Lu Fan, Zhong JiWei, Liu Hui, Xiao Hong
Department of Pain Management, West China Hospital, Sichuan University, Chengdu, China.
Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China.
Front Neurol. 2023 Sep 12;14:1258464. doi: 10.3389/fneur.2023.1258464. eCollection 2023.
This study explored the impact of different doeses of doxorubicin in CT-guided transvertebral foraminal injections for postherpetic neuralgia (PHN) treatment and the impact of 0.5% doxorubicin treatment on patients with different disease courses and lesion locations.
This retrospective study included 291 patients with PHN who received CT-guided doxorubicin injection at West China Hospital between April 2014 and February 2020.
A total of 228 patients received 0.5% doxorubicin treatment and 63 received 0.33% doxorubicin. Both groups showed significantly improvement in visual analogue scale (VAS) and Brief Pain Inventory (BPI) scores. The 0.5% doxorubicin group demonstrated significant lower VAS scores at 6 and 12 months after surgery (all < 0.001) and a significant lower score on the BPI at 6 and 12 months than the 0.33% doxorubicin group (all < 0.05). Stratified analysis of 0.5% doxorubicin demonstrated a significant reduction in VAS score at 1 week, 3 months, 6 months, and 12 months after treatment compared to baseline (all < 0.05) and significant improvements in BPI score after treatment compared to baseline ( < 0.05). The VAS score of the chest group was significant higher than facial, neck and upper limbs and abdomen groupsin groups 1 week after surgery (all < 0.05). Various aspects of quality of life, including daily life, enjoyment of life, sleep, relationships, work, walking ability, and emotions, significantly decreased after surgery ( < 0.05). Especially in sleep duration, there was an increase in patients reporting intermediate sleep (4-7 h) and a proportion achieving a normal sleep duration of ≥7 h. And no significant differences of BPI were observed among different affected locations. The incidence of adverse events in the 0.5% doxorubicin group and 0.33% doxorubicin group was 8.78 and 6.34%, respectively.
CT-guided doxorubicin injection therapy has the potential to alleviate pain and enhance the quality of life in patients with PHN. Notably, the use of a 0.5% doxorubicin concentration yields more pronounced pain relief compared to a 0.33% concentration. While longer durations of PHN and specific affected sites may influence the response to treatment, the overall improvements in quality of life remain consistent.
本研究探讨不同剂量阿霉素在CT引导下经椎间孔注射治疗带状疱疹后神经痛（PHN）中的作用，以及0.5%阿霉素治疗对不同病程和病变部位患者的影响。
本回顾性研究纳入了2014年4月至2020年2月期间在华西医院接受CT引导下阿霉素注射的291例PHN患者。
共有228例患者接受0.5%阿霉素治疗，63例接受0.33%阿霉素治疗。两组患者的视觉模拟评分（VAS）和简明疼痛量表（BPI）评分均有显著改善。0.5%阿霉素组术后6个月和12个月的VAS评分显著低于0.33%阿霉素组（均<0.001），6个月和12个月时的BPI评分也显著低于0.33%阿霉素组（均<0.05）。对0.5%阿霉素进行分层分析显示，治疗后1周、3个月、6个月和12个月的VAS评分与基线相比显著降低（均<0.05），治疗后的BPI评分与基线相比也有显著改善（<0.05）。术后1周，胸部组的VAS评分显著高于面部、颈部、上肢和腹部组（均<0.05）。生活质量的各个方面，包括日常生活、生活乐趣、睡眠、人际关系、工作、行走能力和情绪，术后均显著下降（<0.05）。尤其是在睡眠时间方面，报告中等睡眠时间（4-7小时）的患者有所增加，达到正常睡眠时间≥7小时的患者比例也有所增加。不同受累部位的BPI评分无显著差异。0.5%阿霉素组和0.33%阿霉素组的不良事件发生率分别为8.78%和6.34%。
CT引导下阿霉素注射治疗有可能缓解PHN患者的疼痛并提高其生活质量。值得注意的是，与0.33%的浓度相比，使用0.5%的阿霉素浓度能产生更明显的疼痛缓解效果。虽然PHN病程较长和特定受累部位可能会影响治疗反应，但生活质量的总体改善仍然是一致的。
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