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。
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,clini⁃cal efficacy,and occurrence of complications were compared between the two groups.Results After one week of treat⁃ment,the levels of serum interleukin(IL)⁃1β,IL⁃6,and tumor necrosis factor⁃α(TNF⁃α)of patients were significantly lower 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.
作者
姜一春
毛东方
JIANG Yichun;MAO Dongfang(Department of Dermatology,Nanyang Central Hospital,Nanyang,Henan 473000,China)
出处
《中国烧伤创疡杂志》
2023年第3期248-252,共5页
The Chinese Journal of Burns Wounds & Surface Ulcers
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
Short⁃term spinal cord stimulation
Dorsal root ganglion pulsed radiofrequency
Herpes zoster
Neuralgia
Sleep quality
