CAJ | 학술논문

目的：探讨选择性神经根阻滞在预防老年带状疱疹后神经痛中的作用。方法按照随机、对照的研究方法，将70例65岁以上伴有中重度疼痛的老年带状疱疹患者分为2组：阿昔洛韦+盐酸曲马多缓释片组（A组）35例，和阿昔洛韦、盐酸曲马多缓释片联合选择性神经根阻滞组（B组）35例。用数字评分量表（NRS）评估治疗前、治疗后第1周、2周、4周、8周、12周末患者的疼痛程度，以及治疗后第1周、2周、4周、8周、12周末盐酸曲马多缓释片的平均消耗量，并在第12周末比较两组患者带状疱疹后神经痛的发生率。结果①与治疗前相比，两组患者治疗后的NRS评分均明显降低（P＜0﹒05）；在治疗后第1周和第2周末，B组患者的NRS评分低于A组（P＜0﹒05）。②在治疗后第1周、第2周和第4周末，B组患者盐酸曲马多缓释片的用量少于A组（P＜0﹒05）。③在第12周末， B组患者带状疱疹后神经痛的发生率稍低于A组，但差异缺乏统计学意义（P＞0﹒05）。结论选择性神经根阻滞联合阿昔洛韦、盐酸曲马多缓释片可以有效减轻带状疱疹患者的疼痛，但是不能降低带状疱疹后神经痛的发生率。
목적：탐토선택성신경근조체재예방노년대상포진후신경통중적작용。방법안조수궤、대조적연구방법，장70례65세이상반유중중도동통적노년대상포진환자분위2조：아석락위+염산곡마다완석편조（A조）35례，화아석락위、염산곡마다완석편연합선택성신경근조체조（B조）35례。용수자평분량표（NRS）평고치료전、치료후제1주、2주、4주、8주、12주말환자적동통정도，이급치료후제1주、2주、4주、8주、12주말염산곡마다완석편적평균소모량，병재제12주말비교량조환자대상포진후신경통적발생솔。결과①여치료전상비，량조환자치료후적NRS평분균명현강저（P＜0﹒05）；재치료후제1주화제2주말，B조환자적NRS평분저우A조（P＜0﹒05）。②재치료후제1주、제2주화제4주말，B조환자염산곡마다완석편적용량소우A조（P＜0﹒05）。③재제12주말， B조환자대상포진후신경통적발생솔초저우A조，단차이결핍통계학의의（P＞0﹒05）。결론선택성신경근조체연합아석락위、염산곡마다완석편가이유효감경대상포진환자적동통，단시불능강저대상포진후신경통적발생솔。
Objective To investigate function of selective nerve root infiltration in preventing neuralgia after aged acute posterior ganglionitis﹒Method according to randomized, controlling study method, divide 70 patients over age of 65 with moderate and severe pain aged acute posterior ganglionitis into 2 groups: acyclovir + hydrochloride tramadol sustained release tablet group (group A) 35 cases, and acyclovir, hydrochloride tramadol sustained release tablets combined with selective nerve root infiltration group (group B) 35 cases. Evaluate pain degree of patients by Number Rating Scale (NRS) 1 week, 2 weeks, 4 weeks, 8 weeks, 12 weeks before and after treatment, and average consumption amount of hydrochloride tramadol sustained selease tablets at the end of the 1st week, 2nd week, 4th week, 8th week, 12th week after treatment, and at the end of the 12th week compared incidence of two groups with neuralgia after acute posterior ganglionitis﹒Results①NRS scores of two groups patients after treatment were significantly lower compared with those before treatment (P< 0﹒05);at the end of the first and second week, NRS scores of group B were lower than group A (P < 0﹒05)﹒② at the end of the 1st, 2nd, and 4th week after treatment, dosage of tramadol hydrochloride sustained release tablets of group B is less than group A (P < 0﹒05)﹒③at the end of the 12th week, incidence of group B with neuralgia after aged acute posterior ganglionitis is slightly lower than group A, but difference showed less statistical significance (P>0﹒05)﹒ Conclusion selective nerve root infiltration combined with acyclovir, tramadol hydrochloride sustained release tablets may effectlively release pain of acute posterior ganglionitis patients, but it can not reduce incidence of neuralgia after aged acute posterior ganglionitis.