背根神经节脉冲射频治疗老年急性期带状疱疹神经痛的研究  

Clinical study of pulsed radiofrequency of dorsal root ganglion for acute herpes zoster neuralgia in the elderly

作　　者：胡鑫 蒋宗滨[1] 何睿林[1] 兰琪欣 刘劲洲 HU Xin;JIANG Zongbin;HE Ruilin;LAN Qixin;LIU Jingzhou(Department of Pain Treatmeng,the Second Affiliated Hospital of Guangxi Medical University,Nanning 530007,China)

机构地区：[1]广西医科大学第二附属医院疼痛科,南宁530007

出　　处：《实用医学杂志》2020年第6期779-783,共5页The Journal of Practical Medicine

基　　金：广西自然科学基金项目(编号:2017GXNSFAA198110)。

摘　　要：目的探讨背根神经节脉冲射频在老年急性期带状疱疹神经痛中的临床效果与安全性。方法选择2016年1月至2018年1月在我院疼痛科确诊为急性带状疱疹神经痛患者80例,年龄60~85岁。按照随机数字的方法分为对照组和观察组,每组40例,对照组予常规抗病毒及口服普瑞巴林治疗,观察组在此基础上使用背根神经节脉冲射频进行治疗。观察治疗后1周、1个月及3个月两组患者的疼痛程度、睡眠质量、不良反应及带状疱疹后神经痛(PHN)的发生情况。结果治疗后两组疼痛视觉模拟评分(VAS)及匹兹堡睡眠质量指数(PSQI)评分在各时间点均低于治疗前(P<0.01),并且观察组评分低于对照组(P<0.01)。在治疗过程中,观察组患者头晕、嗜睡及共济失调的发生率低于对照组(P<0.05)。与对照组相比,观察组患者PHN的发生率亦显著降低(P<0.01)。结论背根神经节脉冲射频联合普瑞巴林治疗老年急性期带状疱疹神经痛安全有效,并能降低PHN的发生,值得临床应用推广。Objective To investigate the clinical efficacy and safety of pulsed radiofrequency of dorsal root ganglion for acute herpes zoster neuralgia in the elderly.Methods Eighty patients,aged from 60~85,with acute herpes zoster neuralgia diagnosed in the department of pain treatment of our hospital from January 2016 to January 2018 were selected.They were divided into two groups,the control group(n=40)and observation group(n=40),according to the random number method.Patients in the control group received antiviral treatment and oral pregabalin,while patients in the observation group were treated with pulsed radiofrequency of dorsal root ganglion in addition to antiviral treatment and oral pregabalin.The degree of pain,sleep quality,adverse reactions and the incidence of postherpetic neuralgia(PHN)were observed at 1 week,1 month and 3 months after treatment.Results The scores of VAS and PSQI in both groups significantly decreased at each follow-up point after treatment(P<0.01).And the scores in the observation group were lower than those in the control group(P<0.01).During the treatment,the incidence of dizziness,somnolence and ataxia in the observation group was lower than that in the control group(P<0.05).Compared with the control group,the incidence of PHN in the observation group was also significantly lower(P<0.01).Conclusion Pulsed radiofrequency of dorsal root ganglion combined with pregabalin is safe and effective in the treatment of elderly patients with acute herpes zoster neuralgia,and could prevent the occurrence of PHN.It is worthy of clinical application and promotion.

关 键 词：带状疱疹 脉冲射频 普瑞巴林 神经痛 

分 类 号：R745[医药卫生—神经病学与精神病学]