The Efficacy Of Paraspinal Nerve Block Combined With Pregabalin For The Treatment Of Herpes Zoster Related Pain

Objective:This reserch by adopting different methods for the treatment of acute herpes zoster pain,to evaluate the treatment effect,and to follow the treatment of patients with long-term complications,and provide a reference for future clinical research and treatment.Methods:90 patients with herpes zoster?NRS,numeric rating pain scale digital score rating>6?were randomly divided into 3 groups:group A?pregabalin group?;Group B?paraspinal nerve block?;Group C?paraspinal nerve block combined with pregabalin?.In group A and group C,the dose was 75mg,2 times/day,and the oral dose was 150mg every time,2days/time,and the treatment duration was 4 weeks.Group B,group C by the vertebral nerve block,under ultrasound guided by the pain of the section area corresponding vertebral side clearance to block drugs,nerve block drug for:1 ml of compound betamethasone injection,adenosine cobalt amino 3 mg,2 ml of 2%lidocaine and physiological saline dilution to 5ml.Two blocks were separated for 7 days,and four nerve block treatments were performed.In the course of treatment,if the patient is conscious of pain,he can't tolerate the oral hydroxyacetone sustained release tablets,5mg,2 times/day.Outcomes:1.The NRS score changes of T₁,T₂,T₃ and T₄ in the three groups were statistically significant compared with the T₀ before treatment?P<0.05?.The NRS scores of the patients in the three groups were significantly reduced in the 21st day after treatment,and the difference was statistically significant?P<0.05?;The NRS scores of patients in both groups A and B were similar,and there was no statistically significant difference between the groups?P>0?.05).However,the NRS scores of both groups were lower than those of A and B,and the difference was statistically significant?P<0.05?2.In the 7th day of treatment,the efficiency of group A,B and C was 0%,the total effective rate of group A was 0%,the total effective rate of groupB was 18.75%and the total effective rate of group C was 14.71%.In the 14th day of treatment,the efficiency of group A and group B was 0%,the efficiency of group C was 26.47%,the total effective rate of group A was 35.48%,the total effective rate of group B was 59.38%,and the total effective rate of group C was 85.29%.In the 21 days of treatment,group A showed A remarkable efficiency of 35.48%,group B showed an efficiency of 31.25%,group C showed an efficiency of 70.59%,the total effective rate of group A was 58.06%,the total effective rate of group B was 68.75%,and the total effective rate of group C was88.24%.On the 28th day of treatment,the efficiency of group A was 51.61%,the efficiency of group B was 62.50%,the efficiency of group C was 84.38%,the total effective rate of group A was 77.42%,the total effective rate of group B was 71.88%,and the total effective rate of group C was 91.76%.At the same time point,the efficiency and total efficiency of group C were significantly higher than that of group A and group B,and the difference was statistically significant?P<0.05?.3.In T₁ treatment time points,group B need oral oxycodone hydrochloride zyban more cases than in group A and group C,statistically significant difference?P<0.05?,At the treatment time point of T2,T3 and T4,the number of use cases in group A,group B,and C group was not statistically significant?P>0.05?.4.In the third month after the treatment,the telephone follow-up was followed by the neuralgia following herpes zoster.Group A:7 cases?22.58%?,group B:3cases?9.38%?,group C:3cases?8.82%?.The incidence of neuralgia after herpes zoster?22.58%?was significantly higher than that in group B?9.38%?and group C?8.82%?,and the difference was statistically significant?P<0.05?.There was no significant difference between group B?9.38%?and group C?8.82%??P>0.05?.Conclusions:1.Pregabalin,and on paraspinal nerve block therapy can relieve herpes zoster pain,combination therapy can relieve pain degree increase,and oral opioid pain reduced dosage,drug related adverse reaction is less,the overall effect is better than single treatment.2.Nerve block therapy can significantly reduce the incidence of PHN in the forward complication of herpes zoster.