胸椎旁神经脉冲射频联合高能量激光或皮内注射治疗带状疱疹后神经痛的临床观察*

Clinical observation of thoracic paraspinal nerve pulse combined with high intensity laser therapy or Intradermal injection in the treatment of postherpetic neuralgia JI Yun-Jing SUN Yue LIU Yao et al. Xuzhou Medical University, Xuzhou 221004,China

摘要:

目的：观察超声引导下胸椎旁神经脉冲射频联合高能量激光或皮内注射治疗带状疱疹后神经痛(postherpetic neuralgia, PHN)的疗效。方法：选取120例2019年2月至2019年9月入住我科的胸背部带状疱疹后神经痛的患者,随机分为三组,每组40例：A组脉冲射频组,B组脉冲射频联合高能量激光组,C组脉冲射频联合皮内注射组。记录三组患者治疗前、后1周、1月、3月自发性疼痛及触诱发痛的视觉模拟疼痛评分(visual analogue scale, VAS)和睡眠质量评分(self-rating scale of sleep, SRSS),同时记录治疗后患者满意度、治疗前、后1周、1月及3月的医院焦虑抑郁量表评分(hospital anxiety and depression scale,HADS)、简式McGill疼痛问卷(short-form of McGill pain questionnaire, SF-MPQ)评分以及出院后平均每天加巴喷丁使用量及盐酸曲马多使用率。结果：与治疗前比较,三组患者治疗后各时间点的自发性疼痛及触诱发痛的VAS和SRSS评分均明显降低(P＜0.05)；与A组相比,B 、C组患者治疗后1周、1月的自发性疼痛的VAS 和SRSS评分显著降低(P＜0.05),治疗后3月的评分无明显差异(P＞0.05)；与A组相比,B、C组治疗后各时间点触诱发痛VAS评分均降低(P＜0.05)；治疗后各时间点的HADS、SF-MPQ评分以及出院后平均每天加巴喷丁使用量及盐酸曲马多使用率均较A组减少(P＜0.05)；B、C组各时间段的VAS和SRSS评分无明显差异(P＞0.05),治疗后各时间段HADS、SF-MPQ评分以及出院后每周加巴喷丁使用量无明显差异(P＞0.05)；B组患者满意度明显高于A、C组(P＜0.05)；B、C组不良反应发生率低于A组(P<0.05)。结论：超声引导下胸椎旁神经脉冲射频联合高能量激光或皮内注射较单独治疗能更好的改善PHN患者的疼痛,联合治疗后各时间点的VAS及SRSS均明显改善,高能激光组患者满意度较高。

Abstract:

Objective：The aim of this study was to observe the efficacy of ultrasound-guided parathoracic nerve pulsed radiofrequency combined with high intensity laser therapy or Intradermal injection for postherpetic neuralgia (PHN).Methods: 120 patients over 60 years of age with postherpetic neuralgia were randomly assigned to the group A(n=40) and the group B (n=40) and the group C (n=40) . Both groups were treated with conventional drug treatment including antiepileptic drugs and analgesics and received ultrasound-guided thoracic spinal nerve pulse radiofrequency (UG-PRF). high intensity laser therapy was set on the basis of drug therapy and UG-PRF in group B. Intradermal injection was set on the basis of drug therapy and UG-PRF. TheScurative effectSwasSevaluatedSat 1week, 1month, 3months and after the end of the treatments bySvisual analog scale (VAS), self-rating scale of sleep (SRSS), patient satisfaction ,hospital anxiety and depression scale(HADS), short-form of McGill pain questionnaire(SF-MPQ) , the average daily dose of gabapentin and the proportion of patients consuming tramadol hydrochloride after discharge from the hospital.The adverse reactions during the treatments were also recorded.