目的 探討巴氯芬聯(lián)合腺苷鈷胺治療三叉神經(jīng)痛的臨床療效。方法 選取2015年6月-2016年6月在天津市寶坻區(qū)人民醫(yī)院進(jìn)行治療的三叉神經(jīng)痛患者82例，根據(jù)治療方案的差別分為對照組（41例）和治療組（41例）。對照組患者肌肉注射注射用腺苷鈷胺，1次/d。治療組在對照組的基礎(chǔ)上口服巴氯芬片，初始劑量為5 mg/次，3次/d，每4天增加5 mg，直至所需劑量，最大劑量不超過100 mg/次。兩組均連續(xù)治療4周。觀察兩組患者臨床療效，同時(shí)比較兩組患者治療前后生活質(zhì)量評分、血清C反應(yīng)蛋白（CRP）、白細(xì)胞介素-1β（IL-1β）、IL-6、腫瘤壞死因子-α（TNF-α）、超氧化物歧化酶（SOD）和谷胱甘肽過氧化物酶（GSH-Px）水平以及疼痛評分變化。結(jié)果 治療后，對照組和治療組總有效率分別為80.49%和95.12%，兩組總有效率比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組患者行動能力和自我照顧能力等各項(xiàng)生活質(zhì)量評分均明顯降低（P<0.05）；且治療組的生活質(zhì)量評分降低程度優(yōu)于對照組（P<0.05）。治療后，兩組患者血清CRP、IL-1β、IL-6及TNF-α水平明顯低于治療前（P<0.05）；且治療組上述指標(biāo)水平優(yōu)于對照組（P<0.05）。治療后，兩組患者血清SOD、GSH-Px水平明顯高于治療前（P<0.05）；與對照組相比，治療組增高的更明顯（P<0.05）。治療后，兩組患者VAS評分明顯降低（P<0.05）；且治療組比對照組降低的更明顯（P<0.05）。結(jié)論 巴氯芬聯(lián)合腺苷鈷胺治療三叉神經(jīng)痛效果顯著，可明顯提高患者睡眠質(zhì)量，減輕機(jī)體炎性反應(yīng)和應(yīng)激反應(yīng)，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To investigate the clinical effect of baclofen combined with cobamamide in treatment of trigeminal neuralgia. Methods Patients (82 cases) with trigeminal neuralgia in Tianjin Baodi People's Hospital from June 2015 to June 2016 were divided into control group (41 cases) and treatment group (41 cases) based on different treatments. Patients in the control group were im administered with Cobamamide for injection, once daily. Patients in the treatment group were po administered with Baclofen Tablets on the basis of the control group, the initial dosage was 5 mg/time, three times daily, and which was increased by 5 mg every 4 days until the required dosage, and the maximum dosage was less than 100 mg/time. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacy was evaluated, and life quality score, CRP, IL-1β, IL-6, TNF-α, SOD, GSH-Px, and pain score in two groups before and after treatment were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 80.49% and 95.12%, respectively, and there were differences between two groups (P<0.05). After treatment, the life quality scores in two groups was significantly decreased (P<0.05). And the decrease degree in the treatment group was significantly better than those in the control group (P<0.05). After treatment, CRP, IL-1β, IL-6, and TNF-α level in two groups was significantly decreased (P<0.05). And the observational indexes in the treatment group were significantly better than those in the control group (P<0.05). After treatment, SOD and GSH-Px in two groups were significantly increased (P<0.05). And the increase degree of SOD and GSH-Px in the treatment group was more significant than that in the control group (P<0.05). After treatment, the VAS scores in two groups were significantly decreased (P<0.05). And the decrease degree in the treatment group was more significant than that in the control group (P<0.05). Conclusion Baclofen combined with cobamamide has a significant clinical effect in treatment of trigeminal neuralgia, can improve the sleep quality, and reduce the inflammatory response and stress response, which has a certain clinical application value.