脊神经节脉冲射频对PHN发生率的随机对照临床研究*

A multicenter Randomized Controlled Clinical Study of Dorsal Root Ganglion Pulsed Radiofrequency for the Prevention of PHN

摘要:

目的:应用脊神经节脉冲射频(Dorsal root ganglion - pulsed radiofrequency,DRG-PRF)结合规范药物治疗急性带状疱疹神经痛(Acute herpetic neuralgia, AHN),探讨其对带状疱疹后神经痛(Postherpetic neuralgia ,PHN)的预防作用。方法:采用随机对照试验方法,将214例AHN患者随机分为药物加DRG-PRF治疗组(A组)和药物治疗组(B组),并观察两组患者带状疱疹后神经痛(Postherpetic neuralgia , PHN)发生率,以及治疗前(T0)、治疗后 1周(T1)、治疗后1个月(T2)、治疗后3个月(T3)的疼痛数字评分法(Numerical rating scale,NRS)评分、匹兹堡睡眠质量指数(Pittsburgh sleep quality index, PSQI)评分及两组患者治疗不良事件发生情况。结果:A组的PHN发生率为11%,明显低于B组的48%(P＜0.05)。两组治疗后的NRS评分、PSQI评分均显著低于治疗前(P＜0.05),A组的疼痛减轻程度和睡眠治疗改善程度优于B组(P＜0.05)。两组均无不良事件发生。结论:药物加DRG-PRF相较单纯药物治疗AHN的PHN发生率显著下降,安全性高,可有效预防PHN的发生。

Abstract:

Objective: To investigate the preventive effect of applying Dorsal Root Ganglion-Pulsed Radiofrequency (DRG-PRF) combined with standardized drug therapy on Postherpetic Neuralgia (PHN) in patients with Acute Herpetic Neuralgia (AHN). Methods: Using a multicenter randomized controlled trial approach, 200 AHN patients were randomly divided into a group receiving drug therapy combined with DRG-PRF treatment (Group A) and a group receiving drug therapy only (Group B). The incidence rateof PHN in both groups was observed, along with pain scores using the Numerical Rating Scale (NRS) and Pittsburgh Sleep Quality Index (PSQI) scores at baseline (T0), 1 week post-treatment (T1), 1 month post-treatment (T2), and 3 months post-treatment (T3), as well as the incidence of adverse events related to both treatments. Results: The incidence rate of PHN in Group A was 11%, significantly lower than the 48% in Group B (P < 0.05). NRS and PSQI scores in both groups post-treatment were significantly lower than at baseline (P < 0.05). Group A exhibited greater pain relief and sleep improvement than Group B (P < 0.05). No adverse events were reported in either group. Conclusion: The combination of DRG-PRF and drug therapy significantly reduces the incidence of PHN compared to drug therapy alone for AHN, with a high level of safety. This approach effectively prevents the occurrence of PHN.