不同强度超声波联合加巴喷丁治疗神经病理性疼痛的临床疗效及对miR-132和miR-34a表达的影响  

Clinical efficacy of ultrasound with different intensities combined with gabapentin in treatment of neuropathic pain and its effect on the expression of miR-132 and miR-34a

作　　者：李朦[1] 吉伟丽[1] 李玲芝[1] 杨楠[1] 刘彤彤 LI Meng;JI Weili;LI Lingzhi;YANG Nan;LIU Tongtong(Department of Pain,Affiliated Hospital of Hebei University,Baoding,Hebei 071000,China;Department of Neurology,Affiliated Hospital of Hebei University,Baoding,Hebei 071000,China)

机构地区：[1]河北大学附属医院疼痛科,河北保定071000 [2]河北大学附属医院神经内科,河北保定071000

出　　处：《国际神经病学神经外科学杂志》2023年第2期6-11,共6页Journal of International Neurology and Neurosurgery

基　　金：河北省医学科学研究课题计划(20200574)。

摘　　要：目的 探讨不同强度超声波联合加巴喷丁治疗神经病理性疼痛的临床疗效及对miR-132和miR-34a表达的影响。方法 选取2018年12月至2019年12月间河北大学附属医院收治的180例神经病理性疼痛患者,根据使用超声波强度的不同将其分为低、中、高强度超声波组,每组各60例。3组患者均在使用超声波的基础上联合加巴喷丁进行治疗,疗程为3个月。比较治疗前后3组的睡眠干扰、疼痛数字分级评分法评分、疼痛介质(前列腺素E2、5-羟色胺、内皮素1、P物质)水平、复发状况、临床疗效及miR-132和miR-34a的表达水平。结果 治疗前3组睡眠干扰评分、疼痛数字分级评分法评分、疼痛介质水平及miR-132和miR-34a表达水平比较,差异无统计学意义(P>0.05)。治疗后,3组上述检测数值与治疗前比较均有降低,差异有统计学意义(P<0.05);高强度超声波组的检测数值低于中、低强度超声波组,差异有统计学意义(P<0.05)。高强度超声波组临床总有效率为98.3%,中强度超声波组为93.3%,低强度超声波组为86.7%,3组间比较差异具有统计学意义(P<0.05)。低强度超声波组、中强度超声波组、高强度超声波组不良反应发生率分别为8.3%、11.7%、13.3%,3组间比较差异无统计学意义(P>0.05)。随访调查表明,高强度超声波组、中强度超声波组、低强度超声波组复发率分别为0、5.0%、13.3%,3组间比较差异有统计学意义(P<0.05)。结论 不同强度超声波联合加巴喷丁治疗神经病理性疼痛效果显著;随着超声波强度的增加,联合治疗发挥的作用越明显;高强度超声波可有效提高其睡眠质量,显著降低miR-132、miR-34a表达水平,显著改善患者疼痛程度。Objective To investigate the clinical efficacy of ultrasound therapy with different intensities combined with gabapentin in the treatment of neuropathic pain and its effect on the expression of miR132 and miR34a.Methods A total of 180 patients with neuropathic pain who were admitted to Affiliated Hospital of Hebei University from December 2018 to December 2019 were enrolled.According to the intensity of ultrasound therapy,they were divided into low,medium,and highintensity ultrasound groups,with 60 patients in each group.All three groups were given ultrasound therapy combined with gabapentin,with a course of treatment of 3 months.The three groups were compared in terms of sleep disturbance,Numerical Rating Scale(NRS)pain score,levels of pain mediators(prostaglandin E2,5hydroxytryptamine endothelin substance P),recurrence,clinical outcome,and the expression levels of miR132 and miR34a before and after treatment.Results Before treatment,there were no significant differences among the three groups in sleep disturbance score,NRS pain score,the levels of pain mediators,and the expression levels of miR132 and miR34a(P>0.05).After treatment,all three groups had significant reductions in the above indicators(P<0.05),and the highintensity ultrasound group had significantly lower values than the lowand mediumintensity ultrasound groups(P<0.05).The overall response rate was 98.3%in the highintensity ultrasound group,93.3%in the mediumintensity ultrasound group,and 86.7%in the lowintensity ultrasound group,and there was a significant difference in overall response rate among the three groups(P<0.05).The incidence rate of adverse events was 8.3%in the lowintensity ultrasound group,11.7%in the mediumintensity ultrasound group,and 13.3%in the highintensity ultrasound group,with no significant difference among the three groups(P>0.05).Followup investigation showed a recurrence rate of 0%in the highintensity ultrasound group,5.0%in the mediumintensity ultrasound group,and 13.3%in the lowintensity ultrasound group(P<0.05).Conclusi

关 键 词：神经病理性疼痛 超声波 加巴喷丁 miR-132 MIR-34A 

分 类 号：R741[医药卫生—神经病学与精神病学]