摘要
目的探究CT引导下脉冲射频(PRF)联合神经阻滞治疗头面部带状疱疹后神经痛(PHN)的疗效及可能机制。方法选择2021年2月—2023年8月连云港市第一人民医院收治的头面部PHN患者104例,采用随机数表法将其分为研究组(52例)与对照组(52例)。对照组给予神经阻滞治疗,研究组行CT引导下PRF联合神经阻滞治疗。治疗1个月后评价疗效及安全性,对比2组治疗前后疼痛视觉模拟评分(VAS)、匹兹堡睡眠质量指数(PSQI)、汉密尔顿焦虑/抑郁量表(HAMA/HAMD)评分,且治疗前后采血测定疼痛递质[β-内啡肽(β-EP)、P物质(SP)、降钙素基因相关肽(CGRP)、神经肽Y(NPY)]与炎症指标[白细胞介素(IL)-6、IL-26、CC趋化因子受体2(CCR2)]。结果治疗后,研究组总有效率高于对照组[90.38%(47/52)vs.73.08%(38/52),P<0.05)];研究组VAS评分为(2.21±0.64)分,低于对照组的(3.37±1.00)分(F=802.273,P<0.001),研究组PSQI、HAMA及HAMD评分、血清疼痛递质及炎症指标水平均低于对照组(P<0.05);2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论CT引导下PRF联合神经阻滞治疗头面部PHN安全有效,能减轻患者疼痛,其机制可能与抑制疼痛介质、降低血清IL-6、IL-26、CCR2水平有关。
Objective To investigate the efficacy and possible mechanism of CT-guided pulse radiofrequency(PRF)combined with nerve block in the treatment of post-herpetic neuralgia(PHN)of the head and face.Methods A total of 104 patients with head and face PHN admitted to the First People' s Hospital of Lianyungang from February 2021 to Au-gust 2023 were randomly divided into the study group(52 cases)and the control group(52 cases)using the random number table method.The control group underwent a nerve block procedure.The study group received CT-guided PRF combined nerve block treatment.Efficacy and safety were evaluated after 1 month of treatment,and changes in VAS,Pittsburgh sleep quality index(PSQI),Hamilton anxiety/depression scale(HAMA/HAMD)scores were compared be-tween the two groups before and after treatment.Pain transmitters[β-endorphin(β-EP),substance P(SP),calcitonin gene-related peptide(CGRP),neuropeptide Y(NPY)]and inflammatory markers[interleukin-6,IL-26,CC chemo-kine receptor 2(CCR2)]were measured in blood samples before and after treatment.Results Following treatment,the total effective rate in the study group was significantly higher[90.38%(47/52)vs.73.08%(38/52),P<0.05];Ad-ditionally,the VAS score in the study group was(2.21±0.64)points,which was lower than that in the control group[(3.37±1.00)points,F=802.273,P<0.001].The PSQI,HAMA,HAMD scores,as well as serum pain transmitters and inflammatory marker levels,were significantly lower in the study group(P<0.05).Conversely,there was no statisti-cally significant difference in the incidence of adverse reactions(P>0.05).Conclusion CT-guided PRF combined with nerve block in the treatment of PHN of the head and face is safe and effective and can reduce pain in patients.The mech-anism may be related to inhibition of pain mediators and reduction of serum levels of IL-6,IL-26 and CCR2.
作者
陆磊磊
耿祝生
LU Leiei;GENG Zhusheng(Department of Pain,the First People's Hospital of Lianyungang/The Affiliated Lianyungang Hospital of Xuzhou Medical University Lianyungang City,Lianyungang,Jiangsu 222000,China)
出处
《中华全科医学》
2024年第10期1696-1699,共4页
Chinese Journal of General Practice
基金
2021年江苏省卫健委科研项目(M2020105)。
