超声引导下高电压脉冲射频联合三氧注射治疗带状疱疹后神经痛  

Combined high voltage pulsed radiofrequency and ozone therapy versus ozone therapy alone in treating postherpetic neuralgia:a retrospective evaluation

作　　者：李雪萌 赵倩男 张建峰 孙丽娜[4] 周国明[1] 安建雄[2,3,4] LI Xuemeng;ZHAO Qiannan;ZHANG Jianfeng;SUN Lina;ZHOU Guoming;AN Jianxiong(Department of Pain,Affiliated Hospital of Chengde Medical College,Chengde 067000,China;Department of Anesthesiology,Pain and Sleep Medicine,Aviation General Hospital of China Medical University and Beijing Institute of Translational Medicine,Chinese Academy of Sciences,Beijing 102400,China;Savaid Medical School,University of Chinese Academy of Sciences,Beijing 102400,China;Department of Anesthesiology,Pain and Sleep Medicine,Affiliated Hospital of Weifang Medical University,Weifang 261000,China)

机构地区：[1]承德医学院附属医院疼痛科,承德067000 [2]中国医科大学航空总医院麻醉、疼痛与睡眠医学中心,北京102400 [3]中国科学院大学存济医学院,北京102400 [4]潍坊医学院麻醉学院暨潍坊医学院附属医院麻醉、疼痛与睡眠医学中心,潍坊261000

出　　处：《中国疼痛医学杂志》2023年第5期346-352,共7页Chinese Journal of Pain Medicine

基　　金：首都卫生发展科研专项项目(首发2020-3-6101)。

摘　　要：目的:评估超声引导下背根神经节(dorsal root ganglion,DRG)高电压脉冲射频(pulsed radiofrequency,PRF)联合三氧注射与单纯三氧注射治疗带状疱疹后神经痛(postherpetic neuralgia,PHN)的临床疗效。方法:收集航空总医院2019年6月至2021年12月接受治疗的137例PHN病人信息,按治疗方式分为联合治疗组(A组)78例,三氧治疗组(B组)59例。A组采取PRF联合DRG三氧注射,B组采取单纯DRG三氧注射(11.5μg/ml)。在治疗前和治疗后1周记录两组机械痛阈值。在治疗前、治疗后1周、1个月、3个月和6个月通过疼痛视觉模拟评分法(visual analogue scale,VAS)评估治疗效果。结果:与治疗前相比,两组在治疗后不同时间点的VAS评分均显著降低。与B组相比,A组在治疗后1个月、3个月、6个月时VAS评分均显著降低(P<0.05)。在1个月、3个月时,B组的总有效率显著低于A组(P<0.05)。与治疗前相比,两组治疗后的机械痛阈均显著降低(P<0.05),但两组间差异无统计学意义。Logistic回归分析显示,糖尿病史、病程、发病部位是预后不良的危险因素。结论:两种治疗方式均可缓解PHN病人疼痛,但高电压脉冲射频联合三氧注射临床疗效更显著。Objective:The purpose of this study was to assess the effects of ozone alone and in combination with high voltage pulsed radiofrequency(PRF)in the treatment of postherpetic neuralgia(PHN).Methods:Information was collected on 137 PHN patients treated at the Aviation General Hospital from June 2019 to December 2021,and they were divided into the combined treatment group(group A,n=78)and the ozone therapy alone(group B,n=59)according to the treatment modality.In group A,the PRF was applied to the target dorsal root ganglion(DRG).Then the ozonated water(11.5μg/ml)was injected through the inner cannula.In group B,only the ozonated water was injected in DRG.Tactile sensation were recorded in both groups at pre-treatment and 1 week post-treatment.The therapeutic efficacy was evaluated via visual analogue scale(VAS)scores and tactile sensation at pre-treatment,1 month,3 months,and 6 months after treatment.Results:Compared with pre-treatment,the VAS scores was significantly decreased in both group at different time points.Compared with group B,the VAS scores was significantly decreased at 1 month,3 months,and 6 months in group A(P<0.05).The total efficacy rate was significantly lower in group B than in group A at 1 month,3 months(P<0.05).Similarly,the tactile sensation was also significantly decreased at post-treatment when compared to pre-treatment(P<0.05).However,there was no statistical differences between two groups.Regression analysis showed that the history of diabetes mellitus,disease course,location of pain had significant negative effects on the treatment results.Conclusion:The administration of PRF+ozone and ozone therapy alone both improved pain symptoms.Moreover,treatment effects and total efficacy rates tended to be higher for the combination of PRF and ozone than ozone alone.

关 键 词：高电压脉冲射频 三氧注射 带状疱疹后神经痛 

分 类 号：R445.1[医药卫生—影像医学与核医学] R752.12[医药卫生—诊断学]