Huang Youqing, Luo Fang, He Xiaofeng
Department of Pain Management, The Second Affiliated Hospital of Kunming Medical University, Yunnan, People's Republic of China.
Department of Anesthesiology and Pain Management, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China.
Neurol India. 2018 Nov-Dec;66(6):1706-1710. doi: 10.4103/0028-3886.246245.
This study investigated the clinical effects of selective dorsal root ganglion pulsed radiofrequency lesioning in combination with oral administration of gabapentin in the treatment of postherpetic neuralgia (PHN).
One hundred and sixteen consecutive cases of initially diagnosed patients with PHN were randomly divided into the control and the observation groups, with each group consisting of 58 patients. The control group was treated with oral gabapentin (2400 mg/d, tid), while the observation group received gabapentin and pulsed radiofrequency lesioing of the dorsal root ganglion. The clinical efficacy of both the regimens was compared after a follow up period of 6 months.
The observation group had a significantly lower score on the visual analog scale than the control group (P ≤ 0.05, with no significant complications occurring in both the groups) at a 1, 2, and 4 week posttreatment duration. The percentage of cluster of differentiation (CD) 4+ cells and the CD4+/CD8+ ratio increased gradually, while the percentage of CD8 + cells decreased in the observation group (P ≤ 0.05). No significant alterations were observed in the control group (P > 0.05). The observation group had significantly lower serum interleukin-6, C-reactive protein, and tumor necrosis factor-α levels than the control group (P < 0.05) at 1, 2, and 4 weeks after the treatment was instituted. The observation group also demonstrated a superior total effective rate and efficiency than the control group (P ≤ 0.05).
Our study demonstrated that radiofrequency combined with gabapentin in the treatment of PHN has a good safety and efficacy profile. The effects of this treatment may be related to an increased T-cell immunity and an inhibited inflammatory response.
本研究探讨选择性背根神经节脉冲射频毁损联合口服加巴喷丁治疗带状疱疹后神经痛（PHN）的临床效果。
116例初诊的PHN患者连续入选，随机分为对照组和观察组，每组58例。对照组口服加巴喷丁（2400mg/d，每日3次），观察组接受加巴喷丁及背根神经节脉冲射频毁损治疗。随访6个月后比较两种治疗方案的临床疗效。
治疗后1、2和4周时，观察组视觉模拟评分显著低于对照组（P≤0.05，两组均未发生明显并发症）。观察组中分化簇（CD）4+细胞百分比及CD4+/CD8+比值逐渐升高，而CD8+细胞百分比降低（P≤0.05）。对照组未观察到明显变化（P>0.05）。治疗开始后1、2和4周时，观察组血清白细胞介素-6、C反应蛋白和肿瘤坏死因子-α水平显著低于对照组（P<0.05）。观察组总有效率及效率也优于对照组（P≤0.05）。
我们的研究表明，射频联合加巴喷丁治疗PHN具有良好的安全性和疗效。该治疗效果可能与T细胞免疫增强及炎症反应受抑制有关。
