门诊推广。
목적：연구위벌광조사연합흉추방조체치료흉배부대상포진후신경통적효과。방법흉배부대상포진후신경통환자60례，수궤분위량조：흉추방조체조(a조，n=30)，위벌광조사연합흉추방조체조(B조，n=30)。량조환자소용소염진통약물균위：복방배타미송、염산리다잡인、염산라고잡인、갑고알매주1차，공3차。분별기록량조환자치료전후적시각모의평분(visual analogue scale,Vas)치，필자보수면질량지수(pittsburge sleep quality index,PsQi)치，시부존재통각초민이급치료과정중화치료후적불량반응。결과여치료전비교，량조환자치료후Vas치화PsQi균현저강저(P<0.05)；삼차치료후위벌광조사연합흉추방조체조(B조)적Vas평분급PsQi균교흉추방조체조(a조)저(P<0.05)；량조환자통각초민균현저개선(a조85%，B조85.71%),량조환자치료중화치료후균미출현명현불량반응。결론위벌광조사연합흉추방조체치료흉배부대포진후신경통료효학절，안전가행，치득동통문진추엄。
Objective To analyze the effects of water-filtered infrared-a (wira) therapy combined with thoracic paravertebral block (TPVB) on post-herpetic neuralgia patients.Method sixty patients undergoing post-herpetic neuralgia were equally randomized into thoracic paravertebral block group (group a) and water-filtered infrared-a (wira) therapy combined with thoracic paravertebral block group(group B). The two groups both received thoracic paravertebral block with diprospan, lidocaine, ropivacaine and cobalamin weekly for 3 weeks. The pain intensity, sleep quality, symptoms of allodynia and side effects during the therapy and after treatment were observed. The intensity of pain was assessed by Visual analogue scale (Vas), and the quality of sleep was measured by Pittsburgh sleep Quality index (PsQi).Result The Vas and PsQi of the two groups both decreased significantly (P<0.05) and the symptoms of allodynia were mostly cured (85% in group a and 85.71% in group B). after 3 weeks of treatment, the Vas and PsQi of group B were both lower than those of group a (P<0.05). no obvious side effect was found.Conclusion Water-filtered infrared-a (wira) therapy combined with thoracic paravertebral block is safe and more effective for post-herpetic neuralgia patients.