摘要：

目的 探讨神经传导阻滞联合脊髓电刺激术治疗带状疱疹后神经痛的疗效。方法 共135 例带状疱疹后神经痛患者行神经传导阻滞联合脊髓电刺激术，分别于术前和术后 1、3、5、7、30 d 采用视觉模拟评分（VAS）和匹兹堡睡眠质量指数（PSQI）评价疼痛缓解程度和睡眠质量改善情况，比较不同年龄组的治疗周期。结果 神经传导阻滞联合脊髓电刺激术治疗显效率为 95.56%（129/135），总有效率为 100%（135/135）。手术前后 VAS 评分（F = 46.891，P = 0.000）和 PSQI 评分（F = 55.993，P = 0.000）差异均有统计学意义，术后 1、3、5、7 和 30 d VAS 评分（t = 6.395，P = 0.012；t  = 8.104，P = 0.000；t  = 5.693，P = 0.013；t  = 8.294，P = 0.000；t  = 7.193，P = 0.007）和 PSQI 评分（t = 7.142，P = 0.006；t  = 3.959，P = 0.034；t  = 7.142，P = 0.006；t  = 3.959，P = 0.034；t  = 8.104，P = 0.000）均低于术前。平均治疗周期（15.97 ± 2.44）d，各年龄组患者治疗周期差异有统计学意义（F = 9.184，P = 0.001），≤ 30 岁组治疗周期最短（q = 4.593，P = 0.019；q = 5.693，P = 0.018；q = 4.583，P = 0.021；q = 7.204，P = 0.008；q = 5.593，P = 0.013）、> 70 岁组治疗周期最长（q = 5.593，P = 0.013；q = 8.104，P = 0.000；q = 7.142，P = 0.006；q = 5.693，P = 0.011；q = 4.298，P = 0.033）。结论 神经传导阻滞联合脊髓电刺激术治疗带状疱疹后神经痛，在缓解疼痛的同时改善睡眠质量，有望成为临床治疗带状疱疹后神经痛的理想方法。

关键词: 神经痛, 带状疱疹后, 神经传导阻滞, 电刺激疗法, 脊髓

Abstract:

Objective To observe the curative effect of nerve block combined with spinal cord stimulation (SCS) for postherpetic neuralgia (PHN). Methods A total of 135 patients with PHN were treated with nerve block combined with SCS. Visual Analogue Scale (VAS) was adapted to assess the degree of pain relief and Pittsburgh Sleep Quality Index (PSQI) was applied to evaluate quality of sleep before treatment and 1, 3, 5, 7, 30 d after treatment. Treatment cycle was compared among different age subgroups. Results The effective rate of nerve block combined with SCS was 95.56% (129/135), and the total effective rate was 100% (135/135). There was significant difference on VAS (F = 46.891, P = 0.000) and PSQI (F = 55.993, P = 0.000) scores before and after treatment. The results showed that VAS score (t = 6.395, P = 0.012; t = 8.104, P = 0.000; t = 5.693, P = 0.013; t = 8.294, P = 0.000; t = 7.193, P = 0.007) and PSQI score (t = 7.142, P = 0.006; t = 3.959, P = 0.034; t = 7.142, P = 0.006; t = 3.959, P = 0.034; t = 8.104, P = 0.000) 1, 3, 5, 7 and 30 d after treatment were significantly lower than before treatment. The average treatment cycle was (15.97 ± 2.44) d, and there was significant difference on treatment cycle among different age subgroups (F = 9.184, P = 0.001). The treatment cycle in subgroup of ≤ 30 years was shortest (q = 4.593, P = 0.019; q = 5.693, P = 0.018; q = 4.583, P = 0.021; q = 7.204, P = 0.008; q = 5.593, P = 0.013), and the treatment cycle in subgroup of > 70 years was longest (q = 5.593, P = 0.013; q = 8.104, P = 0.000; q = 7.142, P = 0.006; q = 5.693, P = 0.011; q = 4.298, P = 0.033). Conclusions Nerve block combined with SCS in the treatment of PHN alleviates pain and improves the quality of sleep. It is expected to be an ideal method for clinical treatment of PHN.

Key words: Neuralgia, postherpetic, Nerve block, Electric stimulation therapy, Spinal cord