背根神经节射频调控联合阿霉素损毁术与射频热凝术对胸背部带状疱疹后神经痛疗效的比较  

Comprising the effects of radiofrequency regulation combined with adriamycin lysis and radiofrequency thermocoagulation in dorsal root ganglion for the treatment of thoracic postherpetic neuralgia

作　　者：王祥[1] 韩冲芳[1] 姚太平 段丽珍[1] 郭耀耀 邢瑞雪[1] Wang Xiang;Han Chongfang;Yao Taiping;Duan Lizhen;Guo Yaoyao;Xing Ruixue(Department of Pain Medicine,Shanxi Dayi Hospital,Shanxi Academy of Medical Sciences,Taiyuan City,Shanxi Province 030000,China)

机构地区：[1]山西医学科学院山西大医院疼痛科,太原市030000

出　　处：《实用疼痛学杂志》2019年第5期342-347,共6页Pain Clinic Journal

摘　　要：目的探讨背根神经节(DRG)射频调控联合阿霉素损毁术与射频热凝术对胸背部带状疱疹后神经痛的临床疗效。方法收集2017年1月至2018年1月于山西医学科学院山西大医院疼痛科收治的胸背部带状疱疹后神经痛患者46例作为研究对象,年龄、性别不限;按照随机数字表法将所有患者分为射频调控联合阿霉素损毁术组(RA组,n=23)及射频热凝术组(RF组,n=23)。RA组给予DRG射频调控进行治疗后予0.66%阿霉素局部注射,RF组给予射频热凝治疗,出院后进行6个月的随访。比较两组治疗前后的视觉模拟评分(VAS)、每日疼痛发作次数、每次疼痛持续时间、辅助镇痛药物使用情况及治疗后总有效率,对比治疗前后不同时点生活质量相关指标及治疗不良反应的发生情况。结果与治疗前比较,两组治疗后VAS评分均降低,每日疼痛发作次数均减少,每次疼痛持续时间均缩短,镇痛药物使用均减少,生活质量均提高(P均<0.05);与RF组比较,RA组治疗后同一时点VAS评分更低,每日疼痛发作次数更少,每次疼痛持续时间更短,镇痛药物使用量更少,生活质量改善更明显,总有效率更高(P均<0.05);两组均未见严重不良反应。结论CT引导DRG射频调控联合阿霉素损毁术与射频热凝术均能有效缓解胸背部带状疱疹后神经痛,但前者的效果更好,患者生活质量改善更明显。Objective To investigate the clinical effects between radiofrequency regulation combined with adriamycin lysis and radiofrequency thermocoagulation in dorsal root ganglionin(DRG)on the treatment of patients with thoracic postherpetic neuralgia.Methods Forty-six patients with postherpetic neuralgia on thoracic and dorsal region in department of Pain Medicine of Shanxi Dayi Hospital,Shanxi Academy of Medical Sciences from January 2017 to January 2018,were collected in this study.All patients were divided into radiofrequency combined with adriamycin group(group RA,n=23)and radiofrequency group(group RF,n=23)according to the randomized control grouping method.Patients were received local injection of 0.66%adriamycin after treatment with DRG pulsed radiofrequency in group RA,and radiofrequency thermocoagulation in group RF.Patients were followed up for 6 months.Visual analogue scale(VAS),daily pain episodes,duration of each episode and supplementary use of analgesics before and after the treatment were compared between the two groups.Quality of life,excellent effect,total effective rate and adverse reactions were also compared.Results Compared with pretreatment,VAS and number of daily pain episodes were decreased,duration of each episode was shortened,supplementary use of analgesics decreased and quality of life improved in the two groups after the treatment(all P<0.05).Compared with group RF,VAS and number of daily pain episodes were even decreased,the duration of each episode even shortened,the supplementary use of analgesics even decreased,the quality of life,excellent effect even increased in group RA at the same time after the treatment(all P<0.05).No serious adverse reactions were found in both groups.Conclusion CT-guided DRG pulse radiofrequency regulation combined with adriamycin lysis and radiofrequency thermocoagulation can both effectively relieve thoracic postherpetic neuralgia,but the former has a better effect and the patients'quality of life improved more significantly.

关 键 词：神经痛 带状疱疹后 神经节 脊 导管消融术 多柔比星 

分 类 号：R75[医药卫生—皮肤病学与性病学]