背根神经节低温等离子消融术联合药物治疗带状疱疹后神经痛的研究

    Effect of the low-temprature plasma ablation of dorsal root ganglion combined with drug in the treatment of postherpetic neuralgia

    • 摘要:
      目的研究背根神经节(dorsal root ganglion,DRG)低温等离子消融术联合药物治疗带状疱疹后神经痛(postherpetic neuralgia,PHN)的有效性及安全性。
      方法60例PHN病人随机分为口服药物治疗组(A组)、口服药物联合椎旁神经阻滞治疗组(B组)、口服药物联合DRG低温等离子消融术治疗组(C组),每组20例。于治疗前、治疗后1、8、12、24周以简化McGill疼痛问卷(short-form McGill pain questionnaire,SF-MPQ)评估病人疼痛程度,记录并发症发生情况。
      结果治疗前,3组病人的SF-MPQ中的疼痛分级指数(pain rating index,PRI)、视觉模拟评分(visual analogous scale,VAS)及现时疼痛强度(present pain intensity,PPI)评分比较差异均无统计学意义(P>0.05)。组间比较显示,治疗后1周、8周、12周及24周,B组和C组病人VAS、PRI、PPI评分均显著低于A组(P < 0.05~P < 0.01),治疗后24周,B组与C组病人VAS、PRI、PPI评分差异无统计学意义(P>0.05);各组组内比较显示,治疗后各时间点VAS、PRI、PPI评分显著低于治疗前(P < 0.05~P < 0.01)。治疗后B、C组病人均无明显不良反应,部分病人在口服普瑞巴林后出现程度不等的头晕、嗜睡,均可耐受,且随着治疗的进行均明显减轻或消失。
      结论DRG低温等离子消融术联合药物治疗PHN安全有效。

       

      Abstract:
      ObjectiveTo study the efficacy and safety of low-temperature plasma ablation of dorsal root ganglion (DRG) combined with drug in the treatment of postherpetic neuralgia (PHN).
      MethodsSixty patients with PHN were randomly divided into the oral medicine group (group A), oral medicine combined with paravertebral nerve block group (group B), and oral medicine combined with low-temperature plasma ablation of dorsal root ganglion (group C) (20 cases each group).The pain degrees of patients before treatment and after 1 week, 8 weeks, 12 weeks and 24 weeks of treatment were investigated using short-form McGill pain questionnaire (SF-MPQ), and the occurrence of complications was recorded.
      ResultsBefore treatment, the differences of the PRI, VAS and PPI scores of SF-MPQ among three groups were not staistically significant (P>0.05).After 1, 8 and 12 weeks of treatment, the PRI, VAS and PPI scores in group B and group C were significantly lower than those in group A (P < 0.05 to P < 0.01).After treatment, the differences of the PRI, VAS and PPI scores of SF-MPQ between group B and group C were not statistically significant (P>0.05).Compared with before treatment, the PRI, VAS and PPI scores in three groups were significantly decreased after treatment (P < 0.05 to P < 0.01).After treatment, no obvious adverse reaction was found in group B and group C.The varying degrees of dizziness and lethargy in group B and group C were found, the patients could tolerate, and the symptoms significantly alleviated or disappeared after treatment.
      ConclusionsThe low-temperature plasma ablation of dorsal root ganglion combined with drug in treating PHN is safe and effective.

       

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