早期脉冲射频治疗带状疱疹相关性疼痛临床研究

CLINICAL STUDY OF EARLY PULSED RADIOFREQUENCY THERAPY FOR HERPES ZOSTER RELATED PAIN

摘要:

目的：回顾性分析早期脉冲射频(Pulsed Radiofrequency, PRF)治疗对带状疱疹相关性疼痛(Zoster Related Pain, ZRP)临床疗效的影响,为提高ZRP临床疗效和预防带状疱疹后神经痛(Postherpetic Neuralgia,PHN)提供依据。方法：2019年6月至2020年6月在中日友好医院疼痛科初次接受PRF治疗的120名中重度疼痛的老年ZRP患者,按PRF干预时间分为早期治疗组(＜3个月)和晚期治疗组(≥3个月),分别于术前、术后第1天、1、3、6个月对患者数字评分法(Numerical Rating Scale, NRS)评分进行随访,并采用倾向性评分匹配法,对两组匹配后的样本进行临床疗效差异性分析。结果：在倾向性评分匹配之前,晚期治疗组中爆发痛患者比例高于早期治疗组,差异有统计学意义(P＜0.05)。经匹配后除了PRF干预时间,其余特征组间差异无统计学意义(P＞0.05)。两组术后第1天、1、3、6个月的NRS评分均低于术前,差异有统计学意义(P＜0.001)。组间比较,早期治疗组术后1、3、6个月的NRS评分均低于晚期治疗组,差异有统计学意义(P＜0.01)。术后3、6个月,早期治疗组有效和完全缓解率均明显高于晚期治疗组,差异有统计学意义(P＜0.01)。术后3、6个月,早期治疗组中PHN发生率低于晚期治疗组,差异有统计学意义(P＜0.01)。结论：对于50岁或50岁以上伴有中度至重度疼痛的ZRP患者,早期PRF治疗能够取得良好的短期和长期疗效,并可能预防急性带状疱疹相关性疼痛向慢性疼痛的进展。

Abstract:

Objective: To retrospectively analyze the effect of early pulsed radiofrequency (PRF) treatment on the clinical outcome of herpes zoster related pain (ZRP), To provide a basis for improving the clinical efficacy of ZRP and preventing postherpetic neuralgia (PHN). Methods：A total of 120 elderly ZRP patients with moderate to severe pain who were initially treated with PRF in the pain department of China Japan Friendship Hospital from June 2019 to June 2020 were divided into early treatment (< 3 months) and late treatment (≥3 months) groups according to PRF intervention duration. Patients were followed up for numeric rating scale (NRS) scores preoperatively and at day1, 1, 3, and 6 months postoperatively. After propensity score matching, the samples from the two matched groups were analyzed for differences in clinical efficacy.