• 短时程 SCS 与背根神经节 PRF 治疗带状疱疹后遗神经痛疗效对比
  • Comparison of the Therapeutic Effect of Short-term Spinal Cord Stimulation and Dorsal Root Ganglion Pulsed Radiofrequency in the Treatment of Postherpetic Neuralgia
  • 姜一春,毛东方.短时程 SCS 与背根神经节 PRF 治疗带状疱疹后遗神经痛疗效对比[J].中国烧伤创疡杂志,2023,(3):248~252.
    DOI:
    中文关键词:  短时程脊髓电刺激  背根神经节脉冲射频  带状疱疹  神经痛  睡眠质量
    英文关键词:Short-term spinal cord stimulation  Dorsal root ganglion pulsed radiofrequency  Herpes zoster  Neuralgia  Sleep quality
    基金项目:
    作者单位
    姜一春 473000 河南 南阳南阳市中心医院皮肤科 
    毛东方  
    摘要点击次数: 1549
    全文下载次数: 4188
    中文摘要:
          【摘要】目的 对比分析短时程脊髓电刺激(SCS)与背根神经节脉冲射频(PRF)治疗带状疱疹后遗神经痛(PHN)的临床效果。方法 选取2019年3月至2021年3月南阳市中心医院收治的135例PHN患者作为研究对象,按照随机数表法将其随机分为SCS组(67例)和PRF组(68例),SCS组患者行短时程SCS治疗,PRF组患者行背根神经节PRF治疗,对比观察两组患者血清炎症因子水平、疼痛程度、睡眠质量以及临床疗效与并发症发生情况。结果 治疗后1周,SCS组患者血清白细胞介素(IL)-1β、IL-6及肿瘤坏死因子-α(TNF-α)水平均明显低于PRF组(t=12.192、5.338、7.018,P均<0.001),IL-10水平明显高于PRF组(t=2.623,P=0.010);治疗后1周、1个月、3个月,SCS组患者视觉模拟评分法(VAS)评分均明显低于PRF组(t=9.209、9.677、13.268,P均<0.001);治疗后3个月,SCS组患者匹兹堡睡眠质量指数(PSQI)评分明显低于PRF组(t=2.105,P=0.037);治疗后3个月,SCS组患者中显效61例、好转5例、无效1例,明显优于PRF组患者的显效54例、好转6例、无效8例(Z=-2.010,P=0.044);治疗期间,两组患者均未发生出血或穿刺部位感染等并发症。结论 与背根神经节PRF相比,短时程SCS治疗PHN,可明显降低患者机体炎症反应及疼痛程度,改善患者睡眠质量,疗效显著。
    英文摘要:
          【Abstract】 Objective To analyze and compare the therapeutic effects of short-term spinal cord stimulation (SCS) and dorsal root ganglion pulsed radiofrequency (PRF) in the treatment of postherpetic neuralgia (PHN). Methods 135 PHN patients, admitted to Nanyang Central Hospital from March 2019 to March 2021, were enrolled as research subjects,and then divided, using the random number table, into SCS group (n=67) treated with short-term SCS, and PRF group(n=68) treated with dorsal root ganglion PRF. The levels of serum inflammatory factors, pain degree, sleep quality, clinical efficacy, and occurrence of complications were compared between the two groups. Results After one week of treatment, the levels of serum interleukin (IL) -1β,IL-6,and tumor necrosis factor-α(TNF-α) of patients were significantlylower in the SCS group compared with the PRF group (t= 12.192, 5.338 and 7.018, all P<0.001), and the level of IL-10 was markedly higher in the SCS group (t = 2.623, P = 0.010). Respectively after 1 week, 1 month, and 3 months of treatment, the visual analogue scale (VAS) scores of patients in the SCS group were all significantly lower than that in the PRF group (t = 9.209, 9.677 and 13.268, all P<0.001). After 3 months of treatment, the Pittsburgh sleep quality index (PSQI) score of patients was significantly lower in the SCS group compared with the PRF group (t= 2.105, P=0.037),the clinical efficacy was evaluated as markedly effective in 61 cases, turned better in 5 cases and ineffective in 1 case in the SCS group, which was obviously better than that in PRF group - markedly effective in 54 cases, turned better in 6 cases and ineffective in 8 cases (Z=- 2.010, P =0.044). During the course of treatment, no complication such as bleeding or puncture infection occurred in either group. Conclusion Compared with the dorsal root ganglion PRF, the short-term SCS in the treatment PHN can significantly reduce patients’ systemic inflammatory responses and pain intensity, improve their sleep quality, and realize definite therapeutic effect.