超声引导下高电压脉冲射频联合三氧治疗带状疱疹后神经痛

COMBINED HIGH-VOLTAGE PULSED RADIOFREQUENCY AND OZONE THERAPY VERSUS OZONE THERAPY ALONE IN TREATING POSTHERPETIC NEURALGIA: A RETROSPECTIVE?EVALUATION

摘要:

目的：评估超声引导下背根神经节(dorsal root ganglion, DRG)高电压脉冲射频(pulsed radiofrequency, PRF)联合三氧注射与单纯三氧注射治疗带状疱疹后神经痛(postherpetic neuralgia, PHN)的临床疗效。方法：回顾性分析PHN病人137例，分为联合治疗组(A组：n=78)，三氧治疗组(B组：n=59)。A组采取DRG三氧注射联合PRF，B组采取DRG三氧注射 (11.5 μg/mL)。在治疗前后、随访的1月、3月、6月，通过视觉模拟量表(visual analogue scale, VAS)和触觉评估治疗效果。结果：与治疗前相比，两组在不同时间点的VAS均显著降低。与B组相比，A组在1个月、3个月、6个月时VAS均显著降低(P<0.05)。在1个月、3个月时，B组的总有效率显著低于A组(P<0.05)。同样，与治疗前相比，治疗后的触觉阈值也显著降低(P<0.05)，但组间差异无统计学意义。logistic回归分析显示，糖尿病史和病程是预后不良的危险因素。结论：两种治疗方式均可缓解PHN病人疼痛，但是DRG高电压脉冲射频联合三氧注射临床疗效更显著。

Abstract:

Objective: The purpose of this study was to assess the effects?of?ozone alone and in combination with pulsed radiofrequency (PRF) in the treatment of postherpetic neuralgia (PHN) Methods: One hundred and thirty-seven patients with PHN were assigned into two groups: combination therapy with PRF and ozone (Group A, n = 78) and?ozone?therapy alone (Group B, n = 59). In Group A, the PRF was applied to the target dorsal root ganglions (DRGs). Then the ozonated water (11.5 μg/mL) was injected through the inner cannula. In group B, only the ozonated water was injected.The therapeutic efficacy was evaluated via visual analog scale (VAS) and tactile sensation at pre-treatment, post-treatment, 1 months, 3 months, and 6 months. Results: Compared with pre-treatment, the VAS was significantly decreased, in both group at different time points. Compared with group B, the VAS was significantly decreased, at 1 months, 3 months, and 6 months in group A (P<0.05).The total efficacy rate was significantly lower in group B than in group A at 1 months, 3 months(P<0.05).Similarly, the tactile sensation was also significantly decreased at post-treatment when compared to pre-treatment (P<0.05).However, there were no statistical differences between two groups. Regression analysis showed the history of diabetes mellitus and course of diseases had significant negative effects on the treatment results.Conclusion: The administration of PRF + ozone and ozone therapy alone both improved pain?symptoms. Moreover, treatment effects and total efficacy rates tended to be higher for the combination?of PRF and ozone compared with ozone?monotherapy.