| Objective Application of gastrodin sustained-release tablets combined with oxcarbazepine control primary trigeminal neuralgia(primary trigeminal neuralgia, PTN), to observe the patient’s degree of pain relief, the cure rate, sleep quality improvement and side-effect in the whole course of treatment, efficacy and safety evaluation of gastrodin sustained-release tablets combined with oxcarbazepine in treatment of PTN. Through the detection of peripheral serum before and after treatment in patients with tumor necrosis factor alpha(tumor necrosis factor- TNF- alpha, alpha) and nerve growth factor(nerve growth, factor, NGF) level, in order to investigate the possible pathogenic factors and the possible mechanism of improving the clinical symptoms of PTN with gastrodin sustained-release tablets, and provide a theoretical basis for the treatment of this disease to seek new ideas and new methods.Methods Select the outpatient department of internal medicine Wuhan General Hospita of Guangzhou Military Region nerve of 60 cases of PTN patients as the research object, randomly divided into the integrated Chinese and Western medicine group(30 cases) and Western medicine group(30 cases), two groups of course, with general information distribution, age, gender and so on are at the same level, comparable. The western medicine group was given oxcarbazepine treatment, the first day after bedtime 1 tablets, 2 times a day, each time 1 tablets, if tolerated, every 2 days to increase 1 pieces(daily dose increases and then can be divided into 3-4 oral), until the pain relief(maximum dose should not exceed 1500mg/d), continue to take the medicine 1 weeks, and then began to reduce, a week by 1 pieces(minimum dose should not be less than 600mg/d, that is the effective maintenance dose), such as pain again or aggravate is always increase the dose, the treatment period of 4 weeks. Traditional Chinese medicine and Western Medicine Group on the basis of Western medicine group and sustained-release tablets with gastrodia elata, daily 2, sooner or later each time, each time 1 tablets, maintaining the dose was administered for 4 weeks. All subjects had banned the use of muscle relaxants, before and after treatment with analgesics, tricyclic antidepressants and all other treatment measures. Recording began to all patients before treatment, after treatment of every weekend, a total of five time points of VAS score, quality score, sleep treatment before and after the end of the SF-MPQ questionnaire, and respectively in the course of treatment before and after the detection of patients serum TNF-α,NGF levels.Results ①Pain symptoms in the patients of two groups showed different degree by remission after treatment. Traditional Chinese medicine and Western medicine group, the total efficiency of 90%, markedly effective rate was 73.3%; the western medicine group the total effective rate was 83.3%, markedly effective rate was 36.7%; comparison of curative effect of two groups after the treatment, the statistical test, the integrated Chinese and Western medicine group markedly effective rate was better than western medicine group(P < 0.05), no significant difference(clinical efficiency P > 0.05).②Comparison of VAS score in group two two, two groups of patients at 5 time points, the statistical test,, appeared after treatment than before treatment to alleviate the pain degree(P < 0.005, after adjusting for the level of test alpha ’), and the pain degree decreases gradually with increasing treatment time. The integrated Chinese and Western medicine group before and after the treatment, every weekend, VAS score T respectively 912,924.5,855.5,768.5,736.5; western medicine group VAS score and T value were 918,905.5,974.5,1061.5,1094.5. Comparison between the two groups before treatment, 2 weeks after the treatment, first, two group of VAS scores were not significantly different(P > 0.05); third, 4 weeks after the treatment of traditional Chinese and Western medicine group the VAS score is lower than the western medicine group(P < 0.05), pain improved obviously.③The patients in the two groups after treatment SF-MPQ score were decreased than that before treatment. In the course of treatment of traditional Chinese and Western medicine group before and after the end of the SF-MPQ T of the total score values were 899680.5; the western medicine group in the T values were 931,1149.5. No significant difference before treatment, western medicine group and integrated traditional Chinese and Western medicine group in SF-MPQ total scores(P > 0.05), 4 weeks after treatment, SF-MPQ score was significantly lower than that of Western medicine and traditional Chinese medicine group, western medicine group(P < 0.05).④The average dose of traditional Chinese medicine and Western medicine for oral drug oxcarbazepine group is 783.22±124.74(mg/d), western medicine group average dose of 986.79±104.84(mg/d), traditional Chinese medicine and Western medicine group were orally given oxcarbazepine dosage levels were significantly lower than the western medicine group(P < 0.05).⑤The patients in the two groups after treatment sleep quality than before treatment improved. Traditional Chinese medicine and Western medicine in treatment group before and after the end of the sleep quality of T values were 900,783; the western medicine group in the T values were 930,1047; better than western medicine group and Western medicine group after treatment in patients with the sleep quality(P < 0.05).⑥The integrated Chinese and Western medicine group before treatment of serum TNF-α, NGF concentrations were 18.93±4.22, 483.91±59.71(ng/ml)(pg/ml), after treatment were decreased to 3.06 ±1.46, 248.35±41.17(ng/ml)(pg/ml); western medicine group before treatment of serum TNF-α, NGF concentrations were 18.97±4.63(ng/ml), 480.95±57.50(pg/ml), after treatment were decreased to 3.01±1.21(ng/ml), 250.24 ±38.09(pg/ml); the two group after treatment, serum levels of TNF-α and NGF concentrations were lower than those before therapy(P < 0.05); the two groups after treatment in patients with serum levels of TNF-α and NGF concentration have no significant the difference(P > 0.05).Conclusion ①The observation research topic two groups after treatment, all patients had different degree of ease; gastrodin sustained-release tablets combined with oxcarbazepine integrated Chinese and Western medicine group: pain relief to a greater degree, higher cure rate.②Gastrodin sustained-release tablets combined with oxcarbazepine is effective in treating PTN pain at the same time, can significantly reduce the oral dose of oxcarbazepine.③Gastrodin sustained-release tablets combined with oxcarbazepine treatment of PTN can improve the quality of sleep in patients with significant, to better promote the clinical symptoms disappeared.④After treatment of PTN patients with Gastrodin sustained-release tablets combined with oxcarbazepine or single use of oxcarbazepine, both the serum levels of TNF- alpha and NGF level decreased, attack of PTN related with serum levels of TNF-α and NGF. |
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