目的 观察糖皮质激素对椎旁阻滞治疗胸背部带状疱疹神经痛疗效的影响。方法 选择2014年8月至2016年1月我院门诊住院的80例顽固性带状疱疹后遗神经痛（带状疱疹后疼痛持续大于3个月且视觉模拟评分VAS大于7分）的病变累及范围在T1-T12患者。随机分为神经妥乐平联合激素组和不联合激素组。分别每2周行一次椎旁阻滞，每个患者连续治疗4次，观察患者每次治疗后疼痛改善情况、疗程结束时爆发痛发作频率未变化及不良反应。结果 两组患者每次治疗后疼痛较前一次均有明显缓解（P＜0.05），疗程结束时两组患者疼痛症状较治疗前明显改善（P＜0.01），部分爆发痛缓解明显，均未出现明显不良反应；但两组间比较，无论是各时间节点疼痛缓解还是爆发痛发作频率，差异均不具有统计学意义（P＞0.05）。结论 椎旁阻滞时加入糖皮质激素治疗带状疱疹后遗神经痛疗效并不优于不加激素阻滞。
Objective To compare the efficacy of paravertebral block with or without steroids on patients suffered from post-herpetic neuralgia in the chest region. Methods 80 patients diagnosed with post-herpetic neuralgia were randomly divided into steroid group and non-steroid group. The only difference between the two groups was whether to use the steroids while paravertebral blocking. For each patient, nerve block was done every other week for four times. The score of VAS, frequency of outbreak pain and therapy-related adverse effect were recorded after each treatment and at the end of the trial. Results The VAS score was improved after each treatment as contrasted to the one before(P＜0.05) and pre-treatment level (P＜0.01). The frequency of outbreak pain was also improved in both groups. But there were no significant differences (P＞0.05) between two groups. Conclusion Paravertebral block with NTP combined with steroids have no significant effect than without steroids.
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