目的 探讨巴氯芬联合腺苷钴胺治疗三叉神经痛的临床疗效。方法 选取2015年6月-2016年6月在天津市宝坻区人民医院进行治疗的三叉神经痛患者82例，根据治疗方案的差别分为对照组（41例）和治疗组（41例）。对照组患者肌肉注射注射用腺苷钴胺，1次/d。治疗组在对照组的基础上口服巴氯芬片，初始剂量为5 mg/次，3次/d，每4天增加5 mg，直至所需剂量，最大剂量不超过100 mg/次。两组均连续治疗4周。观察两组患者临床疗效，同时比较两组患者治疗前后生活质量评分、血清C反应蛋白（CRP）、白细胞介素-1β（IL-1β）、IL-6、肿瘤坏死因子-α（TNF-α）、超氧化物歧化酶（SOD）和谷胱甘肽过氧化物酶（GSH-Px）水平以及疼痛评分变化。结果 治疗后，对照组和治疗组总有效率分别为80.49%和95.12%，两组总有效率比较差异具有统计学意义（P<0.05）。治疗后，两组患者行动能力和自我照顾能力等各项生活质量评分均明显降低（P<0.05）；且治疗组的生活质量评分降低程度优于对照组（P<0.05）。治疗后，两组患者血清CRP、IL-1β、IL-6及TNF-α水平明显低于治疗前（P<0.05）；且治疗组上述指标水平优于对照组（P<0.05）。治疗后，两组患者血清SOD、GSH-Px水平明显高于治疗前（P<0.05）；与对照组相比，治疗组增高的更明显（P<0.05）。治疗后，两组患者VAS评分明显降低（P<0.05）；且治疗组比对照组降低的更明显（P<0.05）。结论 巴氯芬联合腺苷钴胺治疗三叉神经痛效果显著，可明显提高患者睡眠质量，减轻机体炎性反应和应激反应，具有一定的临床推广应用价值。

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.