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中华口腔医学研究杂志(电子版)

中华口腔医学研究杂志(电子版) ›› 2020, Vol. 14 ›› Issue (01) : 24 -28. doi: 10.3877/cma.j.issn.1674-1366.2020.01.006

所属专题： 文献；

临床研究

A型肉毒毒素复合罗哌卡因治疗三叉神经痛的疗效
卢杨1, 张真真1, 张霞2, 张雪迪2, 王纯2, 杨智杰1, 白晓峰1,†()   
  1. 1. 中国医科大学口腔医学院·附属口腔医院，辽宁省口腔疾病重点实验室，口腔颌面外科学教研室，沈阳　110002
    2. 中国医科大学口腔医学院·附属口腔医院，辽宁省口腔疾病重点实验室，麻醉学教研室，沈阳　110002
  • 收稿日期:2019-11-15 出版日期:2020-02-01
  • 通信作者: 白晓峰

Efficacy of botulinum toxin type A combined with ropivacaine in the treatment of trigeminal neuralgia

Yang Lu1, Zhenzhen Zhang1, Xia Zhang2, Xuedi Zhang2, Chun Wang2, Zhijie Yang1, Xiaofeng Bai1,†()   

  1. 1. Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang 110002, China
    2. Department of Anesthesiology, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang 110002, China
  • Received:2019-11-15 Published:2020-02-01
  • Corresponding author: Xiaofeng Bai
  • About author:
    Corresponding author: Bai Xiaofeng, Email:
  • Supported by:
    National Natural Science Foundation of China(81400530); The Natural Science Foundation of Liaoning Province(201602811, 20180530097)
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引用本文：

卢杨, 张真真, 张霞, 张雪迪, 王纯, 杨智杰, 白晓峰. A型肉毒毒素复合罗哌卡因治疗三叉神经痛的疗效[J/OL]. 中华口腔医学研究杂志(电子版), 2020, 14(01): 24-28.

Yang Lu, Zhenzhen Zhang, Xia Zhang, Xuedi Zhang, Chun Wang, Zhijie Yang, Xiaofeng Bai. Efficacy of botulinum toxin type A combined with ropivacaine in the treatment of trigeminal neuralgia[J/OL]. Chinese Journal of Stomatological Research(Electronic Edition), 2020, 14(01): 24-28.

目的

评价A型肉毒毒素（BTX-A）复合罗哌卡因治疗特发性三叉神经痛的临床效果。

方法

选取2018年12月至2019年10月在中国医科大学附属口腔医院就诊的特发性三叉神经第三支疼痛患者20例，随机数字表法分为试验组、对照组，每组10例。试验组采用BTX-A复合罗哌卡因治疗，对照组采用卡马西平治疗。两组治疗前及治疗后1 h、6 h、12 h、1周、1个月、3个月和6个月行视觉模拟量表（VAS）评分比较疼痛程度，同时统计和比较疼痛发作频率及睡眠质量，进行疗效评价。使用SPSS 20.0软件进行数据分析。

结果

试验组疼痛VAS评分在治疗后1 h、1个月分别为0.4 ± 0.5和2.8 ± 3.1，分别低于对照组（1.2 ± 1.0、5.1 ± 1.4），差异均有统计学意义（t1 h=-2.191，P1 h= 0.047；t1个月=-2.155，P1个月= 0.045）；试验组治疗后1个月睡眠质量评分为7.8 ± 3.2，对照组为10.8 ± 2.4，差异有统计学意义（t=-2.395，P= 0.028）；试验组疼痛发作频率在治疗后1周、1个月、3个月均低于对照组，而在治疗后6个月高于对照组，差异均有统计学意义（t1周=-2.900，P1周= 0.010；t1个月= -4.544，P1个月= 0.001；t3个月=-5.156，P3个月= 0.000；t6个月= 3.391，P6个月= 0.003）。

结论

BTX-A复合罗哌卡因可缓解特发性三叉神经痛，改善患者的睡眠状况。

关键词: 三叉神经痛, A型肉毒毒素, 罗哌卡因, 卡马西平
Objective

To evaluate the clinical effect of botulinum toxin type A (BTX-A) combined with ropivacaine in the treatment of idiopathic trigeminal neuralgia.

