Clinical Study Of The Intradermal Block Treatment For Post-herpetic Neuralgia Using Different Dose Of Compound Betamethasone

Objective: Compare the effect of different doses of betamethasone intradermal block on Post-herpetic Neuralgia(PHN), to provide safe, effective and rational clinical evidence of using glucocorticoid.Methods: 96 old patients who matched the diagnostic criteria of PHN, had poor effect with conventional oral drug alone, and without any contraindications with intradermal block were chosen. The 96 patients were randomly divided into group A, group B and group C. In group A, the 20 ml of analgesic liquid included 5ml of 2% lidocaine and 15 ml of 0.9% sodium chloride. In group B, the 20 ml of analgesic liquid included 5ml of 2% lidocaine, 0.5ml of compound betamethasone and 14.5ml of 0.9% sodium chloride; In group C, the 20 ml of analgesic liquid included 5ml of 2% lidocaine, 1ml of compound betamethasone and 14 ml of 0.9% sodium chloride. The patients got intracutaneous injection once in the affected area on the 1st, 8th, 15 th day respectively, and each group was injected the same solution of analgesic liquid. All the cases were asked to conventionally take 0.3g gabapentin orally three times a day; 12.5mg amitriptyline every night; 100 mg tramadol twice a day, 0.5mg mecobalamin three times a day. After the treatment, patients continued taking medicine, and came back to our department regularly. Their Visual Analog Scale(VAS), Quality of Sleep(QS), Self-rating Depression Scale(SDS) variation before treatment(T0), the 17 th day oftreatment(T1), and 3 months after leaving hospital(T2) were carefully noted for comprehensive assessment of the efficacy, meanwhile, the serious adverse reactions during treatment of the three groups’ patients were observed and processed.Results:1. Visual Analog Scale(VAS)There was no statistical significant difference in the VAS of the patients among the three groups at T0; When at T1 and T2, the VAS of the three groups decreased significantly(P<0.05). The decreasing degree of group B and C was higher than group A, this difference was statistically significant, the difference between group B and C was statistically insignificant(p=0.486).2. Quality of Sleep(QS)There was no statistical significant difference in the QS between the three groups at T0, when at T1 and T2, the QS of the three groups increased remarkably(P<0.05). The increasing degree of group B and C was much higher than group A, this difference was statistically significant, the difference in QS between group B and C was not statistically significant(p=0.418).3. Self-rating Depression Scale(SDS)There was no statistical significant difference in the SDS between the three groups at T0; while at T1 and T2, the SDS of three groups decreased remarkably(P<0.05). The decreasing degree in SDS of group B and C in T1 and T2 was higher than group A, the difference was statistically significant, while the difference between group B and C was not statistically significant(p=0.48).4. Adverse reactionsA certain degree of fluctuation in blood pressure or blood sugar happened on patients with a history of hypertension or diabetes after the injection of compound betamethasone, after symptomatic treatment, there were no serious complications.Conclusion:1. Adding 0.5ml or 1ml of compound betamethasone to the 20 ml analgesic liquid for the intradermal block treatment on PHN can obviously release the patients’ pain, improve their sleep quality and depression symptoms.2. There is no obvious difference in efficacy whether 0.5ml or 1ml compound betamethasone is added to the 20 ml analgesic liquid for intradermal block treatment on PHN.