带状疱疹后遗神经痛(PHN)是带状疱疹感染最常见和最严重的并发症之一。脉冲射频(PRF)疗法已成为治疗PHN的神经调节技术。两种治疗方案可用于PRF,包括高压和标准电压PRF。一些研究表明,前者比后者具有更好的临床疗效。第一次,这项汇总分析比较了这两种手术治疗PHN的疗效和安全性.5个常用的数据库被用于确定符合条件的研究。本研究已在PROSPERO(ID:CRD42023460236)上注册,提供了更多相关信息。最后,纳入了4项随机对照试验(RCT),共285名参与者.综合比值比(OR)显示,高压PRF的治疗效率明显高于标准PRF(OR=1.4,95CI:1.16至1.69,P<0.001)。此外,1周时高电压PRF组视觉模拟评分(VAS)明显低于标准PRF组(SMD=-0.776,95CI:-1.408~-0.145,P=0.016),一个月(SMD=-0.544,95CI:-0.907至-0.180,P=0.003),治疗后3个月(SMD=-1.096,95CI:-1.504至-0.687,P<0.001),特别是在手术后的三个月。然而,两组间的VAS具有可比性(SMD=-0.94,95CI:-1.985~0.104,P=0.077).高电压PRF患者的不良事件发生率未显著高于标准PRF患者(OR=1.56,95CI:0.78~3.13,P=0.208)。总之,目前的研究显示,在改善PHN患者的镇痛效果方面,高电压PRF优于标准电压PRF.此外,它不会增加治疗相关不良反应的发生率.仍需要进一步的研究来确定PHN患者PRF治疗的最佳电压和持续时间。
Postherpetic neuralgia (PHN) is one of the most common and serious complications of herpes zoster infection. Pulsed radiofrequency (PRF) therapy has emerged to be a neuromodulation technique for the treatment of PHN. Two therapeutic options are available for PRF, including high-voltage and standard-voltage PRF. Some studies suggested that the former one had better clinical efficacy than the latter one. For the first time, this pooled analysis compared the efficacy and safety of these two surgeries for the treatment of PHN. Five commonly used databases were applied to identify the eligible studies. This study was registered on the PROSPERO (ID: CRD42023460236), which provided more relevant information. Finally, four randomized controlled trials (RCTs) with 285 participants were included. The combined odds ratios (OR) showed that high-voltage PRF exhibited a significantly higher treatment efficiency than the standard PRF (OR = 1.4, 95%CI: 1.16 to 1.69, P < 0.001). Additionally, the visual analogue scale (VAS) in the high-voltage PRF group was significantly lower than that of the standard PRF group at one week (SMD = -0.776, 95%CI: -1.408 to -0.145, P = 0.016), one month (SMD = -0.544, 95%CI: -0.907 to -0.180, P = 0.003), and three months (SMD = -1.096, 95%CI: -1.504 to -0.687, P < 0.001) after treatment, particularly at the three months after surgery. However, the VAS was comparable between the two groups (SMD = -0.94, 95%CI: -1.985 to 0.104, P = 0.077). Patients who underwent high-voltage PRF did not have a significantly higher incidence of adverse events than those with standard PRF (OR = 1.56, 95%CI: 0.78 to 3.13, P = 0.208). In summary, the current study revealed that high-voltage PRF is superior to standard-voltage PRF in improving analgesic efficacy in patients with PHN. Additionally, it does not increase the incidence of treatment-related adverse effects. Further studies are still warranted to determine the optimal voltage and duration of PRF treatment for patients with PHN.