短时程眶上神经电刺激治疗额部带状疱疹性神经痛的临床研究

A clinical study of short-term supraorbital nerve stimulation in treating herpetic neuralgia in forehead

摘要:

目的： 比较短时程眶上神经电刺激和眶上神经脉冲射频治疗亚急性期额部带状疱疹性神经痛的临床疗效。 方法： 纳入2020年1月至2023年12月额部亚急性期带状疱疹性神经痛患者40例,按治疗方式随机分为眶上电刺激(A组)20例和脉冲射频组(B组)20例,搜集两组患者治疗前、治疗后1、15、30、90、180天视觉模拟评分 (VAS)、匹兹堡睡眠质量指数(PSQI)、普瑞巴林及曲马多缓释片使用剂量及术后不良反应等相关指标。 结果： A组VAS评分在术后第1、15、30天较B组有明显降低(P <0.05),A组患者PSQI评分在术后第1、15、30、90天较B组有明显降低(P <0.05)。A组在术后90、180天普瑞巴林使用剂量较B组明显降低(P <0.05)。A组在术后15、30天曲马多缓释片使用剂量较B组明显降低(P <0.05)。两组患者治疗期间均未发生严重不良反应及并发症。 结论：短时程眶上神经电刺激和眶上神经脉冲射频均可有效缓解额部亚急性期带状疱疹性神经痛,且短时程眶上电刺激疗效更优。

Abstract:

Objective To evaluate the clinical efficacy of short-term supraorbital nerve electrical stimulation and supraorbital nerve pulsed radiofrequency in the treatment of subacute herpetic neuralgia in the forehead. Methods From January 2020 to December 2023, 40 PHN patients in V1 distribution area of trigeminal nerve were selected from the Department of pain medicine, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School. One group was treated with supraorbital nerve electrical stimulation (group A, 20) and the other group was treated with supraorbital nerve pulsed radiofrequency (group B, 20). The visual analog score (VAS), Pittsburgh sleep quality index (PSQI), pregabalin and opioid dosage were recorded before and 1, 15, 30, 90, 180 days after the operation, and the postoperative adverse reactions and complications were also observed. Results The VAS score of group A was significantly lower than that of group B at 1, 15 and 30 days after the operation (P < 0.05). The PSQI score of group A was significantly lower than that of group B at 1, 15, 30 and 90 days after operation (P < 0.05). The dosage of pregabalin in group A was significantly lower than that in group B at 90 and 180 days after operation (P < 0.05). The dosage of tramadol in group A was significantly lower than that in group B at 15, 30 days after operation (P < 0.05) . There were no adverse reactions and complications in both groups during treatment. Conclusion Both pulsed radiofrequency and peripheral nerve electrical stimulation can effectively alleviate subacute herpetic neuralgia in the forehead and improve patients" sleep quality,and The peripheral nerve electrical stimulation showed it better than pulsed radiofrequency in subacute herpetic neuralgia in the forehead.