CT引导下脉冲射频联合臭氧注射治疗带状疱疹相关性疼痛患者的疗效及安全性  

Efficacy and safety of CT-guided pulsed radiofrequency combined with ozone injection for treatment of patients with zoster-associated pain

作　　者：王祥[1] 霍建忠[2] 王奇 冯晓月 张文静[1] 赵一帆 陈建平 Wang Xiang;Huo Jianzhong;Wang Qi;Feng Xiaoyue;Zhang Wenjing;Zhao Yifan;Chen Jianping(Department of Pain Medicine,Third Hospital of Shanxi Medical University,Shanxi Bethune Hospital,Taiyuan City,Shanxi Province 030032,China;Department of Orthopedics,Taiyuan Central Hospital of Shanxi Medical University,Taiyuan Central Hospital,Taiyuan City,Shanxi Province 030006,China)

机构地区：[1]山西医科大学第三医院山西白求恩医院疼痛科,太原市030032 [2]山西医科大学附属太原中心医院太原市中心医院骨科,太原市030006

出　　处：《中华疼痛学杂志》2024年第2期223-230,共8页Chinese Journal Of Painology

摘　　要：目的评价CT引导下脉冲射频联合臭氧注射治疗带状疱疹相关性疼痛的临床疗效及安全性。方法回顾性分析2019年1月1日至2021年12月30日,在山西白求恩医院疼痛科行脉冲射频联合臭氧注射治疗的带状疱疹相关性疼痛患者84例,性别、年龄不限。根据病程持续时间不同将患者分为3组:急性带状疱疹性神经痛组(AHN组,≤30 d,28例)、亚急性带状疱疹性神经痛组(SHN组,>30~90 d,32例)、带状疱疹后神经痛组(PHN组,>90 d,24例)。比较3组患者基线资料,收集并比较患者治疗前、治疗后当日及治疗后1、3、6和12个月的视觉模拟评分(VAS)、匹兹堡睡眠质量指数(PSQI)及普瑞巴林日用量。比较3组患者治疗后1、3、6和12个月时药物补救使用率、治疗无效率及不良反应情况。结果3组患者一般资料中病程比较差异有统计学意义(P<0.05),其余差异均无统计学意义(P均>0.05)。与治疗前比较,3组患者治疗后各时点VAS、PSQI评分及普瑞巴林日用量均降低(P均<0.05)。与PHN组比较,AHN组和SHN组患者治疗后各时点VAS、PSQI评分及普瑞巴林日用量更低(P均<0.05)。AHN组和SHN组患者治疗后1、3、6、12个月时药物补救使用率比PHN组更低[(14.3%、14.3%、10.7%、3.6%)和(15.6%、15.6%、12.5%、6.3%)比(45.8%、41.7%、37.5%、25.0%),χ^(2)组间=9.04,P组间<0.001]。AHN组和SHN组患者治疗后1、3、6、12个月时无效率比PHN组更低[(7.1%、7.1%、7.1%、7.1%)和(6.3%、9.4%、9.4%、9.4%)比(29.2%、33.3%、29.2%、29.2%),χ^(2)组间=23.59,P组间=0.011]。3组患者均无严重不良反应发生。结论CT引导下脉冲射频联合臭氧注射治疗带状疱疹相关性疼痛患者安全有效,近期和远期疗效显著,但早期脉冲射频联合臭氧注射临床效果更佳。Objective To evaluate the clinical efficacy and safety of CT-guided pulsed radiofrequency combined with ozone injection in the treatment of patients with zoster-associated pain.Methods A total of 84 patients with zoster-related pain treated by pulsed radiofrequency combined with ozone injection were analyzed retrospectively,in the Pain Medicine Department of Shanxi Bethune Hospital from January 1,2019 to December 30,2021.According to the duration of the disease,the patients were divided into three groups:acute herpetic neuralgia group(AHN group,≤30 days,28 cases),subacute herpetic neuralgia group(SHN group,>30-90 d,32 cases),and postherpetic neuralgia group(PHN group,>90 days,24 cases).The baseline data of the three groups were compared,and the visual analogue score(VAS),Pittsburgh sleep quality index(PSQI)and daily dosage of pregabalin were collected and compared before the treatment,on the day after the treatment and 1,3,6 and 12 months after the treatment.The drug rescue,treatment inefficiency and adverse reactions were compared among the three groups at 1,3,6 and 12 months after the treatment.Results There was no significant difference among the three groups(all P>0.05),except the course of disease(P<0.05).Compared with pre-treatment,VAS,PSQI and the daily dosage of pregabalin decreased at each time point after the treatment in the three groups(all P<0.05).Compared with PHN group,VAS,PSQI and the daily dosage of pregabalin were lower at each time point after the treatment in AHN group and SHN group.At 1,3,6 and 12 months after the treatment,the drug remedial utilization rate was lower in the AHN group and SHN group than that in the PHN group[(14.3%,14.3%,10.7%,and 3.6%)and(15.6%,15.6%,12.5%,and 6.3%)vs.(45.8%,41.7%,37.5%,and 25.0%),χ^(2)=9.04,P<0.001].At 1,3,6 and 12 months after the treatment,the inefficiency in the AHN group and SHN group was lower than that in the PHN group[(7.1%,7.1%,7.1%,7.1%)and(6.3%,9.4%,9.4%,9.4%)vs.(29.2%,33.3%,29.2%,29.2%),χ^(2)=23.59,P=0.011].There were no serious adverse react

关 键 词：臭氧 射频疗法 带状疱疹相关性疼痛 疗效 

分 类 号：R752.12[医药卫生—皮肤病学与性病学]