脉冲射频治疗激惹型与混合型带状疱疹后神经痛的疗效

Efficacy of pulsed radiofrequency in the treatment of provoked versus mixed post-herpetic neuralgia

摘要:

目的：探讨脉冲射频治疗激惹型与混合型带状疱疹后神经痛的疗效。方法：纳入2020年1月至2023年3月就诊于西南医科大学附属医院疼痛科的带状疱疹后神经痛患者190例为研究对象，根据纳入和排除标准共纳入90例，基于倾向性评分匹配分混合型组（混合组30例）与激惹型组（激惹组30例）。采用超声引导下外周神经脉冲射频。比较两组术后1周及术后1、3、6个月时的NRS评分与PSQI评分，并对术后6个月时疗效进行评价。结果：与术前比较，两组患者NRS、PSQI评分在术后各时点降低（P均<0.05）。与混合组比较，激惹组术后3个月时NRS评分较低（P<0.05）；术后1周、术后1、6个月两组NRS评分差异无统计学意义。术后各时点PSQI评分均较低（P均<0.05）。术后6个月时，两组疗效比较，差异无统计学意义（P>0.05）；混合组与激惹组优良率相比为76.67%：43.44%，差异有统计学意义。结论：脉冲射频能有效缓解带状疱疹后神经痛患者疼痛，在混合组与激惹组中，中远期疗效无差异，但混合组优良率更高。

Abstract:

Objective:To investigate the efficacy of pulsed radiofrequency in the treatment of provoked versus mixed postherpetic neuralgia, with the aim of informing therapeutic choices. Methods: A total of 190 patients with postherpetic neuralgia who attended the pain department of the Affiliated Hospital of Southwest Medical University from January 2020 to March 2023 were included in the study. A total of 90 cases were enrolled according to the inclusion and exclusion criteria, and they were divided into a mixed group (30 cases in the mixed group) and an agitated group (30 cases in the agitated group) based on the propensity score matching. Ultrasound-guided pulsed radiofrequency of peripheral nerves was used. The NRS scores and PSQI scores were compared between the two groups at 1 week postoperatively and at 1, 3, and 6 months postoperatively, and the efficacy was evaluated at 6 months postoperatively. Results: Compared with the preoperative period, NRS and PSQI scores were lower in both groups at all postoperative time points (both P<0.05). Compared with the mixed group, NRS scores were lower in the provoked group at 3 months postoperatively (P<0.05); the differences in NRS scores between the two groups were not statistically significant at 1 week postoperatively, 1 and 6 months postoperatively. PSQI scores were lower at all postoperative time points (all P<0.05). At 6 months postoperatively, there was no statistically significant difference between the efficacy of the two groups (P>0.05); the excellent rate of the mixed group versus the provoked group was 76.67% versus 43.44%, and the difference was statistically significant (P<0.05). Conclusion: Pulsed radiofrequency is effective in relieving pain in patients with postherpetic neuralgia, and there was no difference in mid- and long-term efficacy between the mixed and provoked groups, but the mixed group had a higher rate of excellence.