选择性神经根脉冲射频术联合普瑞巴林治疗不宁腿综合征的临床观察

OBSERVATION OF SELECTIVE NERVE ROOT PULSE RADIOFREQUENCY COMBINED WITH PREGABALIN IN THE TREATMENT OF RESTLESS LEGS SYNDROME

摘要:

目的：观察选择性神经根脉冲射频术联合普瑞巴林治疗不宁腿综合征(restless legs syndrome, RLS)的临床疗效及安全性。方法：收集我院2019年1月1日至2021年6月30日间RLS患者51例,按照不同治疗方式分为：普拉克索组(Group PRA,n=19),普瑞巴林组(Group PRE,n=17)及联合治疗组(Group COM,n=15)。PRA组给予普拉克索0.125mg/天,PRE组给予普瑞巴林300mg/天；COM组给予普瑞巴林150mg/天,并对责任神经根行脉冲射频治疗。收集治疗前及治疗后7天RLS严重程度评分(IRLS 评分)、不适程度数字分级评分(NRS)、入睡质量评分及助眠药物使用情况的变化,并收集并发症和不良反应的发生率。结果：治疗后三组患者IRLS评分、NRS评分及助眠药物使用率较治疗前显著降低(P<0.01),入睡质量评分升高。三个组中,COM组的IRLS评分、NRS评分、助眠药物使用率最低(P<0.01)。PRA组主要的不良反应是头痛和恶心,PRE组和联合治疗组主要的不良反应为头晕、恶心,未出现围手术期并发症。结论：选择性神经根脉冲射频术联合普瑞巴林治疗RLS的临床疗效良好,明显改善患者不适症状,从而改善入睡质量且安全性良好。

Abstract:

Objective: To observe the clinical efficacy and safety of selective nerve root pulse radiofrequency combined with pregabalin in the treatment of restless legs syndrome (RLS). Methods: 51 patients with RLS from January 1, 2019 to June 30, 2021 were collected and tit into three groups according to the treatment： pramipexole group (Group PRA, n = 19); Pregabalin group (Group PRE, n = 17) and combined treatment group (Group COM, n = 15). Group PRA was given pramipexole 0.125mg/day, group PRE was given pregabalin 300mg / day; group COM was given pregabalin 150mg / day, and the corresponding nerve roots were treated with pulsed radiofrequency. The changes of RLS severity score (IRLS score), digital grading score of discomfort (NRS), sleep quality score and the use of sleeping drugs before and 7 days after treatment were recorded, and the incidence of complications and adverse reactions were collected. Results: after treatment, the IRLS score, NRS score and the use rate of sleeping drugs in the three groups were significantly lower than those before treatment (P < 0.01), and the sleep quality score was higher. Among the three groups, the IRLS score, NRS score and the use rate of sleeping drugs in the group COM were the lowest (P < 0.01). The main adverse reactions in group PRA were headache and nausea. The main adverse reactions in group PRE and group COM were dizziness and nausea, and there were no perioperative complications. Conclusion: selective nerve root pulse radiofrequency ablation combined with pregabalin is effective in the treatment of RLS, obviously improves the discomfort symptoms of patients, so as to improve the quality of sleep and has good safety.