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脉冲射频联合加巴喷丁治疗急性带状疱疹神经痛的疗效及安全性

[Efficacy and safety of pulsed radiofrequency combined with gabapentin in the treatment of acute herpetic neuralgia].

作者信息

Li H Q, Xia L J, Jiang Y H, Liu L, Xing X F, Tao R, Ma S H

机构信息

Department of Pain, Henan Provincial People's Hospital, Zhengzhou 450003, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2023 Dec 26;103(48):3954-3958. doi: 10.3760/cma.j.cn112137-20230921-00517.

DOI:10.3760/cma.j.cn112137-20230921-00517
PMID:38129173
Abstract

To explore the clinical efficacy and safety of pulsed radiofrequency (PRF) combined with gabapentin in the treatment of acute herpetic neuralgia (AHN). A total of 123 AHN patients were retrospectively selected in Henan Provincial People's Hospital from November 2019 to July 2022, who were divided into two groups based on treatment methods: control group (treated with gabapentin, =61) and study group (treated with gabapentin and PRF, =62). The visual analog scale (VAS) was utilized for pain severity assessment and the self-rating scale for sleep (SRSS) was utilized for sleep quality evaluation. The differences in serum levels of interleukin (IL)-10, chemokine ligand 10 (CXCL-10), prostaglandin E2 (PGE2), cyclooxygenase-2 (COX-2), IL-2 and IL-6 before and after treatment were compared between the two groups. The overall treatment effectiveness and the occurrence rates of postherpetic neuralgia and adverse reactions were evaluated in both groups. Among the study group patients, 28 were male and 34 were female, and the age was (62.8±8.5) years. Among the control group patients, 35 were male and 26 were female, and the age was (64.0±7.8) years. The VAS scores of the study group before and after treatment were 7.96±1.33 and 1.52±0.60, respectively, while the control group were 7.68±1.52 and 2.70±0.64. The SRSS scores before and after treatment in the study group were 31.74±5.90 and 12.06±2.81, respectively, while those in the control group were 33.10±5.54 and 14.14±2.96, respectively. Before treatment, there were no statistically differences of the VAS scores and SRSS scores in both groups (all >0.05). After treatment, the VAS scores and SRSS scores in both groups decreased compared with before treatment (all <0.05), the study group's VAS scores and SRSS scores were lower than those in the control group (all <0.05). Before treatment, there were no statistically differences of the serum levels of IL-10, CXCL-10, PGE2, COX-2, IL-2 and IL-6 in both groups (all >0.05). After treatment, the serum levels of IL-10, CXCL-10, PGE2, COX-2 and IL-6 in both groups decreased compared with before treatment, while the IL-2 level increased. Additionally, the study group had lower serum levels of IL-10, PGE2, COX-2 and IL-6 compared with the control group (all <0.05). After treatment, the study group had 35 cases of cure, 26 cases of effectiveness, and 1 case of ineffectiveness, while the control group had 22 cases of cure, 31 cases of effectiveness, and 8 cases of ineffectiveness. The overall treatment efficacy of the study group was better than that of the control group (=0.012). The incidence of postherpetic neuralgia in the study group after treatment was 16.1% (10/62), which was lower than that in the control group, which was 37.7% (23/61) (<0.05). There were no statistically differences of the occurrence rates of adverse reactions in both groups (all >0.05). Combining PRF with gabapentin for the treatment of AHN demonstrates better overall efficacy and safety, which can more effectively alleviate pain, improve sleep, and reduce inflammatory cytokine levels.

摘要

探讨脉冲射频(PRF)联合加巴喷丁治疗急性带状疱疹神经痛(AHN)的临床疗效及安全性。回顾性选取2019年11月至2022年7月在河南省人民医院就诊的123例AHN患者,根据治疗方法分为两组:对照组(采用加巴喷丁治疗,n = 61)和研究组(采用加巴喷丁联合PRF治疗,n = 62)。采用视觉模拟评分法(VAS)评估疼痛严重程度,采用睡眠自评量表(SRSS)评估睡眠质量。比较两组治疗前后血清白细胞介素(IL)-10、趋化因子配体10(CXCL-10)、前列腺素E2(PGE2)、环氧化酶-2(COX-2)、IL-2和IL-6水平的差异。评估两组的总体治疗效果、带状疱疹后神经痛发生率及不良反应发生率。研究组患者中,男性28例,女性34例,年龄为(62.8±8.5)岁。对照组患者中,男性35例,女性26例,年龄为(64.0±7.8)岁。研究组治疗前后VAS评分分别为7.96±1.33和1.52±0.60,而对照组分别为7.68±1.52和2.70±0.64。研究组治疗前后SRSS评分分别为31.74±5.90和12.06±2.81,对照组分别为33.10±5.54和14.14±2.96。治疗前,两组VAS评分和SRSS评分差异均无统计学意义(均>0.05)。治疗后,两组VAS评分和SRSS评分均较治疗前降低(均<0.05),研究组VAS评分和SRSS评分低于对照组(均<0.05)。治疗前,两组血清IL-10、CXCL-10、PGE2、COX-2、IL-2和IL-6水平差异均无统计学意义(均>0.05)。治疗后,两组血清IL-10、CXCL-10、PGE2、COX-2和IL-6水平均较治疗前降低,而IL-2水平升高。此外,研究组血清IL-10、PGE2、COX-2和IL-6水平低于对照组(均<0.05)。治疗后,研究组治愈35例,显效26例,无效1例,对照组治愈22例,显效31例,无效8例。研究组总体治疗效果优于对照组(P = 0.012)。研究组治疗后带状疱疹后神经痛发生率为16.1%(10/62),低于对照组的37.7%(23/61)(P<0.05)。两组不良反应发生率差异无统计学意义(均>0.05)。PRF联合加巴喷丁治疗AHN总体疗效和安全性较好,能更有效缓解疼痛、改善睡眠并降低炎性细胞因子水平。

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