高压氧联合脉冲射频胸背根神经节治疗老年带状疱疹后神经痛的临床效果  

Clinical Effect of Hyperbaric Oxygen Combined with Pulsed Radiofrequency Thoracic Dorsal Root Ganglion in the Treatment of Postherpetic Neuralgia in the Elderly

作　　者：罗章才 杨俊 LUO Zhangcai;YANG Jun(Pain Unit,Yudu Hospital of Gannan Medical University,Yudu 342300,China;不详)

机构地区：[1]赣南医科大学附属于都医院疼痛科,江西于都342300 [2]赣南医科大学第一附属医院疼痛科,江西赣州341000

出　　处：《中国医学创新》2025年第12期148-153,共6页Medical Innovation of China

基　　金：江西省中医药管理局科技计划项目(2022B0683)。

摘　　要：目的:探讨高压氧联合脉冲射频胸背根神经节治疗老年带状疱疹后神经痛的效果。方法:选取赣南医科大学附属于都医院2020年11月—2023年11月收治的106例老年带状疱疹后神经痛患者,采用随机数字表法分为对照组和试验组。两组均给予脉冲射频胸背根神经节和常规药物治疗,对照组在模拟高压氧舱环境中,给予戴面罩吸空气治疗,试验组在高压氧舱环境中,给予戴面罩吸氧治疗。分别于治疗前、治疗4周、治疗12周评估或检测两组患者的匹兹堡睡眠质量指数(PSQI)评分、视觉模拟评分法(VAS)评分、皮肤病生活质量指数(DLQI)、单核细胞趋化蛋白-1(MCP-1)、红细胞沉降率(ESR)、疼痛介质[β-内啡肽(β-EP)、神经肽-1(NK-1)、前列素E_(2)(PGE_(2))、降钙素基因相关肽(CGRP)]、压痛阈(PPT)及CXC趋化因子配体10(CXCL10)水平。记录两组患者治疗期间的不良反应。结果:治疗前,两组PSQI评分、PPT、DLQI评分、VAS评分比较,差异均无统计学意义(P>0.05)。治疗4、12周后,两组PSQI评分、DLQI评分、VAS评分均低于治疗前,且试验组均低于对照组,差异均有统计学意义(P<0.05);两组PPT均高于治疗前,且试验组均高于对照组,差异均有统计学意义(P<0.05)。治疗前,两组间疼痛介质、MCP-1、ESR、CXCL10水平比较,差异均无统计学意义(P>0.05)。治疗4、12周后,两组间β-EP水平均高于治疗前,且试验组均高于对照组,差异均有统计学意义(P<0.05);两组CGRP、MCP-1、CXCL10、NK-1、ESR、PGE_(2)水平均低于治疗前,且试验组均低于对照组,差异均有统计学意义(P<0.05)。两组间头晕、嗜睡、水肿等不良反应发生率(对照组5.66%,试验组7.55%)比较,差异无统计学意义(P>0.05)。结论:高压氧联合脉冲射频胸背根神经节治疗老年带状疱疹后神经痛可降低血清MCP-1、ESR、CXCL10的水平,调节β-EP、NK-1、PGE_(2)、CGRP的表达,减轻疼痛。Objective:To explore the effect of hyperbaric oxygen combined with pulsed radiofrequency thoracic dorsal root ganglion in the treatment of postherpetic neuralgia in the elderly.Method:One hundred and six elderly patients with postherpetic neuralgia admitted to Yudu Hospital of Gannan Medical University between November 2020 and November 2023 were selected and divided into the control group and the experimental group using a random number table.Both groups were given pulsed radiofrequency thoracic dorsal root ganglion and conventional medication,and the control group was given air inhalation treatment with a mask in a simulated hyperbaric chamber environment,while the experimental group was given oxygen inhalation treatment with a mask in a hyperbaric chamber environment.The Pittsburgh sleep quality index(PSQI)score,visual analog scale(VAS)score,dermatologic life quality index(DLQI),monocyte chemotactic protein-1(MCP-1),erythrocyte sedimentation rate(ESR),pain mediators[β-endorphin(β-EP),neurokinin-1(NK-1),prostaglandin E_(2)(PGE_(2)),calcitonin gene-related peptide(CGRP)],pressure pain threshold(PPT)and CXC chemokine ligand 10(CXCL10)levels were evaluated or tested before treatment,4 weeks and 12 weeks after treatment.Adverse reactions during treatment were recorded in both groups.Result:Before treatment,PSQI scores,PPT,DLQI scores,and VAS scores were compared between the two groups,the differences were not statistically significant(P>0.05).After 4 and 12 weeks of treatment,PSQI scores,DLQI scores and VAS scores of the two groups were lower than those before treatment,and those of the experimental group were lower than those of the control group,the differences were statistically significant(P<0.05).PPT of both groups were higher than those before treatment,and those of the experimental group were higher than those of the control group,the differences were statistically significant(P<0.05).Before treatment,there were no statistically significant differences in the levels of pain mediators,MCP-1,ESR and CXCL10 b

关 键 词：高压氧 疼痛介质 带状疱疹后神经痛 不良反应 脉冲射频胸背根神经节 

分 类 号：R758.25[医药卫生—皮肤病学与性病学]