本文關鍵詞： 三叉神經痛 穴位注射 鹽酸利多卡因 卡馬西平　出處：《南京中醫(yī)藥大學》2017年碩士論文　論文類型：學位論文

【摘要】：目的:探討鹽酸利多卡因穴位注射治療原發(fā)性三叉神經痛的療效。方法:將符合納入標準患者60例隨機分配,其中治療組(穴位注射組)30例,對照組(藥物治療組)30例。治療組采用鹽酸利多卡因進行穴位注射(第1支疼痛:魚腰;第2支疼痛:四白;第3支疼痛:下關),隔日1次,7次為一療程,連續(xù)2個療程,療程間隔2天。對照組卡馬西平口服,每天2次,首次口服0.1克,后每日遞加0.1克,直到面痛等癥狀消失,但每日最大量不能超于1.0克,以后根據其疼痛的程度和次數(shù)調整藥量,確定最低有效維持量,連續(xù)治療4周。兩組于治療前、治療2周、4周及治療結束3月后分別記錄納入者視覺模擬評分、中醫(yī)癥候積分,分別評定近期與遠期療效。結果:1.近期效果:2周后,總有效率治療組(96.67%)與對照組(90.00%)無顯著性差異(P0.05);4周后,總有效率治療組(100.00%)明顯高于對照組(90.00%),兩組差異明顯(P0.05)。兩組患者無論在治療2周后還是4周后的視覺模擬評分均呈下降趨勢,有統(tǒng)計學差異(P0.01),但兩組間患者治療2周后的VAS評分無統(tǒng)計學差異(P0.05),治療4周后,兩組患者間的VAS評分存在統(tǒng)計學差異(P0.01);兩組患者中醫(yī)癥狀積分在治療后均呈下降趨勢,有統(tǒng)計學差異(P0.05)。2.遠期治療效果:治療組總有效率(100.00%)明顯高于對照組(90.00%),存在統(tǒng)計學差異(P0.01);兩組患者VAS評分較治療前均有統(tǒng)計學差異(P0.05);兩組間的VAS評分亦有統(tǒng)計學差異(p0.01)。中醫(yī)癥狀評分,兩組較治療前均有統(tǒng)計學差異(P0.05),但兩組間在治療3個月后無統(tǒng)計學差異(p0.05)。結論:鹽酸利多卡因穴位注射對原發(fā)性三叉神經痛癥狀改善優(yōu)于單純口服卡馬西平。
[Abstract]:Objective: to investigate the efficacy of lidocaine hydrochloride point injection in the treatment of primary trigeminal neuralgia. Control group (drug treatment group, n = 30). The treatment group was injected with lidocaine hydrochloride for acupoint injection (the first pain: fish waist; the second branch pain: four white; the third branch pain: Xiaguan Pao, 7 times a second day as a course of treatment, 2 consecutive courses of treatment, The control group took carbamazepine twice a day for the first time, then added 0.1 g daily, until the symptoms such as facial pain disappeared, but the maximum dose of carbamazepine could not exceed 1.0 g per day. According to the degree and times of pain, the lowest effective maintenance dose was determined, and the continuous treatment was 4 weeks. The visual analogue score and TCM symptom score were recorded in the two groups before treatment, 2 weeks and 4 weeks before treatment and after March, respectively. Results: there was no significant difference in the total effective rate between the treatment group (96.67g) and the control group (90.005 weeks after 2 weeks). The total effective rate in the treatment group was significantly higher than that in the control group, and the difference between the two groups was significant (P 0.05). The visual analogue scores of the two groups showed a downward trend both after 2 weeks of treatment and 4 weeks after treatment. There was significant difference in VAS scores between the two groups after 2 weeks of treatment, but there was no significant difference in the VAS scores between the two groups after 2 weeks of treatment. After 4 weeks of treatment, there was a statistical difference in the VAS scores between the two groups (P 0.01), and the scores of TCM symptoms in the two groups showed a downward trend after treatment. The long-term therapeutic effect: the total effective rate in the treatment group was 100.00g) significantly higher than that in the control group (P 0.01); the VAS scores of the two groups were significantly different from those before treatment (P0.05A); the VAS scores of the two groups were also statistically poor. Chinese medicine symptom score, There was significant difference between the two groups before and after treatment, but there was no significant difference between the two groups after 3 months of treatment. Conclusion: the improvement of the symptoms of primary trigeminal neuralgia by acupoint injection of lidocaine hydrochloride is superior to that of carbamazepine alone.
【學位授予單位】：南京中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R745.11

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