脊神经射频与脊髓电刺激治疗带状疱疹相关性疼痛的临床研究  

Clinical study on the efficacy of spinal nerve radiofrequency and spinal cord stimulation in the treatment of postherpetic neuralgia

作　　者：陈燕中 赖尚导[1] 刘炯锋 刘宇权 赖斐然 丘文凤 Chen Yan-zhong;Lai Shang-dao;Liu Jiong-feng;Liu Yu-quan;Lai Fei-ran;Qiu Wen-feng(Department of Pain,People's Hospital of Meizhou,Meizhou,Guangdong 514031,China)

机构地区：[1]梅州市人民医院疼痛科,广东梅州514031

出　　处：《中国现代医学杂志》2024年第15期94-98,共5页China Journal of Modern Medicine

基　　金：广东省中医药局科研项目(No:20221393)。

摘　　要：目的比较脊神经射频和脊髓电刺激两种治疗方式对带状疱疹相关性疼痛的临床效果。方法回顾性分析2022年3月-2024年3月1日梅州市人民医院收治的106例带状疱疹患者的临床资料。根据治疗方式不同,分为A组64例接受脊神经射频治疗,B组42例接受脊髓电刺激治疗。比较两组治疗效果,数字评分表评分(NRS)和疼痛差异(PD)值,治疗前、治疗1、3和7时的匹兹堡睡眠质量指数(PSQI)评分及视觉模拟评分表评分(VAS),治疗前后的红外热像温度差值及不良反应发生率。结果A组和B组的总有效率比较,差异无统计学意义(P>0.05)。B组治疗前后NRS评分和PD值的差值均高于A组(P<0.05)。B组PSQI评分低于A组(P<0.05)。A组治疗前后红外热像温度的差值高于B组(P<0.05)。两组患者在治疗前以及治疗1、3和7周的PSQI、VAS评分比较,结果:①不同时间点PSQI、VAS评分比较,差异有统计学意义(P<0.05);②A组和B组PSQI、VAS评分比较,差异有统计学意义(P<0.05),A组PSQI评分高于B组,VAS评分低于A组;③两组PSQI、VAS评分变化趋势比较,差异有统计学意义(P<0.05)。两组总并发症发生率比较,差异无统计学意义(P>0.05)。结论脊髓电刺激在短时程内能够更有效地缓解带状疱疹相关性疼痛、提高睡眠质量。脊髓电刺激可能是一种更有效的治疗选择,值得在未来更大规模的研究中进一步验证。Objective To compare the clinical efficacy of spinal nerve radiofrequency(rF)and spinal cord stimulation(SCS)for the treatment of postherpetic neuralgia(PHN).Method A retrospective analysis was conducted on 106 patients with PHN treated at Meizhou People's Hospital from March 2022 to March 2024.Patients were divided into two groups based on the treatment method:Group A(64 patients)received spinal nerve RF treatment,and Group B(42 patients)received SCS treatment.Treatment outcomes were compared,including Numeric Rating Scale(NRS)scores,pain difference(PD)values,Pittsburgh Sleep Quality Index(PSQI)scores,Visual Analog Scale(VAS)scores at baseline,1,3,and 7 weeks,infrared thermography temperature differences,and the incidence of adverse reactions.Result There was no significant difference in the overall effective rate between Group A and Group B(P>0.05).However,the changes in NRS scores and PD values in Group B were greater than those in Group A(P<0.05).Group B had lower PSQI scores compared to Group A(P<0.05).The changes in infrared thermography temperature in Group A were greater than those in Group B(P<0.05).When comparing PSQI and VAS scores at different time points,significant differences were observed(P<0.05).Group A had higher PSQI scores and lower VAS scores compared to Group B(P<0.05).There were no significant differences in the incidence of complications between the two groups(P>0.05).Conclusion Spinal cord stimulation is more effective in the short term for relieving postherpetic neuralgia and improving sleep quality compared to spinal nerve radiofrequency.SCS may be a more effective treatment option and warrants further validation in larger-scale studies.

关 键 词：带状疱疹 脊神经射频 脊髓电刺激 相关性疼痛 睡眠质量 

分 类 号：R752.12[医药卫生—皮肤病学与性病学]