Objective To evaluate the efficacy of high-voltage pulsed radiofrequency at the dorsal root ganglion combined with continuous epidural block on acute herpetic zoster pain and preventing postherpetic neuralgia in patients with acute phase of herpes zoster.Methods Fifty-seven patients with herpes zoster,from March 2016 to February 2018 in Second Affiliated Hospital of Xiamen Medical College and Fujian Provincial Hospital,were divided into two groups randomly:continuous epidural block group (29 cases) and combination treatment group (28 cases).Patients were received continuous epidural block combined drug therapy including tramadol,pregabalin and antiviral agents in the continuous epidural block group.While patients were received pulsed radiofrequency at the dorsal root ganglion additional to the combination treatment group.Numerical rating scale (NRS) was observed before the treatment and at 1 week,1,3 and 6 months after the treatment.The rate of patients received tramadol and pregabalin,the incidence of PHN were recorded at 1 week,1 month,3 months and 6 months after the treatment.Results Compared with pretreatment,NRS was significantly decreased in the two groups at each time point after the treatment (P＜0.05).NRS was even significantly lower in the combination treatment group than that in the continuous epidural block group at 6 months after the treatment (P＜0.05).Compared with the continuous epidural block group,the incidence of PHN was significantly decreased at 1,3 months in the combination treatment group [7％ (2/28 cases) vs.31％ (9/29 cases),0 vs.14％(4/29 cases)](P＜0.05).Compared with the continuous epidural block group,the usage rate of pregabalin was significantly decreased at 1 week in the combination group (P＜0.05).Conclusion High-voltage pulse radiofrequency at the dorsal root ganglion combined with continuous epidural block can effectively relieve the acute herpetic zoster pain and decrease the incidence of PHN in patients with acute herpes zoster.%目的 评价背根神经节高电压脉冲射频联合连续硬膜外阻滞治疗带状疱疹急性期疼痛及预防带状疱疹后神经痛的疗效.方法 纳入厦门医学院附属第二医院及福建省立医院2016年3月至2018年2月收治的出疱疹1个月内的急性带状疱疹患者57例,性别不限,年龄62～82岁,按照随机数字表法随机分为连续硬膜外组(29例)和联合治疗组(28例).连续硬膜外组采用连续硬膜外阻滞联合口服镇痛、抗惊厥与抗病毒药物治疗;联合治疗组在连续硬膜外组的基础上给予1次相应节段的背根神经节高电压脉冲射频治疗.观察治疗前、治疗后1周及治疗后1、3及6个月时疼痛数字分级评分(NRS)、镇痛药及抗惊厥药的使用率和带状疱疹后神经痛的发生率.结果 与治疗前比较,两组患者治疗后NRS评分均降低,差异有统计学意义(P＜0.05);联合治疗组治疗后6个月时NRS评分低于连续硬膜外组,差异有统计学意义(P＜0.05);联合治疗组治疗后1、3个月时带状疱疹后神经痛的发生率低于连续硬膜外组[7％(2/28例)比31％(9/29例),0比14％(4/29例)](P＜0.05);与连续硬膜外组比较,联合治疗组治疗后1周内普瑞巴林的使用率明显较少,差异有统计学意义(P＜0.05).结论 背根神经节高电压脉冲射频联合连续硬膜外阻滞治疗急性期带状疱疹可减轻疼痛,并可降低疱疹后神经痛的发生率.
展开▼
