摘要
目的比较脊髓电刺激和神经阻滞以及二者联合治疗带状疱疹后遗神经痛的疗效及安全性。方法以2017年1月至2020年1月在中山市人民医院接受带状疱后遗疹神经痛治疗的221例患者为研究对象,通过查阅患者病史,收集其基本信息,并根据患者接受的不同治疗方法将其分为脊髓电刺激治疗组(79例)、神经阻滞治疗组(85例)、脊髓电刺激和神经阻滞联合治疗组(简称联合治疗组,57例)。每组再根据年龄是否超过65岁,细分为低年龄亚组和高年龄亚组。电话随访患者,记录患者术后12周的疼痛视觉模拟评分(visual analogue scale,VAS)、匹兹堡睡眠质量评分(Pittsburgh sleep quality index,PSQI)、不良反应发生情况、并发症发生情况。结果与治疗前比较,经3种方法治疗后,患者第1、3、6以及12周的VAS评分和PSQI评分均显著性降低(P<0.05);且低年龄组降低的程度显著大于高年龄组(P<0.05)。在3种方法治疗期间,患者均出现轻微且相似的不良症状。结论脊髓电刺激、神经阻滞及联合治疗均对带状疱疹后遗神经痛有良好的缓解作用,联合治疗能快速地缓解患者的疼痛,有效地改善患者的睡眠质量,并且具有较高的安全系数。因此,从远期效果来看,联合治疗对带状疱疹后遗神经痛具有良好的应用前景。
Objective To compare the efficacy and safety of spinal cord electrical stimulation and nerve block and combined therapy in treatment of patients with postherpetic neuralgia.Methods 221 patients who received herpes zoster neuralgia treatment in Zhongshan People’s Hospital from January 2017 to January 2020 were recruited as study subjects.By referring to the basic information of the patients and the disease records,and by depending on different treatment methods,the patients were divided into the spinal cord electrical stimulation treatment group(n=79),the nerve block treatment group(n=85)and the spinal cord electrical stimulation combined with nerve block group(or simply the combination group)(n=57).Then,they were subdivided into the lower grade subgroups and higher grade subgroups,depending on whether their age was over 65.All the patients had medical follow-ups by telephone.The scores of visual analogue scale(VAS),scores of Pittsburgh sleep quality index(PSQI),rate of adverse reactions and complications were recorded 12 weeks after operation.Results After treatment with 3 methods,the VAS and PSQI scores of the patients all decreased significantly at week 1,week 3,week 6 and week 12,when they were compared with those before treatment(P<0.05),with the extent of decrease in the low age group being significantly higher than that in the high age group(P<0.05).There were only mild and similar adverse reactions during therapy with 3 methods.Conclusion Spinal cord electrical stimulation,nerve block and combined therapy all have good relief effects on herpes zoster neuralgia.Combined therapy could not only quickly relieve patient pain,but also effectively improve sleep quality,and with good safety as well.Therefore,from the standpoint of long-term effect,the combined therapy has a good promise for the treatment of postherpetic neuralgia.
作者
解小丽
苏圣贤
林志光
杨源锋
Xie Xiaoli;Su Shengxian;Lin Zhiguang;Yang Yuanfeng(Department of Pain Medicine,Zhongshan People’s Hospital,Guangdong Province,Zhongshan 528403,China)
出处
《海军医学杂志》
2022年第5期499-504,共6页
Journal of Navy Medicine
基金
广东省中山市科技计划项目(2021B1037)。
关键词
脊髓电刺激
神经阻滞
带状疱疹后遗神经痛
疗效
Spinal cord electrical stimulation
Nerve block
Neuralgia after herpes zoster
Curative effect
