[1]高谦,李宝福,刘冰,等.脉冲射频联合神经阻滞治疗顽固性带状疱疹神经痛的疗效[J].介入放射学杂志,2024,33(10):1083-1087.
GAO Qian,LI Baofu,LIU Bing,et al.Curative effect of pulsed radiofrequency combined with nerve block for the treatment of refractory postherpetic neuralgia[J].journal interventional radiology,2024,33(10):1083-1087.
点击复制
脉冲射频联合神经阻滞治疗顽固性带状疱疹神经痛的疗效()
《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]
- 卷:
-
33
- 期数:
-
2024年10
- 页码:
-
1083-1087
- 栏目:
-
非血管介入
- 出版日期:
-
2024-10-21
文章信息/Info
- Title:
-
Curative effect of pulsed radiofrequency combined with nerve block for the treatment of refractory postherpetic neuralgia
- 作者:
-
高谦; 李宝福; 刘冰; 王春满; 李琳
-
- Author(s):
-
GAO Qian; LI Baofu; LIU Bing; WANG Chunman; LI Lin.
-
Department of Pain Management,Hengshui Municipal People′s Hospital (Harrison International Peace Hospital),Hengshui,Hebei Province 053000,China
-
- 关键词:
-
【关键词】带状疱疹; 神经痛; 脉冲射频治疗; 神经阻滞治疗; 疗效
- 文献标志码:
-
A
- 摘要:
-
【摘要】目的探讨脉冲射频联合神经阻滞治疗顽固性带状疱疹后神经痛(postherpetic neuralgia,PHN)的疗效。方法选取2020年3月至2023年3月衡水市人民医院收治的PHN患者201例,按随机数表法均分为脉冲射频组、神经阻滞组和联合组,每组各67例。3组PHN患者均常规药物治疗,脉冲射频组采取神经脉冲射频治疗,神经阻滞组采取神经阻滞治疗,联合组经神经阻滞治疗后再采取神经脉冲射频治疗。观察治疗前(T0)、治疗后7 d(AT7)、治疗后30 d(AT30)和治疗后90 d(AT90)时PHN患者简式McGill疼痛问卷表(SF-MPQ)、匹兹堡睡眠质量指数(PSQI)、β-内啡肽、P物质、降钙素基因相关肽(CGRP)、肿瘤坏死因子(TNF)-α、白细胞介素(IL)-6变化,记录患者不良反应情况。结果AT7、AT30、AT90时,联合组PHN患者SF-MPQ的PRI、VAS、PPI评分和PSQI评分、P物质、CGRP、TNF-α、IL-6水平均低于脉冲射频组和神经阻滞组(P<0.05),β-内啡肽水平高于脉冲射频组和神经阻滞组(P<0.05),3组PHN患者在治疗过程中均无明显不良反应发生。结论脉冲射频联合神经阻滞治疗对顽固性PHN患者的疼痛、睡眠质量改善效果优于其单独治疗,可能与调节疼痛介质水平和炎性因子水平有关。
参考文献/References:
[1]Finnerup NB,Kuner R,Jensen TS.Neuropathic pain:from mechanisms to treatment[J].Physiol Rev,2021,101:259-301.
[2]Gross GE,Eisert L,Doerr HW,et al.S2k guidelines for the diagnosis and treatment of herpes zoster and postherpetic neuralgia[J].J Dtsch Dermatol Ges,2020,18:55-78.
[3]Bulilete O,Leiva A,Rullan M,et al.Efficacy of gabapentin for the prevention of postherpetic neuralgia in patients with acute herpes zoster:a double blind,randomized controlled trial[J].PLoS One,2019,14:e0217335.
[4]Hua Y,Wu D,Gao T,et al.Minimally invasive interventional therapy for pain[J].J Interv Med,2023,6:64-68.
[5]彭飞飞,周脉涛,司波,等.超声引导下颈神经根及星状神经节阻滞联合药物治疗带状疱疹后遗神经痛的疗效观察[J].中国现代医学杂志,2020,30:55-60.
