【摘要】 目的:探讨通络止痛方结合针灸治疗原发性三叉神经痛(PTN)的疗效及对血浆P物质(SP)和β-内啡肽(β-EB)的影响。方法:94例PTN患者随机按数字法分为对照组46例和观察组48例。对照组服用卡马西平片,首剂100 mg,2次/d,3 d后每隔1天增加至100 mg,直到疼痛减轻(最大量不应超过600 mg·d-1),以后逐渐减量,有效维持量在400 mg·d-1。疗程4周。观察组采用电针及通络止痛方治疗。进行治疗前后疼痛视觉模拟评分(VAS),焦虑自评量表(SAS)评分,抑郁自评量表(SDS)评分及匹兹堡睡眠指数(PSQL)评价,采用放免法检测后血浆SP和β-EB水平。结果:治疗后观察组临床疗效总有效率为93.75%,对照组为78.26%,观察组优于对照组(P<0.01);两组治疗后VAS,SAS,SDS及PSQL评分均较治疗前下降(P<0.01),治疗后观察组上述指标评分均低于对照组(P<0.01);治疗后两组血浆SP水平较治疗前下降,观察组低于对照组(P<0.01);治疗后两组血浆β-EB水平较治疗前上升,观察组高于对照组(P<0.01)。结论:针药结合治疗能减轻原发性三叉神经痛患者疼痛,其作用机制可能与升高β-EB水平,降低SP水平有关;并能改善患者焦虑、抑郁及睡眠,从而有利于生活质量的提高。更多还原

【Abstract】 Objective: The discuss the effects of Tongluo Zhitong decotion combined with electroacupuncture to treat primary trigeminal neuralgia and influence to plasma substance P( PS) and β-endorphin( β-EB). Method: Ninety-four patients with PNT were randomly divided into control group( 46 cases) and observation group( 48 cases) by random number table. Patients in control group taken carbamazepine tablets,the first agent 100 mg,2 times /day,after 3 days,Every 1 days to increase 100 mg,until the relief of pian( maximum should be less than 600 mg·d- 1),and then cut down the dose gradually and kept the effective dose at400 mg ·d- 1. Course of treatment were 4 weeks. Patients in observation group received therapy of electroacupuncture and Tongluo Zhitong decoction. Before and after treatment,pain was measured by visual analogue scale( VAS),self rating anxiety scale( SAS),self rating depression scale( SDS) and pittsburgh sleep quality index( PSQL),the level of plasma PS and β-EB were detected by radioimmunoassay. Result: After treatment the total effective rate of clinical effects in the observation group was 93. 75%,control group78. 26%,in the control group( P < 0. 01). Compared with the time before treatment,both groups’ scores of VAS,SAS,SDS and PSQL decreased( P < 0. 01),and those scores in the observation group were lower than the control group( P <0. 01). And both groups’ levels of plasma PS decreased and which in the observation group was lower than in the control group( P < 0. 01). And both groups’ levels of β-EB increased and which in the observation group was higher than in the control group( P < 0. 01). Conclusion: Needle medicine can reduce patients’ pain in primary trigeminal neuralgia,its mechanism may be associated with raising level of β-EB and reducing level of PS. And it can ameliorate patients’ anxiety,depression and sleeping and it’s beneficial to improve patients’ quality of lives.更多还原