实用老年医学

实用老年医学 ›› 2022, Vol. 36 ›› Issue (3): 261-264.doi: 10.3969/j.issn.1003-9198.2022.03.012

• 临床研究 • 上一篇    下一篇

脉冲射频胸背根神经节联合药物治疗老年重度带状疱疹后神经痛病人的镇痛效果及机制研究

王钦, 宋建民, 李妍, 刘绍正, 王先锋, 刘东华   

  1. 234000 安徽省宿州市,皖北煤电集团总医院疼痛科(王钦,宋建民,李妍);麻醉科(刘绍正,王先锋);
    430000 湖北省武汉市,武汉市第三医院疼痛科(刘东华)
  • 收稿日期:2021-04-14 出版日期:2022-03-20 发布日期:2022-03-29
  • 通讯作者: 王先锋,Email:wangxiaoyinycys@sohu.com
  • 基金资助:
    湖北省卫生健康委科研项目(WJ2019M019)

Study on analgesic effect and mechanism of pulsed radiofrequency thoracic dorsal root ganglion combined with drugs in the treatment of postherpetic neuralgia in elderly patients

WANG Qin, SONG Jian-min, LI Yan, LIU Shao-zheng, WANG Xian-feng, LIU Dong-hua   

  1. WANG Qin, SONG Jian-min, LI Yan. Department of Pain; LIU Shao-zheng, WANG Xian-feng. Department of Anesthesiology, Wanbei Coal Power Group General Hospital, Suzhou 234000, China;
    LIU Dong-hua. Department of Pain, Wuhan Third Hospital, Wuhan 430000, China
  • Received:2021-04-14 Online:2022-03-20 Published:2022-03-29

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摘要： 目的 探讨脉冲射频胸背根神经节联合药物治疗老年重度带状疱疹后神经痛(PHN)病人的镇痛效果及细胞因子的变化。 方法 选取我院收治的88例PHN病人作为研究对象,采用随机数表分为联合组和对照组,各44例,对照组采用口服普瑞巴林及常规药物治疗,联合组在对照组基础上同时给予脉冲射频胸背根神经节治疗。 结果 联合组治疗后1、4、8、12周时VAS评分均低于对照组,差异具有统计学意义(P<0.05);联合组在治疗4、12周时,生活满意度指数B表(LSI-B)评分高于对照组(P<0.05);治疗后2组病人血清IL-10、P物质(SP)、神经肽-1(NK-1)水平均较治疗前降低(P<0.05),联合组显著低于对照组(P<0.05);治疗后2组不良反应发生率比较,差异没有统计学意义(P>0.05)。 结论 脉冲射频胸背根神经节联合药物治疗老年PHN病人的效果优于单纯药物治疗,可能与调节病人的免疫失衡状态有关。

关键词: 脉冲射频, 胸背根神经节, 带状疱疹后神经痛, 普瑞巴林, 老年人

Abstract: Objective To explore the effect of pulsed radiofrequency thoracic dorsal root ganglion combined with drugs in the treatment of elderly patients with severe postherpetic neuralgia (PHN), and to analyze the changes of cytokines. Methods A total of 88 elderly patients with PHN admitted to our hospital were enrolled and randomly divided into the control group and the combined group, with 44 cases in each group. The control group was treated with oral pregabalin and conventional drugs, and the combination group was treated with pulsed radiofrequency thoracic dorsal root ganglion at the same time on the basis of the control group. Results The score of visual analogue scale(VAS) in the combined group was lower than that in the control group 1, 4, 8, 12 weeks after treatment (P<0.05); The score of life satisfaction index B(LSI-B) in the combined group was higher than that in the control group 4, 12 weeks after treatment (P<0.05). After treatment, the serum level of IL-10 in the two groups was significantly lower than that before treatment (P<0.05), especially in the combined group (P<0.05). After treatment, the serum levels of substance P(SP) and neurokinin 1(NK-1) were significantly lower than those before treatment (P<0.05), especially in the combined group (P<0.05). The adverse reaction rate showed no significant difference between the combined group and the control group (P>0.05). Conclusions The effect of pulsed radiofrequency thoracic dorsal root ganglion combined with drugs in the treatment of PHN in the elderly patients is better than that of drug treatment alone, which may be related to the regulation of the patients’ immune imbalance.

Key words: pulsed radiofrequency, thoracic dorsal root ganglion, postherpetic neuralgia, pregabalin, aged

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