[6]陈亮,王进,吴桂鹏,等.超声引导肩胛上神经脉冲射频结合物理疗法治疗脑卒中后肩关节疼痛的疗效分析[J].介入放射学杂志,2022,31:495-498.
[7]韩镇锴,纪美端,朱丹琳,等.CT引导下不同电压脉冲射频治疗带状疱疹后神经痛的临床疗效[J].中国医科大学学报,2022,51:356-360,369.
[8]李水清,易端,贾东林,等.背根神经节阻滞联合脉冲射频治疗腰椎术后根性疼痛的疗效及安全性评价[J].中国微创外科杂志,2020,20:977-981.
[9]带状疱疹后神经痛诊疗共识编写专家组.带状疱疹后神经痛诊疗中国专家共识[J].中国疼痛医学杂志,2016,22:161-167.
[10]Rosamilia LL.Herpes zoster presentation,management,and prevention:a modern case-based review[J].Am J Clin Dermatol,2020,21:97-107.
[11]Ngo AL,Urits I,Yilmaz M,et al.Postherpetic neuralgia:current evidence on the topical film-forming spray with bupivacaine hydrochloride and a review of available treatment strategies[J].Adv Ther,2020,37:2003-2016.
[12]Liu JF,Shen W,Huang D,et al.Expert consensus of Chinese Association for the Study of Pain on the radiofrequency therapy technology in the department of pain[J].World J Clin Cases,2021,9:2123-2135.
[13]Murugesan A,Raghuraman MS.Pulsed radiofrequency of stellate ganglion for neuropathic pain associated with recurrent pleural leiomyosarcoma:a case report[J].Indian J Palliat Care,2021,27:574-576.
[14]尹海玲,张文文,单涛,等.髋关节囊周围神经阻滞联合股外侧皮神经阻滞与髂筋膜间隙阻滞用于老年患者全麻下全髋关节置换术效果的比较[J].中华麻醉学杂志,2021,41:567-570.
[15]刘建东,陈建华,王伟立,等.超声引导胸椎旁神经阻滞对多发肋骨骨折术后镇痛和炎症反应的影响[J].中华创伤杂志,2020,36:608-613.
[16]褚立梅,袁静静.硬膜外神经阻滞联合脊神经背根脉冲射频治疗老年带状疱疹后遗神经痛的临床效果分析[J].临床内科杂志,2020,37:591-592.
[17]Wang VC,Mullally WJ.Pain neurology[J].Am J Med,2020,133:273-280.
[18]Green DP,Limjunyawong N,Gour N,et al.A mast-cell-specific receptor mediates neurogenic inflammation and pain[J].Neuron,2019,101:412.e3-420.e3.
[19]Ma L,Peng S,Wei J,et al.Spinal microglial β-endorphin signaling mediates IL-10 and exenatide-induced inhibition of synaptic plasticity in neuropathic pain[J].CNS Neurosci Ther,2021,27:1157-1172.
[20]Berman G,Croop R,Kudrow D,et al.Safety of rimegepant,an oral CGRP receptor antagonist,plus CGRP monoclonal antibodies for migraine[J].Headache,2020,60:1734-1742.
[21]Zhao P,Mei L,Wang W.Clinical study of ultrasound-guided methylene blue thoracic paravertebral nerve block for the treatment of postherpetic neuralgia[J].Turk Neurosurg,2019,29:811-815.
[22]Chen L,Zhou R,Sun F,et al.Efficacy and safety of the extracorporeal shockwave therapy in patients with postherpetic neuralgia:study protocol of a randomized controlled trial[J].Trials,2020,21:630.
[23]刘大船,杨丽丽,吴玉鹏,等.脉冲射频联合普瑞巴林治疗带状疱疹后神经痛的疗效及对血清炎症因子和免疫水平的影响[J].中国现代医学杂志,2020,30:24-29.
备注/Memo
- 备注/Memo:
-
(收稿日期:2023-10-11)
(本文编辑:新宇)
更新日期/Last Update:
2024-10-17