标题：活血通络胶囊联合卡马西平治疗原发性三叉神经痛疗效观察

      作者：郭强 1，任建红 2，党彩艳 1    1.西安市中心医院疼痛科，陕西 西安 710003；2.乾县中医医院内一科室，陕西 咸阳 713300

      卷次： 2023年34卷14期

      【摘要】 目的 观察活血通络胶囊联合卡马西平治疗原发性三叉神经痛的临床效果。方法 选择2020年3月至2022年3月西安市中心医院收治的100例原发性三叉神经痛患者进行研究，按照随机数表法分为观察组和对照组各50例。对照组患者应用卡马西平治疗，观察组患者则在此基础上联合活血通络胶囊治疗，均连续治疗20 d。比较两组患者治疗前后的视觉模拟评分法(VAS)、匹兹堡睡眠质量指数问卷(PSQI)评分、炎症指标[肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-6、IL-1β]、氧化应激指标[丙二醛(MDA)、超氧化物歧化酶(SOD)和谷胱甘肽过氧化物酶(GSH-Px)]的变化及治疗期间的不良反应发生情况。结果 治疗后，两组患者的VAS评分、PSQI评分均明显低于治疗前，且观察组患者治疗后的VAS评分、PSQI评分分别为(2.39±0.42)分、(6.59±1.13)分，明显低于对照组的(3.18±0.35)分、(8.02±1.42)分，差异均有统计学意义(P<0.05)；治疗后，两组患者的TNF-α、IL-6、IL-1β均明显低于治疗前，且观察组患者治疗后的血清TNF-α、IL-6、IL-1β水平分别为(21.12±2.53) pg/mL、(17.02±2.41) pg/mL、(20.74±2.18) pg/mL，明显低于对照组的(29.05±2.84) pg/mL、(21.62±2.81) pg/mL、(27.43±2.60) pg/mL，差异均有统计学意义(P<0.05)；治疗后，两组患者的MDA均明显低于治疗前，SOD、GSH-Px均明显高于治疗前，且观察组患者治疗后的血清MDA水平为(4.31±1.26) μmol/L，明显低于对照组的(5.27±1.01) μmol/L，SOD、GSH-Px水平分别为(91.35±14.21) U/mL、(69.71±8.56) U/L，明显高于对照组的(80.40±12.53) U/mL、(56.80±6.21) U/L，差异均有统计学意义(P<0.05)；观察组和对照组不良反应发生率分别为14.00%、12.00%，差异无统计学意义(P>0.05)。结论 活血通络胶囊联合卡马西平治疗原发性三叉神经痛能明显缓解患者疼痛，改善睡眠质量及炎症状况，降低氧化应激反应，不良反应发生率低，临床治疗效果显著，值得临床推广。
      【关键词】 原发性三叉神经痛；卡马西平；活血通络胶囊；炎症因子；氧化应激；不良反应
      【中图分类号】 R745.1+1 【文献标识码】 A 【文章编号】 1003—6350（2023）14—2016—05

Efficacy of Huoxue Tongluo Capsule combined with carbamazepine in the treatment of primary trigeminalneuralgia.
GUO Qiang 1, REN Jian-hong 2, DANG Cai-yan 1. 1. Department of Pain, Xi'an Central Hospital, Xi'an710003, Shaanxi, CHINA; 2. First Department of Internal Medicine, Qianxian Hospital of Traditional Chinese Medicine,Xianyang 713300, Shaanxi, CHINA
【Abstract】 Objective To observe the clinical effect of Huoxue Tongluo Capsule combined with carbamaze-pine in the treatment of primary trigeminal neuralgia. Methods A total of 100 patients with primary trigeminal neural-gia admitted to Xi'an Central Hospital from March 2020 to March 2022 were selected, and they were divided into an ob-servation group and a control group according to the random number table method, with 50 cases in each group. Patientsin the control group were treated with carbamazepine, while those in the observation group were treated with HuoxueTongluo Capsule on this basis, for 20 days. The Visual Analogue Scale (VAS), Pittsburgh Sleep Quality Index Question-naire (PSQI) score, inflammatory indicators [tumor necrosis factor-α (TNF-α), interleukin (IL)-6, IL-1 β], oxidativestress indicators [malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px)] before treat-ment and 20 days after treatment and the occurrence of adverse reactions during treatment were compared between thetwo groups. Results After treatment, the VAS score and PSQI score of both groups were significantly lower than thosebefore treatment; the VAS score and PSQI score in the observation group after treatment were (2.39±0.42) points and(6.59±1.13) points, which were significantly lower than (3.18±0.35) points and (8.02±1.42) points in the control group;the differences were statistically significant (P<0.05). After treatment, the serum TNF-α, IL-6, and IL-1β levels of bothgroups were significantly lower than those before treatment; the serum TNF-α, IL-6, and IL-1β levels in the observa-tion group after treatment were (21.12±2.53) pg/mL, (17.02±2.41) pg/mL, and (20.74±2.18) pg/mL, which were signifi-cantly lower than (29.05±2.84) pg/mL, (21.62±2.81) pg/mL, (27.43±2.60) pg/mL in the control group; the differenceswere statistically significant (P<0.05). After treatment, MDA levels in both groups were significantly lower than those be-fore treatment, while SOD and GSH-Px levels were significantly higher than those before treatment; the serum MDA levelin the observation group after treatment was (4.31±1.26) μmol/L, which was significantly lower than (5.27±1.01) μmol/Lin the control group, and SOD and GSH-Px levels were (91.35±14.21) U/mL and (69.71±8.56) U/L, which were signifi-cantly higher than (80.40±12.53) U/mL and (56.80±6.21) U/L in the control group; the differences were statistically sig-nificant (P<0.05). The incidence of adverse reactions in the observation group and the control group were 14.00% and12.00%, with no significant difference between the two groups (P>0.05). Conclusion Huoxue Tongluo Capsules com-bined with carbamazepine has a significant therapeutic effect on primary trigeminal neuralgia, which can significantly al-leviate pain, improve sleep quality and inflammatory status, and reduce oxidative stress reactions, with low incidence ofadverse reactions. It is worthy of clinical promotion.
      【Key words】 Primary trigeminal neuralgia; Carbamazepine; Huoxue Tongluo Capsule; Inflammatory factors; Ox-idative stress; Adverse reactions