Wang Xiang, Yu Jing, Han Chong-Fang, He Jian-Dong, Yang Wen-Qu, Wang Qi, Chen Jian-Ping
Department of Pain Medicine, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, People's Republic of China.
Department of Anesthesiology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, People's Republic of China.
J Pain Res. 2023 Apr 20;16:1321-1332. doi: 10.2147/JPR.S398578. eCollection 2023.
Globally, the incidence of herpes zoster (HZ) is increasing, and the resulting zoster-associated pain (ZAP) severely affects the quality of life of patients. Therefore, active treatment of ZAP and prevention of postherpetic neuralgia (PHN) are very important for patients in the early stage of the disease. This retrospective observational study aimed to evaluate the effect of CT-guided pulsed radiofrequency (PRF) combined with ozone injection on zoster-associated pain.
From 2018 to 2020, 84 patients with AHN (n=28), SHN (n=32), or PHN (n=24) underwent PRF combined with ozone injection treatment after pharmacologic and conservative therapies failed. The visual analogue scale (VAS), the Pittsburgh Sleep Quality Index (PSQI), and pregabalin consumption were recorded at baseline, post-PRF, and at 1, 3, 6, and 12 months after treatment. The number of remediations performed and adverse reactions were recorded, and treatment inefficiency was calculated using a VAS score greater than 3 as the criterion.
The pooled results demonstrated statistically significant decreases in VAS scores, PSQI scores and consumption of pregabalin post-PRF and at 1, 3, 6, and 12 months follow-up (P<0.05). Compared with the PHN group, both the AHN and SHN groups showed clinical and statistical improvement in VAS scores and PSQI scores and in consumption of pregabalin (P< 0.05). At 1 year after the operation, the PHN group had a significantly greater number of remediation events and greater treatment inefficiency than the other two groups. No serious adverse events were observed during the procedure or during the follow-up period.
CT-guided PRF combined with ozone injection is safe and effective for individuals with ZAP, and its short-term and long-term effects are significant. In a sense, early PRF combined with ozone injection is more effective.
在全球范围内，带状疱疹（HZ）的发病率正在上升，由此产生的带状疱疹相关性疼痛（ZAP）严重影响患者的生活质量。因此，在疾病早期积极治疗ZAP并预防带状疱疹后神经痛（PHN）对患者非常重要。这项回顾性观察研究旨在评估CT引导下脉冲射频（PRF）联合臭氧注射对带状疱疹相关性疼痛的疗效。
2018年至2020年，84例急性带状疱疹后神经痛（AHN，n = 28）、亚急性带状疱疹后神经痛（SHN，n = 32）或带状疱疹后神经痛（PHN，n = 24）患者在药物和保守治疗失败后接受了PRF联合臭氧注射治疗。在基线、PRF后以及治疗后1、3、6和12个月记录视觉模拟量表（VAS）、匹兹堡睡眠质量指数（PSQI）和普瑞巴林的消耗量。记录进行补救的次数和不良反应，并以VAS评分大于3为标准计算治疗无效情况。
汇总结果显示，PRF后以及1、3、6和12个月随访时，VAS评分、PSQI评分和普瑞巴林消耗量均有统计学意义的显著下降（P < 0.05）。与PHN组相比，AHN组和SHN组在VAS评分、PSQI评分和普瑞巴林消耗量方面均显示出临床和统计学上的改善（P < 0.05）。术后1年，PHN组的补救事件数量和治疗无效情况明显多于其他两组。在手术过程或随访期间未观察到严重不良事件。
CT引导下PRF联合臭氧注射对ZAP患者安全有效，其短期和长期效果显著。从某种意义上说，早期PRF联合臭氧注射更有效。