Methods

Twenty patients with idiopathic trigeminal neuralgia who were treated at the Stomatological Hospital of China Medical University from December 2018 to October 2019 were selected and divided into experimental group and control group by random number table method. The experimental group was treated with BTX-A combined with ropivacaine, and the control group was treated with carbamazepine. The two groups were assessed with visual analog scores (VAS) before treatment and at the 1st hour, 6th hour, 12th hour, 1st week, 1st month, 3rd month and 6th month after treatment to compare the degree of pain, the frequency of pain onset and sleep quality to evaluate the efficacy. SPSS 20.0 was used for statistical analysis.

Results

The pain VAS scores of the experimental group were 0.4 ± 0.5 and 2.8 ± 3.1 at the 1st hour and the 1st month after treatment, respectively, which were lower than those in the control group (1.2 ± 1.0, 5.1 ± 1.4) , and the differences were statistically significant (t1st h=-2.191, P1st h= 0.047; t1st month=-2.155, P1st month= 0.045) ; The sleep quality scores of the experimental group at the 1st month after treatment were 7.8 ± 3.2, and the sleep quality scores of the control group were 10.8 ± 2.4. The sleep quality scores of the experimental group were lower than those of the control group at the 1st month after treatment, which was statistically significantly different (t=-2.395, P= 0.028) ; The frequency of pain onset of the experimental group was lower than that of the control group at the 1st week, 1st month and 3rd month after treatment, but higher than that of the control group at the 6th month after treatment, which was statistically significantly different (t1stweek=-2.900, P1st week=0.010; t1st month=-4.544, P1st month=0.001; t3rd month=-5.156, P3rd month=0.000; t6th month=3.391, P6th month= 0.003) .

Conclusion

BTX-A combined with ropivacaine can alleviate idiopathic trigeminal neuralgia and improve the quality of sleep of patients.

Key words: Trigeminal neuralgia, Botulinum toxins, type A, Ropivacaine, Carbamazepine
表1 20例入选本研究的特发性三叉神经第三支疼痛患者的基线资料
组别 例数 性别（例，男/女） 年龄（岁） 平均病程（月）
试验组 10 3/7 50.4 ± 8.6 7.4 ± 3.6
对照组 10 3/7 52.5 ± 11.5 6.8 ± 2.7
t值 ? ? -0.462 0.420
P值 ? ? 0.650 0.680
表2 特发性三叉神经第三支疼痛患者治疗前后疼痛VAS评分比较（ ± s）
组别 例数 治疗前 治疗后
1h 6 h 12 h 1周 1个月 3个月 6个月
试验组 10 8.4 ± 1.0 0.4 ± 0.5 0.1 ± 0.3 0.3 ± 0.5 4.4 ± 1.7 2.8 ± 3.1 3.0 ± 2.9 6.5 ± 2.3
对照组 10 8.5 ± 0.8 1.2 ± 1.0 0.2 ± 0.4 0.6 ± 0.8 5.4 ± 1.4 5.1 ± 1.4 4.0 ± 2.1 4.7 ± 2.0
t值 ? -0.246 -2.191 -0.600 -0.976 -1.417 -2.155 -0.881 1.902
P值 ? 0.809 0.047 0.556 0.345 0.173 0.045 0.390 0.073
表3 特发性三叉神经第三支疼痛患者治疗前后睡眠质量评分比较（ ± s）
组别 例数 治疗前 治疗后
1个月 3个月 6个月
试验组 10 13.5 ± 1.8 7.8 ± 3.2 8.0 ± 2.9 9.8 ± 2.0
对照组 10 15.1 ± 1.6 10.8 ± 2.4 9.0 ± 1.6 9.1 ± 2.9
t值 ? -2.077 -2.395 -0.808 0.626
P值 ? 0.052 0.028 0.430 0.539
表4 特发性三叉神经第三支疼痛患者治疗前后疼痛发作频率比较（±s）
组别 例数 治疗前 治疗后
1周 1个月 3个月 6个月
试验组 10 27.2 ± 16.9 1.3 ± 1.7 0.6 ± 0.7 0.9 ± 0.9 11.5 ± 4.6
对照组 10 29.6 ± 17.6 4.6 ± 3.2 5.0 ± 3.0 5.0 ± 2.4 5.9 ± 2.4
t值 ? -0.311 -2.900 -4.544 -5.156 3.391
P值 ? 0.759 0.010 0.001 0.000 0.003
表5 两组特发性三叉神经第三支疼痛患者治疗后"治疗有效"情况（例）
组别 例数 治疗1个月 治疗3个月 治疗6个月
试验组 10 8 8 2
对照组 10 5 7 6
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