带状疱疹相关性疼痛的射频治疗进展:关于参数、模式、靶点及联合治疗的叙述性综述

Progress in Radiofrequency Therapy for Zoster-Associated Pain About Parameters, Modes, Targets, and Combined Therapy: A Narrative Review.

作者信息

Rui Min, Ni Huadong, Xie Keyue, Xu Longsheng, Yao Ming

机构信息

Department of Anesthesiology and Pain Research Center, The Affiliated Hospital of Jiaxing University, No. 1882 South Zhonghuan Road, Jiaxing, China.

Institute of Neuroscience, Soochow University, No.199 Renai Road, Suzhou, China.

出版信息

Pain Ther. 2024 Feb;13(1):23-32. doi: 10.1007/s40122-023-00561-7. Epub 2023 Nov 14.

Abstract

Zoster-associated pain (ZAP) is a painful condition that significantly impacts a patient's quality of life, often leading to postherpetic neuralgia (PHN). Over 30% of patients with herpes probably experience PHN. However, the understanding and treatment of ZAP remain inadequate. Common interventional treatments include radiofrequency therapy, nerve blocks, epidural block, and spinal cord electrical stimulation. Among these, radiofrequency therapy is widely used for pain control in ZAP, but the standard pulsed radiofrequency technique can still be improved. Researchers have explored different radiofrequency parameters, modes, targets, and combined treatments to enhance the therapeutic effect. In this paper, we review the latest research findings and incorporate our own departmental investigations. We conclude that high-voltage, long-duration pulsed radiofrequency and radiofrequency thermocoagulation therapy have shown improved therapeutic outcomes, despite some remaining limitations. Emphasis is placed on safety in intercostal nerve and extracranial nerve radiofrequency treatments. Combination therapy is also safe and effective; however, many studies have a low grade of evidence. Further high-quality research and systematic reviews are needed.

摘要

带状疱疹相关性疼痛(ZAP)是一种会严重影响患者生活质量的疼痛病症,常导致带状疱疹后神经痛(PHN)。超过30%的疱疹患者可能会经历PHN。然而,对ZAP的认识和治疗仍不充分。常见的介入治疗包括射频治疗、神经阻滞、硬膜外阻滞和脊髓电刺激。其中,射频治疗广泛用于ZAP的疼痛控制,但标准脉冲射频技术仍有改进空间。研究人员探索了不同的射频参数、模式、靶点及联合治疗方法以提高治疗效果。在本文中,我们回顾了最新研究成果并纳入了我们科室的调查。我们得出结论,尽管仍存在一些局限性,但高压、长时间脉冲射频和射频热凝治疗已显示出更好的治疗效果。肋间神经和颅外神经射频治疗强调安全性。联合治疗同样安全有效;然而,许多研究的证据等级较低。还需要进一步的高质量研究和系统评价。

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