高电压、长时间脉冲射频作用于背根神经节可改善亚急性期带状疱疹后神经痛的疼痛症状。

High-voltage, Long-duration Pulsed Radiofrequency to the Dorsal Root Ganglion Provides Improved Pain Relief for Herpes Zoster Neuralgia in the Subacute Stage.

作者信息

Sun Chen-Li, Li Xiu-Liang, Li Cheng-Wen, He Nong, Zhang Jie, Xue Fu-Shan

机构信息

Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.

出版信息

Pain Physician. 2023 May;26(3):E155-E162.

DOI:

PMID:37192238

Abstract

BACKGROUND

Postherpetic neuralgia (PHN) is pain persisting beyond 3 months from rash onset and is the most common complication of herpes zoster (HZ); it is commonly refractory to medication treatment. Available evidence indicates that high-voltage, long-duration pulsed radiofrequency (PRF) to the dorsal root ganglion (DRG) is a novel and effective treatment for this complication. Nevertheless, the effects of this intervention on refractory HZ neuralgia less than 3 months have not been evaluated.

OBJECTIVE

The objective of this study was to assess the therapeutic efficacy and safety of high-voltage, long-duration PRF to the DRG for patients with subacute HZ neuralgia compared with that of patients with PHN.

STUDY DESIGN

A retrospective comparative research.

SETTING

Hospital department in China.

METHODS

Sixty-four patients with HZ neuralgia in different stages receiving high-voltage, long-duration PRF to the DRG were included. According to the days from zoster onset to PRF implementation, they were divided into the subacute (one to 3 months) or PHN group (more than 3 months). The therapeutic effect was evaluated by pain relief using the Numeric Rating Scale at one day, one week, one month, 3 months, and 6 months post-PRF. The five-point Likert scale measured patient satisfaction. Post-PRF side effects were also recorded to determine the safety of the intervention.

RESULTS

The intervention significantly reduced pain in all patients, but pain relief at one month, 3 months, and 6 months post-PRF was better in the subacute group than in the PHN group. Furthermore, the success rate of PRF was significantly increased in the subacute group compared with the PHN group (81.3% vs 56.3%, P = 0.031). There was no significant difference in patient satisfaction at 6 months between groups.

LIMITATIONS

This is a single-center retrospective study with a small sample size.

CONCLUSIONS

High-voltage, long-duration PRF to the DRG is effective and safe for HZ neuralgia in different stages, and can provide an improved pain relief for HZ neuralgia in the subacute stage.

摘要

背景

带状疱疹后神经痛（PHN）是皮疹出现后持续超过3个月的疼痛，是带状疱疹（HZ）最常见的并发症；药物治疗通常对此无效。现有证据表明，对背根神经节（DRG）进行高压、长时间脉冲射频（PRF）是治疗该并发症的一种新颖且有效的方法。然而，这种干预措施对病程小于3个月的难治性HZ神经痛的效果尚未得到评估。

目的

本研究的目的是评估对亚急性HZ神经痛患者与PHN患者进行DRG高压、长时间PRF治疗的疗效和安全性。

研究设计

一项回顾性对照研究。

地点

中国的医院科室。

方法

纳入64例接受DRG高压、长时间PRF治疗的不同阶段HZ神经痛患者。根据从带状疱疹发作到进行PRF治疗的天数，将他们分为亚急性组（1至3个月）或PHN组（超过3个月）。通过在PRF治疗后1天、1周、1个月、3个月和6个月使用数字评分量表评估疼痛缓解情况来评价治疗效果。采用五点李克特量表测量患者满意度。还记录PRF治疗后的副作用以确定该干预措施的安全性。