早期应用脊髓电刺激治疗带状疱疹神经痛的疗效分析

Analysis of early efficacy of spinal cord stimulation in zoster-related neuralgia

摘要:

摘要：目的：比较脊髓电刺激（spinal cord stimulation, SCS）和加巴喷丁分别作为带状疱疹性神经痛(zoster-related neuralgia, ZRN)首选治疗方案的临床疗效。方法：回顾性分析2018年9月至2022年1月我院确诊的带状疱疹性神经痛患者60例，分为A组和B组，均行抗病毒治疗，A组在完善入院相关检查后即短时程SCS治疗，B组行规范加巴喷丁胶囊药物治疗。分别于术前、术后7天、14天、28天、3个月各时间点记录患者的VAS评分、McGill评分、睡眠质量、皮肤红外热成像图中患侧与健侧皮肤温度差值ΔT及带状疱疹后遗神经痛（PHN）发生率，并进行数据统计学分析。结果：两组VAS评分、McGill评分、皮肤红外热成像图ΔT值对比，术前差异无统计学意义；术后各随访时间点上，两组均较术前明显下降(P<0.05)，且A组均明显低于B组(P<0.001)。两组患者睡眠质量受影响人数在术后随访时间点上，两组均较术前减少(P<0.05)，A组受影响人数明显少于B组(P<0.001)，且在术后3个月时，A组受影响人数较术后28天时进一步减少(P<0.05)，B组却有所增(P<0.05)。PHN发生率在术后1个月，A组（6.67%）比B组（30%）显著降低(P<0.05)，在术后3个月时，A组（3.33%）较前进一步降低，B组（33.33%）较前有所增加，且A组比B组明显降低(P<0.05)。结论：两种治疗方法均有效，但脊髓电刺激作为首选治疗方案可显著缓解患者疼痛，改善患者生活质量，明显降低带状疱疹后遗神经痛的发生。

Abstract:

Abstract: Objective: To compare the clinical efficacy of spinal cord stimulation(SCS)and gabapentin as the preferred treatment options for zoster-related neuralgia(ZRN),respectively. Methods: A retrospective analysis of 60 patients with herpes zoster neuralgia diagnosed in our hospital from September 2018 to January 2022,they were divided into group A and group B, both underwent antiviral treatment. Group A received short-course SCS after completing admission related examination, and group B underwent standardized gabapentin capsule drug treatment.VAS score, McGill score, sleep quality, the temperature difference between the affected and healthy skin in the skin infrared thermal imaging map ΔT and postherpetic neuralgia (PHN) were recorded at each time point before surgery, 7 days, 14 days, 28 days and 3 months, and statistical analysis of data was conducted. Results:Comparison of VAS score, McGill score, the temperature difference between the affected and healthy skin in the skin infrared thermal imaging map ΔT between the two groups showed no statistically significant difference before surgery; At each postoperative follow-up time point, both groups were significantly lower than preoperative (P<0.05), and group A was significantly lower than group B (P<0.001).The number of affected sleep quality in both groups was decreased at the postoperative follow-up time points (P<0.05), and group A was significantly lower than group B (P<0.001). Moreover, at 3 months, group A decreased compared with 28 days(P<0.05), while group B increased(P<0.05). The incidence of PHN was significantly lower in Group A (6.67%) compared with B (30%) (P<0.05) at 1 month after surgery, at 3 months, group A (3.33%) further lower than before,group B (33.33%) increased from before,moreover, group A was significantly lower compared with group B (P<0.05). Conclusion:Both treatments are effective, but spinal cord stimulation as the preferred treatment regimen can significantly relieve patient pain, improve patient quality of life, and significantly reduce the occurrence of postherpetic neuralgia.