带状疱疹后神经痛三种治疗方法对比分析  

Clinical study on three treatment methods of postherpetic neuralgia

作　　者：夏焱志 查俊 陈洁梅 乔世刚[1] 李华[1] 王琛[1] 李顺[2] XIA Yan-zhi;ZHA Jun;CHEN Jie-mei;QIAO Shi-gang;LI Hua;WANG Chen;LI Shun(Department of Anesthesiology and Perioperative Medicine,Suzhou Hospital Affiliated to Nanjing Medical University;Suzhou Science and Technology Town Hospital,Suzhou 215153,Jiangsu,China;2.Department of Pain,Zhejiang Provincial People＇s Hospital,Hangzhou 310014,Zhejiang,China)

机构地区：[1]南京医科大学附属苏州医院苏州科技城医院麻醉及围手术期医学科,215153 [2]浙江省人民医院疼痛科,杭州310014

出　　处：《中国现代神经疾病杂志》2018年第9期674-677,共4页Chinese Journal of Contemporary Neurology and Neurosurgery

摘　　要：目的探讨针刺触发点治疗、硬膜外神经阻滞术和选择性背根神经节脉冲射频术3种方法治疗带状疱疹后神经痛的临床疗效。方法共60例带状疱疹后神经痛患者随机分为3组,分别予针刺触发点治疗(20例)、硬膜外神经阻滞术(20例)和选择性背根神经节脉冲射频术(20例),治疗后均服用加巴喷丁,分别于治疗前和治疗后2、4、12周采用数字评价量表(NRS)评价疼痛程度。结果与治疗前相比,3组患者治疗后2、4和12周NRS评分均降低(均P=0.000)。治疗后2周,神经阻滞术组和脉冲射频术组NRS评分均低于针刺触发点组(P=0.013,0.000),脉冲射频术组NRS评分亦低于神经阻滞术(P=0.000);至治疗后4和12周,脉冲射频术组NRS评分仍低于针刺触发点组(P=0.000,0.000)和神经阻滞术组(P=0.000,0.000)。结论选择性背根神经节脉冲射频术治疗带状疱疹后神经痛效果最佳,可以迅速缓解疼痛,改善患者工作和生活质量。Objective To observe the clinical efficacy of acupuncture trigger point,nerve block and pulse radiofrequency in the treatment of postherpetic neuralgia（PHN）.Methods A total of 60 cases with PHN were randomly divided into 3 groups：acupuncture trigger point therapy（group A,N=20）,epidural nerve block（group B,N=20）and selective dorsal root ganglion（DRG）pulse radiofrequency（group C,N=20）.All patients in 3 groups took gabapentin orally at the same time after treatment.Numerical Rating Scale（NRS）was used to record the degree of pain in 3 groups before and after treatment（2,4 and12 weeks after operation）.ResultsCompared with before treatment,NRS scores in 3 groups were significanthly decreased at 2,4 and 12 weeks after operation（P=0.000,for all）.There was no significant difference on NRS scores among 3 groups before treatment（P〉0.05,for all）.Two weeks after operation,NRS scores in group B and C were significantly lower than that in group A（P=0.013,0.000）,and NRS score in group C was significantly lower than that in group B（P=0.000）.Up to 4 and 12 weeks after operation,NRS score in group C was significantly lower than that in group A（P=0.000,0.000）and B（P=0.000,0.000）,while there was no significant difference on NRS scores between group A and B（P〉0.05）.ConclusionsSelective dorsal root ganglion pulse radiofrequency is effective in the treatment of PHN,which can relieve the pain quickly and improve the work and life quality of patients.

关 键 词：神经痛 带状疱疹后 针刺镇痛 神经传导阻滞 脉冲射频(非MeSH词) 

分 类 号：R752.12[医药卫生—皮肤病学与性病学]