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目的将恩纳(eutectic mixture of local anesthetics,EMLA)涂抹在带状疱疹后遗神经痛(postherpetic neuralgia,PHN)患者的疼痛皮肤上同时并用神经阻滞,探讨治疗PHN的新方法。方法选择PHN患者40例,用随机、单盲法分成两组。Ⅰ组为试验组,Ⅱ组为对照组。Ⅰ组在疼痛部位涂抹EMLA软膏;Ⅱ组在疼痛部位涂抹红霉素软膏。两组根据疼痛部位所属的脊神经实施肋间神经阻滞或椎间孔阻滞。结果治疗1 h后VAS评分:Ⅰ组0分18例,1-3分2 例;Ⅱ组0分18例,1～3分2例。两组镇痛结果在第1 h差异无统计学意义P>0．05。治疗6-36h 后VAS评分:Ⅰ组0分9例,1-3分11例;Ⅱ组0分1例,1-3分6例,4-6分13例。两组镇痛效果在治疗6-36 h差异有统计学意义P<0．05。1个疗程后Ⅰ组治愈19例(95％),Ⅱ组治愈14例 (70％),两组治愈率差异有统计学意义P<0．05。3个月后随访Ⅰ组总有效率为100％(20例),Ⅱ组总有效率为90％(18例)。两组相比差异有统计学意义P<0．05。结论 EMLA疼痛部位涂抹加神经阻滞治疗PHN比单用神经阻滞有明显的疗效。
Objective To explore the new method of treating PHN by applying smear of eutectic mixture of local anesthetics (EMLA) on painful skin of patients with postherpetic neuralgia (PHN). Methods Forty patients with PHN were randomly divided into two groups according to single-blind method. Group Ⅰ was the experimental group, group Ⅱ was the control group. Group I applied EMLA ointment to the site of pain; Group II applied erythromycin ointment to the site of pain. Two groups according to the painful part of the spinal nerve intercostal nerve block or intervertebral foramen block. Results VAS scores at 1 hour after treatment were 0 in 18 cases and 1 in 2 in 2 cases. There were 0 in 18 cases and 1 in 3 in 2 cases in group Ⅱ. There was no significant difference in the analgesic results between the two groups at 1 hour (P> 0.05). After treatment 6-36h VAS score: Ⅰ group 0 points in 9 cases, 1-3 points in 11 cases; Ⅱ group 0 points in 1 case, 1-3 points in 6 cases, 4-6 points in 13 cases. Two groups of analgesic effect in the treatment of 6-36 h difference was statistically significant P <0.05.1 after a course of treatment in 19 cases were cured (95%), 14 cases were cured (70%), the two groups cure rate The difference was statistically significant P <0.05.3 months follow-up group Ⅰ total effective rate was 100% (20 cases), Ⅱ total effective rate was 90% (18 cases). The difference between the two groups was statistically significant (P <0.05). Conclusion EMLA pain patches plus nerve block treatment of PHN than single nerve block have a significant effect.