短时程脊髓电刺激与双极脉冲射频治疗带状疱疹后神经痛临床疗效比较

Clinical study of spinal cord electrical stimulation and bipolar pulse radiofrequency therapy for postherpetic neuralgia

摘要:

目的：比较短时程脊髓电刺激（short-term spinal cord stimulation, stSCS）和双极脉冲射频（bipolar pulse radiofrequency, bPRF）治疗带状疱疹后神经痛(postherpetic neuralgia, PHN)临床疗效。方法：选取2021年9月至2022年12月福建医科大学附属第一医院收治的PHN患者108例为研究对象，按手术方式分为stSCS组（40例）和bPRF组（68例）。采用视觉模拟评分法（visual analogue scale, VAS）、匹兹堡睡眠质量指数（pittsburgh sleep quality index, PSQI）、焦虑自评量表（self-rating anxiety scale, SAS）和抑郁自评量表（self-rating depression scale, SDS）等指标评估临床疗效。结果：两组患者术后各时间点VAS、PSQI、SAS和SDS评分较术前（T0）显著降低（P < 0.05）。术后除第1天（T1）、第7天（T2）、第14天（T3）、第28天（T4）、第2个月（T5）、第3个月（T6）外，第6个月（T7）、第9个月（T8）、第12个月（T9）时stSCS组VAS评分更明显低于bPRF组（P < 0.05）；术后除T1 ~ T7外，T8、T9时stSCS组患者PSQI、SAS和SDS评分更明显低于bPRF组（P < 0.05）。结论：stSCS组和bPRF组在近期疗效上相当，均可安全有效地治疗PHN。然而，在远期疗效上，stSCS组显示出更明显的优势。

Abstract:

Objective: To compare the clinical efficacy of short-term spinal cord stimulation and bipolar pressure regulation pulse radiofrequency in the treatment of postherpetic neuralgia. Methods: A total of 108 patients with PHN admitted to the First Affiliated Hospital of Fujian Medical University from September 2021 to December 2022 were selected as the study objects, and they were divided into stSCS group (40 cases) and bPRF group (68 cases) according to operation methods. Visual analogue scale, pittsburgh sleep quality index, self-rating anxiety scale and self-rating depression scale were used to evaluate clinical efficacy. Results: The scores of VAS, PSQI, SAS and SDS in both groups were significantly lower than those before surgery (T0) at all time points (P < 0.05). VAS score of stSCS group was significantly lower than that of bPRF group at 6 months (T7), 9 months (T8) and 12 months (T9) except day 1 (T1), day 7 (T2), day 14 (T3), day 28 (T4), month 2 (T5) and month 3 (T6) after surgery (P < 0.05). The PSQI, SAS and SDS scores in stSCS group were significantly lower than those in bPRF group at T8 and T9 after surgery except for T1 ~ T7 (P < 0.05). Conclusion：stSCS group and bPRF group have similar short-term efficacy, and both can treat PHN safely and effectively. However, in terms of long-term efficacy, the stSCS group showed a more obvious advantage.