Efficacy Analysis Of Nerve Block Combined With Gabapentin In The Treatment Of Trigeminal Herpes Zoster

ObjectiveTo investigate the difference in efficacy and safety and efficacy of nerve block combined with gabapentin versus gabapentin alone in the treatment of trigeminal herpes zoster(HZ)and the prevention of postherpetic neuralgia(PHN)in trigeminal herpes zoster,and to provide a reference for the treatment of trigeminal HZ.MethodsOne hundred and twelve patients with trigeminal neuralgia HZ who met the inclusion and exclusion criteria were divided into gabapentin group(group A)and nerve block combined with gabapentin group(group B)according to the random number table method,with 56 patients in each group.Patients in both groups received antiviral therapy.patients in group A were given gabapentin,which was gradually increased from an initial low dose of d1 300 mg orally once a night,d2 300 mg orally twice a day,and d3300 mg orally three times a day,followed by maintenance treatment for 3consecutive months.patients in group B were treated with 1% lidocaine 1 ml+ Dexamethasone 2.5 mg + Micropol 0.25 mg was injected into the affected side of the trigeminal nerve branch pain point block,2 times/week,for 3times.During the patient’s treatment period,if VAS≥4,the therapeutic analgesic drug tramadol hydrochloride extended-release tablets was used.The characteristics of herpes changes and pain duration were observed before and after treatment,and the changes of visual analogue score,Pittsburgh sleep quality index(PSQI),and European visual health scale(EQ-visual analogue score(EQ-VAS)were recorded at each time period.The incidence of PHN,and the occurrence of ocular complications were recorded.The difference was considered statistically significant at P < 0.05.Results:1.VAS: before treatment,there was no statistical difference between the VAS scores of the two groups;after treatment,the VAS scores of the two groups were lower than before treatment,and group B was lower than group A,and the difference was statistically significant(P < 0.05).2.The time to stop blistering,the time to crust 50% of the area,and the time to heal the ulcer were shorter in group B than in group A,and the difference was statistically significant(P<0.05).3.Sleep quality evaluation: the sleep quality of group B was higher than that of group A at the 30 th,60th and 90 th d after treatment,and both groups were better than before treatment after treatment,and the difference was statistically significant(P<0.05).4.Quality of life evaluation: the scores of group B were higher than those of group A at 30 d,60d and 90 d after treatment,and the scores of both groups were better than those before treatment after treatment,and the differences were statistically significant(P<0.05).5.Incidence of trigeminal PHN: The incidence in group B was significantly lower than that in group A,and it was statistically significant(P<0.05).6.comparison of pain duration: the duration in group B was significantly shorter than that in group A,and it was statistically significant(P<0.05).Conclusion:Nerve block combined with gabapentin for the treatment of trigeminal HZ is more effective than gabapentin alone for the treatment of HZ,and it is known through the follow-up results after treatment that combined nerve block treatment can accelerate the healing process of herpes zoster,reduce patients’ pain,improve patients’ sleep quality and quality of life,and shorten the duration of pain and reduce the incidence of trigeminal PHN,which provides a reliable theoretical basis for combined treatment of trigeminal HX It provides a reliable theoretical basis for the combined treatment of trigeminal HZ.