Department of Anesthesiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
Department of Anesthesiology, Sports Hospital Affiliated to Chengdu University of Physical Education, Chengdu, China.
Medicine (Baltimore). 2024 Apr 5;103(14):e36823. doi: 10.1097/MD.0000000000036823.
Postherpetic neuralgia (PHN) is the most common complication of varicella-zoster infection and tends to occur in older people. All patients treated with a single regimen have not achieved consistent success across all current study protocols, and multimodal combination regimens still need to be explored.
A total of 111 patients with PHN were randomly divided into drug group (group A), thoracic paravertebral nerve block group (group B), thoracic paravertebral nerve block combined with acupuncture group (group C), with 37 cases in each group. Group A: received oral gabapentin capsules and external lidocaine gel plaster; group B: combined with thoracic paravertebral nerve block based on group A; group C: combined with acupuncture based on group B. The primary outcome was effective rate, and secondary outcomes included pain sensation score (numerical rating scale), SF-36 quality of life score, and sleep quality.
Before treatment, there were no significant differences in numerical rating scale value, SF-36 quality of life score, and sleep quality level among the 3 groups (P > .05). After 12 weeks of treatment, the total effective rate of treatment of patients in group C (91.43%) was higher than that in group B (77.14%), and significantly higher than that in group A (51.43%) (P < .05).
Based on drug treatment combined with thoracic paravertebral nerve block and acupuncture, the treatment of PHN in the elderly can quickly and effectively relieve pain, improve the quality of life of patients, and improve the quality of sleep.
带状疱疹后神经痛(PHN)是水痘-带状疱疹感染最常见的并发症,倾向于发生在老年人中。所有接受单一方案治疗的患者在所有当前研究方案中并未取得一致的成功,仍然需要探索多模式联合方案。
共有 111 例 PHN 患者被随机分为药物组(A 组)、胸椎旁神经阻滞组(B 组)、胸椎旁神经阻滞联合针刺组(C 组),每组 37 例。A 组:口服加巴喷丁胶囊和外用利多卡因凝胶膏;B 组:在 A 组基础上联合胸椎旁神经阻滞;C 组:在 B 组基础上联合针刺。主要结局是有效率,次要结局包括疼痛感觉评分(数字评分量表)、SF-36 生活质量评分和睡眠质量。
治疗前,3 组患者的数字评分量表值、SF-36 生活质量评分和睡眠质量水平无显著差异(P>0.05)。治疗 12 周后,C 组患者的总有效率(91.43%)高于 B 组(77.14%),显著高于 A 组(51.43%)(P<0.05)。
在药物治疗联合胸椎旁神经阻滞和针刺的基础上,治疗老年 PHN 可快速有效地缓解疼痛,提高患者的生活质量,改善睡眠质量。