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激光联合药物治疗三叉神经痛的治疗及镇痛效果

Therapeutic and Analgesic Efficacy of Laser in Conjunction With Pharmaceutical Therapy for Trigeminal Neuralgia.

作者信息

Ebrahimi Hooman, Najafi Shamsolmoulouk, Khayamzadeh Mina, Zahedi Amirabbas, Mahdavi Atossa

机构信息

Oral Medicine Department, Dental Branch, Islamic Azad University, Tehran, Iran.

Oral Medicine Department, Dental Research Center, Faculty of Dentistry, International Campus of Tehran University of Medical Sciences, Tehran, Iran.

出版信息

J Lasers Med Sci. 2018 Winter;9(1):63-68. doi: 10.15171/jlms.2018.13. Epub 2017 Dec 26.

Abstract

Trigeminal neuralgia (TN) is the most common neuralgia in the head and neck region and a common cause of orofacial pain. It is routinely treated with carbamazepine. Laser, acupuncture and radiofrequency are among other treatment modalities for this condition. This study sought to assess the efficacy of laser therapy in conjunction with carbamazepine for treatment of TN. A total of 30 patients who met the inclusion criteria were divided into 2 groups of cases and controls (n=15) by double blind randomized controlled clinical trial. All patients received 100 mg carbamazepine at baseline and another 100 mg after 2 days for pain control. In the case group, low level laser therapy (LLLT) was also performed in addition to pharmaceutical therapy. Sham laser was used in the control group instead of LLLT. Treatment was continued for 9 sessions (3 days a week). The intensity of pain was measured and compared in the 2 groups using visual analog scale (VAS) in 3 period. The qualitative variables among the groups were compared using the repeated measures analysis of variance (ANOVA). The severity of pain was lower at the end of treatment in the case compared to the control group so this difference was statistically significant (=0.003). The severity of pain decreased in both groups over time. Significant difference was noted in this regard between the 2 groups either (=0.003). At the end of treatment pain intensity dropped in the intervention group from 6/8 to 1/2 and control group from 6/6 to 2/7. Laser therapy did add to the value of pharmaceutical therapy for treatment of TN. Both groups experienced significant improvement over time. So it is better to used laser complementary therapy to reduce side effects and the medicine dosage.

摘要

三叉神经痛(TN)是头颈部最常见的神经痛,也是口面部疼痛的常见原因。常规治疗方法是使用卡马西平。激光、针灸和射频是治疗该疾病的其他方法。本研究旨在评估激光疗法联合卡马西平治疗TN的疗效。通过双盲随机对照临床试验,将30例符合纳入标准的患者分为病例组和对照组(n = 15)。所有患者在基线时服用100 mg卡马西平,2天后再服用100 mg以控制疼痛。病例组除药物治疗外还进行低强度激光治疗(LLLT)。对照组使用假激光代替LLLT。治疗持续9个疗程(每周3天)。在3个时间段内使用视觉模拟量表(VAS)测量并比较两组的疼痛强度。使用重复测量方差分析(ANOVA)比较组间的定性变量。与对照组相比,病例组治疗结束时疼痛严重程度较低,差异具有统计学意义(P = 0.003)。两组疼痛严重程度均随时间下降。两组在这方面也存在显著差异(P = 0.003)。治疗结束时,干预组疼痛强度从6/8降至1/2,对照组从6/6降至2/7。激光疗法确实增加了药物治疗TN的价值。两组随时间均有显著改善。因此,最好使用激光辅助疗法来减少副作用和药物剂量。

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