Guo Suqian, Shen Mengxi, Zhang Linlin, Zhao Qi, Song Chengcheng, Jia Wei, Wang Guolin
Departments of Anesthesiology, Tianjin Medical University General Hospital, Tianjin Research Institute of Anesthesiology, Tianjin 300052, PR China.
Indian J Dermatol. 2019 May-Jun;64(3):251. doi: 10.4103/ijd.IJD_130_18.
Herpes zoster (HZ) is identified to induce postherpetic neuralgia (PHN) which is difficult to cure. PHN-related pain brings patients not only physical discomfort but also mental depression and anxiety. Currently, the main purpose of PHN treatment is to reduce patients' pain. Now treatment combining some international pain management and drug therapy has come up.
This study aims to evaluate the effect of interventional management through meta-analysis.
Interventional pain management was defined as a direct strategy on nerve through physical or chemical method. Drug therapy was always regarded as control. Potentially relevant articles were searched in PubMed, EMBASE, and the Cochrane Library through key words by consensus. Pain severity was evaluated by a validated visual analog scale (VAS). Moreover, the weighted mean difference was used to calculate pain intensity. Some trails recorded the efficiency rate and odds ratio was used to calculate the effectiveness. Statistical heterogeneity was measured by the value of , and when statistical > 50%, subgroup analysis was used to seek for the source of heterogeneity.
Pulsed radiofrequency (PRF) combined with medication reduced the VAS scores at 1, 2, 4, and 8 weeks after treatment. The nerve block combined with medication reduced VAS scores at 8 weeks after treatment, but there is no difference between the results of medication alone at 1, 2, and 4 weeks after treatment.
The interventional mean of PRF combined with medication has a good effect on PHN. The effect of nerve block combined with medication on PHN seems to be the same as that of medication alone. Besides, a long period with high-quality randomized controlled trial should be done to verify the results.
带状疱疹(HZ)可引发难以治愈的带状疱疹后神经痛(PHN)。PHN相关疼痛不仅给患者带来身体不适,还导致精神抑郁和焦虑。目前,PHN治疗的主要目的是减轻患者疼痛。现在出现了一些将国际疼痛管理与药物治疗相结合的治疗方法。
本研究旨在通过荟萃分析评估介入管理的效果。
介入性疼痛管理被定义为通过物理或化学方法对神经的直接策略。药物治疗始终被视为对照。通过共识确定关键词,在PubMed、EMBASE和Cochrane图书馆中检索潜在相关文章。采用经过验证的视觉模拟量表(VAS)评估疼痛严重程度。此外,使用加权平均差来计算疼痛强度。一些试验记录了有效率,并使用比值比来计算有效性。通过I²值测量统计异质性,当I²>50%时,采用亚组分析寻找异质性来源。
脉冲射频(PRF)联合药物治疗在治疗后1、2、4和8周降低了VAS评分。神经阻滞联合药物治疗在治疗后8周降低了VAS评分,但在治疗后1、2和4周单独药物治疗的结果之间没有差异。
PRF联合药物治疗的介入方法对PHN有良好效果。神经阻滞联合药物治疗对PHN的效果似乎与单独药物治疗相同。此外,应该进行长期的高质量随机对照试验来验证结果。