Ikebe H, Miyagawa A, Mizutani A, Miyamoto M, Taniguchi K, Honda N
Department of Anesthesiology, Oita Medical University.
Masui. 1995 Mar 3;44(3):428-33.
We performed iontophoresis with Ca channel blockers for healthy adult volunteers. In this clinical study, we used iontophoresis with Ca channel blockers. Ten out patients with PHN treated at our pain clinic were treated with iontophoresis. They were randomly assigned to one of the following four treatments: (1) 5 ml of 4% lidocaine HCl, (2) 2 mg of nicardipine HCl + 5 ml of distilled water, (3) 2 mg of verapamil HCl + 5 ml of distilled water, and (4) 2 mg of diltiazem HCl + 5 ml distilled water. Iontophoresis was performed using the above four drugs on the positive pole. Using a VAS, each patient was evaluated concerning the analgesic effect. The pain before treatment (10 points) was used as the base line. Compared with the scores before treatment, VAS scores decreased significantly after iontophoresis in all four groups. In the lidocaine group, a significant decrease in VAS scores occurred immediately after iontophoresis and lasted up to 24 hours, reaching the nadir at 2 hours. In the nicardipine group, the decrease occurred immediately after iontophoresis and lasted up to one day, reaching the nadir at four hours. In the verapamil group, the decrease started 1 hour after iontophoresis and lasted up to 48 hours, reaching the nadir at 8 hours. In diltiazem group, the decrease started 1 hour after iontophoresis and lasted up to 48 hours, reaching the nadir at 4 hours. Iontophoresis with Ca channel blockers produced a prolonged analgesic effect in PHN patients. Previously we had observed the same effect in adult volunteers. Therefore, we believe that this therapy will be clinically useful.
我们对健康成年志愿者进行了钙通道阻滞剂离子导入治疗。在这项临床研究中，我们使用了钙通道阻滞剂离子导入治疗。在我们疼痛诊所接受治疗的10例带状疱疹后神经痛（PHN）患者接受了离子导入治疗。他们被随机分配到以下四种治疗方法之一：（1）5毫升4%盐酸利多卡因，（2）2毫克盐酸尼卡地平+5毫升蒸馏水，（3）2毫克盐酸维拉帕米+5毫升蒸馏水，以及（4）2毫克盐酸地尔硫䓬+5毫升蒸馏水。使用上述四种药物在正极进行离子导入。使用视觉模拟评分法（VAS）对每位患者的镇痛效果进行评估。将治疗前的疼痛（10分）作为基线。与治疗前的评分相比，所有四组在离子导入后VAS评分均显著下降。在利多卡因组，离子导入后VAS评分立即显著下降，并持续长达24小时，在2小时时达到最低点。在尼卡地平组，离子导入后立即出现下降，并持续长达一天，在4小时时达到最低点。在维拉帕米组，离子导入后1小时开始下降，并持续长达48小时，在8小时时达到最低点。在地尔硫䓬组，离子导入后1小时开始下降，并持续长达48小时，在4小时时达到最低点。钙通道阻滞剂离子导入在PHN患者中产生了延长的镇痛效果。此前我们在成年志愿者中也观察到了相同的效果。因此，我们认为这种疗法在临床上将是有用的。
