半月节电刺激与脉冲射频治疗带状疱疹三叉神经痛疗效的比较  

Comparison of the therapeutic effects of Gasserian ganglion stimulation and pulsed radiofrequency on herpes zoster trigeminal neuralgia

作　　者：刘文杰 任东海 李新新[1] 孔存龙[1] 马中华 霍浩波 梅展展 刘宏建[3] 樊肖冲[1] Liu Wenjie;Ren Donghai;Li Xinxin;Kong Cunlong;Ma Zhonghua;Huo Haobo;Mei Zhanzhan;Liu Hongjian;Fan Xiaochong(Department of Pain Management,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;School of Computer Engineering,Henan Institute of Economics and Trade,Zhengzhou 453000,China;Department of Orthopedics,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院疼痛科,郑州450052 [2]河南经贸职业学院计算机工程学院,郑州453000 [3]郑州大学第一附属医院骨科,郑州450052

出　　处：《中华实验外科杂志》2025年第1期145-149,共5页Chinese Journal of Experimental Surgery

基　　金：河南省科技攻关计划项目(242102311242)。

摘　　要：目的探讨半月神经节电刺激治疗带状疱疹三叉神经痛的疗效,并与半月节脉冲射频比较。方法收集2020年1月至2023年11月郑州大学第一附属医院疼痛科带状疱疹三叉神经痛患者104例,按治疗方案分为半月节电刺激组(GGS组)52例和半月节脉冲射频组(PRF组)52例,采用t检验、重复测量的方差分析、Mann-Whitney U检验、χ2检验等方法分析组内术前术后及组间各时间点的NRS评分、疼痛缓解率、治疗有效性、睡眠质量、用药情况有否差异,并记录不良反应。结果术后3、7、14 d及1、2、3、6、12个月两组数字评分量表(NRS)评分均低于术前,GGS组术前与术后3 d的NRS评分为[(7.48±1.02)分比(4.79±1.54)分,t=13.155,P<0.01];PRF组术前与术后3 d的NRS评分为[(7.42±1.11)分比(5.48±1.16)分,t=19.283,P<0.01]。术后1、2、3、6、12个月,两组普瑞巴林用量明显低于术前,GGS组术前与术后1个月的用量为[300(150,300)mg/d比150(150,225)mg/d,Z=-5.761,P<0.01];PRF组术前与术后1个月的用量为[300(300,300)mg/d比225(225,300)mg/d,Z=-3.605,P<0.01]。术后7 d及1、3、6、12个月,两组匹兹堡睡眠质量指数优于术前,GGS组术前与术后7 d的指数为[15(13,16)比7(6,9),Z=-8.354,P<0.01];PRF组术前与术后7 d的指数为[15(13,17)比12(11,13),Z=-6.453,P<0.01]。术后3、7、14 d及1、2、3、6、12个月,GGS组NRS评分均低于PRF组,分别为[(4.79±1.54)分比(5.48±1.16)分、(3.85±1.50)分比(4.69±1.11)分、(3.00±1.50)分比(3.94±1.07)分、(2.31±1.30)分比(3.46±1.13)分、(1.77±1.18)分比(2.98±1.00)分、(1.23±1.11)分比(2.46±1.00)分、(0.94±1.10)分比(2.00±1.00)分、(0.81±1.05)分比(1.81±1.03)分,t=-2.589、-3.267、-3.691、-4.852、-5.644、-5.932、-5.174、-4.907,P<0.05];GGS组疼痛缓解率优于PRF组,分别为[(35.91±19.38)%比(25.97±12.40)%、(48.23±20.03)%比(36.47±13.94)%、(59.70±19.90)%比(46.49±14.59)%、(68.91±17.39)%比(53.19±15.35)%、(76.11±16.53)%比(59.81±13.35)%、(83.42±15.02)%�Objective To investigate the efficacy of Gasserian ganglion stimulation(GGS)in the treatment of herpes zoster trigeminal neuralgia,and compare it with pulse radiofrequency(PRF).Methods A total of 104 patients with herpes zoster trigeminal neuralgia were divided into two groups:52 cases in GGS group and 52 cases in PRF group.The t-tests,repeated measures ANOVA,Mann Whitney U test and chi square test were used to analyze the differences in NRS scores,pain relief rates,treatment effectiveness,sleep quality,and medication use within and between groups at various time points before and after surgery,and to record adverse reactions.Results On postoperative day 3,7,14,and month 1,2,3,6,12,NRS scores significantly decreased compared to preoperative levels.The NRS scores in the GGS group before and 3 days after surgery were(7.48±1.02 vs.4.79±1.54,t=13.155,P<0.01).The NRS scores in the PRF group before and 3 days after surgery were(7.42±1.11 vs.5.48±1.16,t=19.283,P<0.01).At 1,2,3,6,and 12 months after surgery,the dosage of pregabalin in both groups was significantly lower than before surgery.The dosage in the GGS group before surgery and 1 month after surgery was[300(150,300)mg/d vs.150(150,225)mg/d,Z=-5.761,P<0.01].The dosage in the PRF group before surgery and 1 month after surgery was[300(300,300)mg/d vs.225(225,300)mg/d,Z=-3.605,P<0.01].On postoperative day 7 and month 1,3,6,12,the Pittsburgh Sleep Quality Index was significantly better in both groups than before surgery.The index in the GGS group before and 7 days after surgery was[15(13,16)vs.7(6,9),Z=-8.354,P<0.01],and the index in the PRF group before and 7 days after surgery was[15(13,17)vs.12(11,13),Z=-6.453,P<0.01].On postoperative day 3,7,14,and month 1,2,3,6,12,the NRS scores of GGS was lower than that in the PRF group,and PRF are(4.79±1.54 vs.5.48±1.16,3.85±1.50 vs.4.69±1.11,3.00±1.50 vs.3.94±1.07,2.31±1.30 vs.3.46±1.13,1.77±1.18 vs.2.98±1.00,1.23±1.11 vs.2.46±1.00,0.94±1.10 vs.2.00±1.00,0.81±1.05 vs.1.81±1.03,t=-2.589,-3.267,-3.691,-4.852

关 键 词：半月节电刺激 半月节脉冲射频 带状疱疹三叉神经痛 

分 类 号：R751[医药卫生—皮肤病学与性病学]