曹晓攀

[摘要] 目的 觀察巴氯芬联合腺苷钴胺治疗三叉神经痛的效果。 方法 选取2019年1月至2020年1月我院就诊以三叉神经痛为诊断收治入院进行保守治疗（口服药物治疗）的患者200例，根据采取口服药物的选择不同分为联合组和单药组，每组各100例。联合组采用巴氯芬联合腺苷钴胺治疗，单药组采用腺苷钴胺治疗。比较两组患者治疗前后疼痛VAS评分、炎症反应指标、氧化应激指标、临床治疗效果及并发症发生率。 结果 治疗前两组患者VAS评分、炎症反应指标、氧化应激指标比较，差异无统计学意义（P>0.05）。治疗后两组以上指标较治疗前均明显下降，差异有统计学意义（P<0.05）。治疗后联合组的VAS评分、IL-6、TNF-α、SOD、MDA均明显低于单药组，差异有统计学意义（P<0.05）。联合组总有效率为92.00%，明显高于单药组的75.00%，差异有统计学意义（P<0.05）。两组并发症发生率比较，差异无统计学意义（P>0.05）。 结论 巴氯芬联合腺苷钴胺治疗三叉神经痛整体治疗效果强于单药治疗。

[关键词] 巴氯芬;腺苷钴胺;联合治疗;三叉神经痛

[中图分类号] R745.1          [文献标识码] B          [文章编号] 1673-9701（2021）06-0042-03

The effect of baclofen combined with cobamamide in the treatment of trigeminal neuralgia

CAO Xiaopan

The Third Department of Neurology，Shenyang First People′s Hospital，Shenyang   110041，China

[Abstract] Objective To observe the effect of baclofen combined with cobamamide in the treatment of trigeminal neuralgia. Methods A total of 200 patients who were diagnosed with trigeminal neuralgia and admitted to the hospital for conservative treatment（oral drug treatment） in our hospital were divided into the combined group and the single-drug group according to the choice of oral drugs，with 100 cases in each group. The combined group was treated with baclofen combined with cobamamide therapy，and the single-drug group was treated cobamamide therapy. The pain VAS scores， inflammatory response indexes， oxidative stress indexes， clinical treatment effect，and complication rate between the two groups were compared before and after treatment. Results There was no significant difference in VAS score， inflammatory response index and oxidative stress index between the two groups before treatment（P>0.05）. After treatment， the above indexes between the two groups all decreased significantly compared with before treatment， and the difference was significant（P<0.05）. After treatment， the VAS score， IL-6， TNF-α， SOD， MDA in the combined group were lower than those in the single-drug group， and the difference was significant（P<0.05）. The effective rate was 92.00% in the combined group， which was higher than that of 75.00% in the single-drug group， and the difference was significant（P<0.05）. There was no difference of  incidence of complications between the two groups（P>0.05）. Conclusion The overall effect of baclofen combined with cobamamide in the treatment of trigeminal neuralgia is stronger than that of monotherapy.

[Key words] Baclofen; Cobamamide; Combination therapy; Trigeminal neuralgia

脑神经科最常见的疾病之一就是三叉神经痛（Trigeminal neuralgia，TN），是一种临床常见的颅神经疾病，也称为神经疼痛疾病[1]。机体的桥脑被三叉神经进入到入脑段，并受到小脑角的异常血管压迫所致，可以很容易地通过面部疼痛予以诊断，为一种神经脱髓鞘病变，其发病率为（4～27）/100 000，女性多于男性，右侧多于左侧，局限于头面部三叉神经一支或多支分布区域内，骤发、骤停闪电样、刀割样、烧灼样难以忍受的剧烈性疼痛，是不典型面部疼痛综合征[2]。有“扳机点”，持续数秒至数分钟不等，可自行缓解，使患者痛苦不堪，严重危害着人们的身体健康、工作和生活。其分为原发性与复发性，复发性三叉神经痛又包括两种，即占位性病变及血管压迫，治疗起来难上加难。目前……