目的:单一的治疗方法并不总是成功的治疗带状疱疹神经痛,不同治疗方法的适当组合值得进一步探索。在这项研究中,我们研究了在超声和C臂双重引导下,高压长持续时间脉冲射频(PRF)联合星状神经节阻滞(SGB)在胸和背侧带状疱疹神经痛急性期的临床疗效。
方法:79例急性带状疱疹神经痛患者根据不同的治疗方法进行分组:标准电压PRF(S组,温度,持续时间,脉冲宽度,频率和电压设置为42°C,300s,20ms,2Hz,和45V),高压长持续时间PRF(H组,PRF的参数设置为42°C,900s,20ms,2Hz,90V,分别),和高压长持续时间PRF结合SGB(C组,PRF的参数设置与H组的参数设置相同)。使用数字评定量表(NRS)评估治疗结果,匹兹堡睡眠质量指数(PSQI)汉密尔顿焦虑量表(HAMA)。已记录了治疗后临床上显着的带状疱疹后神经痛的发生率。
结果:与基线相比,NRS的分数,PSQI,和HAMA在治疗后每个时间点在所有组下降,C组比S组下降更显著。在治疗的后期,C组普瑞巴林和曲马多的消耗量以及血浆白细胞介素-6和半乳糖凝集素-3的水平明显低于S组。C组PHN发生率明显低于S组。
结论:在超声和C臂的双重引导下,高压长持续时间PRF与SGB的组合代表了一种安全的,有效,环保,和成本有效的处理AZN的方法,显著改善睡眠质量,缓解焦虑,降低PHN发生的风险。
OBJECTIVE: A single therapeutic approach is not always successful in the treatment of herpes zoster neuralgia, and the appropriate combination of different treatments deserves further exploration. In this study, we investigated the clinical efficacy of high-voltage long-duration pulsed radiofrequency (PRF) combined with stellate ganglion block (SGB) in the acute phase of thoracic and dorsal herpes zoster neuralgia under dual guidance of ultrasound and C-arm.
METHODS: 79 cases of acute zoster neuralgia were grouped premised upon differing therapeutic approaches: standard voltage PRF (group S, the temperature, duration, pulse width, frequency and voltage were set to 42 °C, 300 s, 20 ms, 2 Hz, and 45 V), high-voltage long-duration PRF (group H, parameters of PRF were set to 42 °C, 900 s, 20 ms, 2 Hz, and 90 V, respectively), and high-voltage long-duration PRF combined with SGB (group C, parameter settings for PRF are the same as those for group H). The therapeutic outcomes were assessed utilizing the numeric rating scale (NRS), Pittsburgh sleep quality index (PSQI), and Hamilton anxiety rating scale (HAMA). The incidence of clinically significant postherpetic neuralgia post-treatment had been documented.
RESULTS: Compared to baseline, scores of NRS, PSQI, and HAMA at each time point post-treatment decreased across all groups, and the decrease was more significant in the C group than in the S group. At the later stage of treatment, the consumption of pregabalin and tramadol and the plasma levels of interleukin-6 and galectin-3 in the C group were significantly lower than those in the S group. The incidence of PHN in the C group was significantly lower than in the S group.
CONCLUSIONS: The combination of high-voltage long-duration PRF combined with SGB under dual guidance of ultrasound and C-arm represents a safe, effective, environmentally friendly, and cost-efficient method for treating AZN, significantly improving sleep quality, alleviating anxiety, and reducing the risk of PHN occurrence.