Zhang Zhen-Wu, Zhao Yan, Du Tian-Yi, Zhang Juan, Wu Qiong, Wang Zhe-Yin
Department of Pain Medicine, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, China.
Front Neurol. 2023 Feb 24;14:1122538. doi: 10.3389/fneur.2023.1122538. eCollection 2023.
This study evaluated the analgesic efficacy and psychological response of low-temperature plasma ablation of dorsal root ganglion (DRG) combined with selective spinal nerve block in patients with acute or subacute zoster-related neuralgia (ZRN).
Totally 90 ZRN patients were randomly and evenly divided into three groups. Treatment was given to Group A using C arm-guided selective spinal nerve block (C-SSVB), Group B using C-SSVB and pulsed radiofrequency (PRF), and Group C using C-SSVB and low-temperature plasma ablation of the DRG. The outcomes were examined using the Visual Analog Scale (VAS). Anxiety and depression of patients were evaluated using the Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS). Quality of life was assessed using the Pittsburgh Sleep Quality Index (PSQI) and postoperative Satisfaction scale. In addition, data on adverse events and medication usage rates were collected.
The 90 patients were eligible for this study. The three treatments reduced VAS scores with no significant difference between groups A and B at the same time points; however, group B tended to have numerically lower VAS scores. Comparatively, group C had significantly reduced VAS scores on day 1 and 1 month after treatment compared with the other two groups. In terms of the decreasing SAS, SDS and PSQI scores, all the three treatments improved the anxiety, depression and sleep quality of the patients. In addition, significant alleviation in anxiety was found in group C compared with group A at all- time points. However, there was no statistically significant difference among the three groups in treatment-related adverse events that mainly focused on puncture pain at the surgical-site, skin numbness and medication usage rates.
C-SSVB and LTPRA of DRG will be considered as a promising treatment option for ZRN patients if those results can be confirmed after further validation.
本研究评估了低温等离子体消融背根神经节（DRG）联合选择性脊神经阻滞对急性或亚急性带状疱疹相关性神经痛（ZRN）患者的镇痛效果和心理反应。
将90例ZRN患者随机平均分为三组。A组采用C臂引导下选择性脊神经阻滞（C-SSVB）治疗，B组采用C-SSVB联合脉冲射频（PRF）治疗，C组采用C-SSVB联合DRG低温等离子体消融治疗。采用视觉模拟评分法（VAS）评估疗效。采用焦虑自评量表（SAS）和抑郁自评量表（SDS）评估患者的焦虑和抑郁情况。采用匹兹堡睡眠质量指数（PSQI）和术后满意度量表评估生活质量。此外，收集不良事件和药物使用率的数据。
90例患者符合本研究条件。三种治疗方法均降低了VAS评分，A组和B组在相同时间点无显著差异；然而，B组的VAS评分在数值上往往较低。相比之下，C组在治疗后第1天和1个月时的VAS评分与其他两组相比显著降低。在降低SAS、SDS和PSQI评分方面，三种治疗方法均改善了患者的焦虑、抑郁和睡眠质量。此外，C组在所有时间点的焦虑程度均较A组有显著缓解。然而，三组在主要集中于手术部位穿刺痛、皮肤麻木和药物使用率的治疗相关不良事件方面无统计学显著差异。
如果这些结果能在进一步验证后得到证实，C-SSVB和DRG的低温等离子体消融术将被视为ZRN患者有前景的治疗选择。
