| Objective:To investigate the clinical study on the therapeutic effects of botulinum toxin type A in the treatment of postherpetic neuralgia by local injecting BTX-A,compared with the method of taking oral carbamazepine and local injecting lidocacine.The intensity of PHN seizure and concomitant symptoms were compared between pre-therapy and post-therapy with BTX-A injection,furthmore,among patients injected by BTX-A and that taken carbamazepine.The purpose was to find the much effective method to treat PHN,probe into the clinical efficacy of BTX-A to treat PHN and provide a new therapy for treating PHN in clinical practice.Methods:Sixty patients with post-herpetic neuralgia were randomly divided into control group with 30 cases(Group A)and treatment group with 30 cases(Group B).Patients in Group A taken 100mg qd oral carbamazepine and local injected lidocacine with 3 days as a period of treatment.Group B was adopted the method of applying local injecting BTX-A in aching area with total dose 100U.Symptoms in intensity,PHN seizure and concomitant symptomos,were retrospected and detailedly recorded in each case at first visit to doctor.After therapy,patients were visited for initial days,and a standardized from including first midst and last of each seizure,intensity and concomitant symptoms,in addition,drug-induced side effects was commanded to fill in for 3 month.Case histories of pre-therapy and post-therapy at 1st,2nd and 3rd months were collected and statistically analyzed with single-blind method to compare and evaluate the efficacy between two groups.Results:(1) There were no signifacant differences in sex,age,course of disease between groupe A and B before treatment(P＞0.05).(2) After treatment,the general effective ratio of group B was 96.7%,while that of group A was 80%.The recovery and excellence rate of group B was 80%,while that of group A was 60%.There was great signifacant difference in group A and B(P＜0.05).(3) After treatment,the intensity of PHN seizure in two groups during 1,2,3months decreased signifacantly than before(P＜0.05),but intensity of PHN in group A from 1st to 3rd month after treatment were declined more than that in group B(P＜0.05).(4)From 1st to 3rd month after treatment,concomitant symptoms in group A and B was reduced than before(P＜0.05). Concomitant symptoms of PHN in post-therapeutic group B during1,2,3months were decreased signifacantly compared with that in post-therapeutic group A(P＜0.05).(5)After BTX-A injection,the pain of 29 cases(96.7%)had been alleviated.After treatment two weeks,28 cases of PHN by injecing BTX-A slept quietly,whose diet and mental symptoms had been improved.After treatment three months,the pain of 24 cases(80%) had been alleviated,there was no drug-induced side effect in 30 cases.Four cases had pain at the injection sites which disappeared with sympomatic treatment.Conclusions:Treating post-herpetic neuralgia by means of local injecting BTX-A effectively alleviate the pains of patients.The method can also improve the quality of life in terms of bettering mental symptoms resulting from PHN.Therefore,to treat PHN by local injecting BTX-A is a new therapy.
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