脉冲射频治疗急性期带状疱疹性神经痛与带状疱疹后遗神经痛效果比较  

Comparison of the efficacy of pulsed radiofrequency on acute herpes zoster neuralgia and postherpetic neuralgia

作　　者：聂会勇[1] 张丹丹[2] 王辉[1] 王欢[1] 王锁良[1] NIE Huiyong;ZHANG Dandan;WANG Hui;WANG Huan;WANG Suoliang(Department of Pain Management,,The First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061;Department of Geriatric Cardiology,The First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061)

机构地区：[1]西安交通大学第一附属医院疼痛科,陕西西安710061 [2]西安交通大学第一附属医院老年内一科,陕西西安710061

出　　处：《西安交通大学学报（医学版）》2024年第6期993-998,共6页Journal of Xi’an Jiaotong University（Medical Sciences）

摘　　要：目的 综合比较脉冲射频治疗急性期带状疱疹性神经痛和带状疱疹后遗神经痛的临床效果。方法 回顾性分析287例胸段带状疱疹相关性疼痛患者,按发病时间分为急性期带状疱疹性神经痛组(AHN组,3个月内)和带状疱疹后遗神经痛组(PHN组,3个月以上)。分析和比较两组脉冲射频术后1周、1个月、3个月、6个月和12个月的疼痛程度(VAS)、睡眠质量(AIS)、焦虑抑郁(GAD-7和PHQ-9)情况。结果 两组术后12个月各时点的VAS、AIS、GAD-7和PHQ-9评分均较术前明显下降(P<0.001)。AHN组在术后1个月至12个月,VAS、AIS、GAD-7和PHQ-9评分均较PHN组下降更多(P<0.001)。随访12个月时,AHN组口服普瑞巴林和阿片类药物患者例数少于PHN组(P=0.001)。结论 脉冲射频对带状疱疹相关性疼痛具有良好的治疗效果,对于急性期带状疱疹性神经痛在缓解疼痛、改善睡眠及焦虑抑郁方面优于带状疱疹后遗神经痛,这可能有利于预防带状疱疹后遗神经痛的发生。Objective To compare the clinical efficacy of pulsed radiofrequency(PRF)in patients with acute herpes zoster neuralgia(AHN)and postherpetic neuralgia(PHN).Methods A retrospective analysis was made on 287 patients with thoracic herpes zoster related pain.The patients were divided into acute herpes zoster neuralgia group(group AHN,within 3 months)and PHN group(group PHN,over 3 months)according to the onset time of herpes zoster.Pain degree(VAS),sleep quality(AIS),anxiety and depression(GAD-7 and PHQ-9)at 1 week,1 month,3 months,6 months and 12 months after the procedure were analyzed and compared between the two groups.Results The scores of VAS,AIS,GAD-7 and PHQ-9 significantly decreased in both groups after surgery(P<0.001).The four scores decreased more in AHN group than in PHN group from 1 to 12 months after surgery(P<0.001).After 12 months of follow-up,there were fewer cases of taking oral pregabalin and opioids in the former group than in the latter group(P=0.001).Conclusion PRF has a good therapeutic effect on herpes zoster related pain and is better than PHN in relieving pain,improving sleep and anxiety and depression in AHN,or can prevent PHN.

关 键 词：疱疹性神经痛 带状疱疹 脉冲射频 生活质量 失眠 

分 类 号：R459.4[医药卫生—治疗学]