背根神经节脉冲射频联合干扰素治疗带状疱疹后神经痛的疗效分析

Analysis of the efficacy of dorsal root ganglion pulsed radio frequency combined with interferon in the treatment of postherpetic neuralgia

摘要:

目的：观察背根神经节脉冲射频联合干扰素治疗带状疱疹后神经痛的临床效果。方法：选择2022年3月至2023年6月期间在山西医科大学第一医院疼痛科就诊的因颈、胸、腰段带状疱疹后神经痛入院接受治疗的78例患者，采用随机数字表法将研究对象随机分为联合治疗组（A组）和对照组（B组），每组39例。两组均在 CT引导下进行背根神经节脉冲射频治疗，A组在射频结束后沿穿刺针注射的药物配方中加用重组人干扰素α-2b（interferon α-2b, IFN α-2b)，B组除在药物配方中未加用IFN α-2b外，其余药物与A组相同。于治疗前及治疗后1、2、4、12周对患者进行视觉模拟评分法 (visual analogue scale, VAS)评分、匹兹堡睡眠质量指数(Pittsburgh sleep quality index, PSQI)评分，并在治疗后第12周进行疼痛缓解程度的评估；于治疗前及治疗后1、4周摄取病变部位皮肤的红外热成像图，并分析病变部位与正常部位皮肤的温度差。结果：与治疗前相比，两组病人在治疗后各时间点的VAS评分及PSQI评分均降低，且A组评分显著低于B组(P<0.05)；治疗后1、4周红外热成像图的患侧与健侧温差变小，且A组病人温差低于B组(P<0.05)；A组病人的疼痛缓解率高于B组(P<0.05)。两组病人均未出现严重不良反应。结论：背根神经节脉冲射频联合干扰素治疗带状疱疹后神经痛的疗效优于单纯背根神经节脉冲射频，且无严重不良反应。

Abstract:

Objective: To observe the clinical effect of dorsal root ganglion pulse radio frequency combined with interferon in the treatment of postherpetic neuralgia. Methods: A total of 78 patients with postherpetic neuralgia in our department from March 2022 to June 2023 were selected and divided into interferon group (group A) and control group (group B). The two groups were treated with dorsal root ganglion pulse radio frequency therapy under the guidance of CT. In group A, recombinant human interferon α-2b (IFN α-2b) was added to the drug formula injected along the puncture needle after radio frequency. In group B, the other drugs were the same as those in group A except that IFN α-2b was not added to the drug formula. Visual analogue scale (VAS) score and pittsburgh sleep quality index (PSQI) score were performed at 1, 2, 4 and 12 time points before treatment and after treatment. The degree of pain relief was evaluated at 12 weeks after treatment. Infrared thermal imaging of the skin of the lesion site was taken before treatment and 1 and 4 weeks after treatment, and the temperature difference between the lesion site and the normal skin site was analyzed. Results: Compared with before treatment, VAS score and PSQI score of both groups were decreased at each time point after treatment, and the score of group A was significantly lower than that of group B (P<0.05). At 1 and 4 weeks after treatment, the temperature difference between the affected side and the healthy side became smaller, and the temperature difference in group A was lower than that in group B (P<0.05). The pain relief rate of group A was higher than that of group B (P<0.05). None of the patients had serious adverse reactions. Conclusion: The efficacy of dorsal root ganglion pulse radio frequency combined with interferon in the treatment of postherpetic neuralgia is better than that of dorsal root ganglion pulse radio frequency alone, and there is no serious adverse reaction.