背根神经节脉冲射频联合普瑞巴林治疗带状疱疹性神经痛患者疗效及影响因素  

Efficacy and Influencing Factors of Dorsal Root Ganglion Pulsed Radiofrequency Combined with Pregabalin in the Treatment of Postherpetic Neuralgia

作　　者：钱志强[1] 李春明[1] QIAN Zhiqiang;LI Chunming(Department of Pain,the Third People's Hospital of Nantong,Nantong Jiangsu 226000)

机构地区：[1]南通市第三人民医院疼痛科,江苏南通226000

出　　处：《医学临床研究》2025年第2期239-242,共4页Journal of Clinical Research

摘　　要：【目的】探讨背根神经节脉冲射频联合普瑞巴林治疗带状疱疹性神经痛(PHN)患者的疗效及影响因素。【方法】选取2020年5月至2023年5月本院收治的90例PHN患者,均给予背根神经节脉冲射频联合普瑞巴林治疗,比较患者治疗前后的疼痛程度[视觉模拟评分法(VAS)]评分、炎症因子[降钙素基因相关肽(CGPR)、β-内啡肽(β-EP)、前列腺素E_(2)(PGE_(2))]水平。治疗后随访半年,根据患者疗效将其分为有效组与无效组,比较两组临床资料,采用多因素Logistic回归分析患者疗效的影响因素。【结果】治疗后,患者VAS评分低于治疗前(P<0.05),CGPR、PGE_(2)水平低于治疗前,β-EP水平高于治疗前(P<0.05)。有效组、无效组年龄、病程、合并糖尿病、抗病毒治疗、持续使用镇痛药物时间比较,差异有统计学意义(P<0.05)。多因素分析结果显示:年龄>65岁、病程>6个月、合并糖尿病、持续使用镇痛药物时间>2周均是影响患者疗效的危险因素(P<0.05)。【结论】背根神经节脉冲射频联合普瑞巴林治疗PHN患者,可显著减轻患者疼痛程度及降低炎症因子水平。年龄>65岁、病程>6个月、合并糖尿病、持续使用镇痛药物时间>2周是影响患者疗效的危险因素。【Objective】To investigate the efficacy of dorsal root ganglion pulsed radiofrequency combined with pregabalin in the treatment of postherpetic neuralgia(PHN)and identify related influencing factors.【Methods】A total of 90 patients with PHN,who were treated at the Third People's Hospital of Nantong between May 2020 and May 2023,were enrolled.All patients received dorsal root ganglion pulsed radiofrequency combined with pregabalin treatment.Pain intensity was assessed before and after treatment using the Visual Analog Scale(VAS),and inflammatory markers including calcitonin gene-related peptide(CGRP),β-endorphin(β-EP),and prostaglandin E_(2)(PGE_(2))were measured as well.After 6 months of follow-up,patients were divided into the effective group and the ineffective groups based on the treatment outcome.Clinical data were collected,and multivariate Logistic regression analysis was performed to determine the factors influencing the treatment efficacy.【Results】After treatment,VAS scores significantly decreased(P<0.05).Levels of CGRP and PGE_(2)were lower,whileβ-EP levels were higher compared to baseline before treatment(P<0.05).There were significant differences between the two groups in terms of age,disease duration,diabetes,antiviral treatment,and the duration of analgesic use(P<0.05).Multivariate analysis showed that age>65 years,disease duration>6 months,diabetes,and prolonged analgesic use(>2 weeks)were risk factors affecting treatment efficacy(P<0.05).【Conclusion】Dorsal root ganglion pulsed radiofrequency combined with pregabalin significantly alleviates pain and reduces inflammatory markers in patients with PHN.Key risk factors influencing treatment efficacy include age>65 years,disease duration>6 months,diabetes,and prolonged use of analgesics for more than 2 weeks.

关 键 词：带状疱疹 神经痛 带状疱疹后 普瑞巴林 脉冲射频术 治疗结果 

分 类 号：R745.11[医药卫生—神经病学与精神病学]