Department of Pharmacy, Hangzhou Third People' s Hospital, Affiliated Hangzhou Dermatology Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Department of dermatology, Affiliated Hangzhou Dermatology Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Medicine (Baltimore). 2023 Jun 9;102(23):e33932. doi: 10.1097/MD.0000000000033932.
Pulsed radiofrequency (PRF), as a new technique, is used to treat a variety of chronic pain syndromes, but it has a high recurrence rate for herpetic neuralgia and is often combined with drugs therapy. The aim of this study was to comprehensively evaluate the efficacy and safety of PRF combined with pregabalin in the treatment of herpetic neuralgia.
The electronic databases, including CNKI, Wanfang data, PubMed, Embase, web of science, and Cochrane Library were searched from inception to January 31, 2023. The outcomes were pain scores, sleep quality and side effects.
Fifteen studies with 1817 patients were included in this meta-analysis. PRF combined with pregabalin significantly reduced the visual analogue scale/score in patients with postherpetic neuralgia or herpes zoster neuralgia when compared with pregabalin or PRF monotherapy [P < .00001, standardized mean difference (SMD) = -2.01, confidence intervals (CI) = -2.36 to -1.66; P < .00001, SMD = -0.69, CI = -0.77 to -0.61]. Compared with pregabalin monotherapy, PRF combined with pregabalin significantly decreased the pittsburgh sleep quality index score, the dosage and number of days of using pregabalin (P < .00001, SMD = -1.68, CI = -2.19 to -1.17; P < .00001, SMD = -0.94, CI = -1.25 to -0.64; P < .00001, SMD = -1.52, CI = -1.85 to -1.19). However, there was no significant difference in the effect of PRF combined with pregabalin versus PRF alone on pittsburgh sleep quality index score in patients with postherpetic neuralgia (P = .70, SMD = -1.02, CI = -6.11 to 4.07). In addition, PRF combined with pregabalin could significantly decrease the incidence of dizziness, somnolence, ataxia and pain at puncture site when compared with pregabalin monotherapy (P = .0007, odds ratio [OR] = 0.56, CI = 0.40 to 0.78; P = .008, OR = 0.60, CI = 0.41 to 0.88; P = .008, OR = 0.52, CI = 0.32 to 0.84; P = .0007, OR = 12.39, CI = 2.87 to 53.43), but no significant difference was observed when compared with PRF alone.
PRF combined with pregabalin can effectively alleviate the pain intensity and improve sleep quality in patients with herpetic neuralgia, and the incidence of complications was low, so it was worthy of clinical application.
脉冲射频（PRF）作为一种新技术，用于治疗各种慢性疼痛综合征，但治疗疱疹后神经痛的复发率较高，常与药物治疗联合应用。本研究旨在综合评价 PRF 联合普瑞巴林治疗疱疹后神经痛的疗效和安全性。
计算机检索中国知网、万方数据、PubMed、Embase、Web of Science 和 Cochrane Library 等数据库，检索时限均从建库至 2023 年 1 月 31 日。比较 PRF 联合普瑞巴林与普瑞巴林或 PRF 单药治疗疱疹后神经痛或带状疱疹后神经痛患者的疼痛评分、睡眠质量和不良反应。
共纳入 15 项研究，包括 1817 例患者。PRF 联合普瑞巴林可显著降低疱疹后神经痛或带状疱疹后神经痛患者的视觉模拟评分/量表评分，与普瑞巴林或 PRF 单药治疗相比[P<0.00001，标准化均数差（SMD）=-2.01，置信区间（CI）=-2.36 至-1.66；P<0.00001，SMD=-0.69，CI=-0.77 至-0.61]。与普瑞巴林单药治疗相比，PRF 联合普瑞巴林可显著降低匹兹堡睡眠质量指数评分，减少普瑞巴林的剂量和使用天数（P<0.00001，SMD=-1.68，CI=-2.19 至-1.17；P<0.00001，SMD=-0.94，CI=-1.25 至-0.64；P<0.00001，SMD=-1.52，CI=-1.85 至-1.19）。然而，PRF 联合普瑞巴林与 PRF 单药治疗疱疹后神经痛患者的匹兹堡睡眠质量指数评分差异无统计学意义（P=0.70，SMD=-1.02，CI=-6.11 至 4.07）。此外，与普瑞巴林单药治疗相比，PRF 联合普瑞巴林可显著降低头晕、嗜睡、共济失调和穿刺部位疼痛的发生率（P=0.0007，比值比[OR]=0.56，CI=0.40 至 0.78；P=0.008，OR=0.60，CI=0.41 至 0.88；P=0.008，OR=0.52，CI=0.32 至 0.84；P=0.0007，OR=12.39，CI=2.87 至 53.43），但与 PRF 单药治疗相比差异无统计学意义。
PRF 联合普瑞巴林能有效减轻疱疹后神经痛患者的疼痛强度，改善睡眠质量，且不良反应发生率低，值得临床应用。
