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计算机断层扫描引导下背根神经节臭氧注射联合脉冲射频治疗中老年带状疱疹神经痛的随机、双盲、对照试验。

Computed Tomography-Guided Dorsal Root Ganglion Ozone Injection Combined With Pulsed Radiofrequency for Acute Herpes Zoster Neuralgia Treatment of Middle-aged and Elderly People: A Randomized, Double-blinded, Controlled Trial.

机构信息

Department of Anesthesiology, Bengbu Medical University, Bengbu.

Department of Anesthesiology and Pain, The Affiliated Hospital of Jiaxing University, Jiaxing, People's Republic of China.

出版信息

Clin J Pain. 2024 Aug 1;40(8):469-477. doi: 10.1097/AJP.0000000000001226.

Abstract

OBJECTIVES

To investigate the efficacy and safety of pulsed radiofrequency of the dorsal root ganglion combined with ozone injection for treating acute herpes zoster (HZ) neuralgia in middle-aged and elderly adults.

METHODS

A total of 164 middle-aged and elderly patients with acute HZ were randomly assigned to 2 groups: the pulsed radiofrequency combined with ozone injection group (group A) and the pulsed radiofrequency group (group B). The therapeutic effects were evaluated using Numeric Rating Scale (NRS) scores and the average doses of gabapentin (mg/d) preoperatively and 1 day, 2 weeks, 4 weeks, 12 weeks, and 24 weeks postoperatively. The incidence of clinically significant postherpetic neuralgia (PHN) and complications in the 2 groups were recorded.

RESULTS

The data showed that the NRS scores and the doses of gabapentin after treatment were significantly lower when compared with the baseline values in both groups. Compared with group B, the NRS scores and the doses of postoperative gabapentin were significantly lower in group A. The incidence of PHN was significantly lower at weeks 4, 12, and 24 in group A than in group B. No adverse reactions occurred in either of the 2 groups post-treatment.

CONCLUSIONS

The results indicated that ozone injection in the dorsal root ganglion combined with pulsed radiofrequency therapy was more effective in treating acute HZ neuralgia in middle-aged and elderly adults. It provides patients with longer-lasting pain relief, decreased incidence of PHN and the doses of medication, and improved quality of life than with Pulsed Radiofrequency treatment.

摘要

目的

探讨脉冲射频联合臭氧注射治疗中老年急性带状疱疹(HZ)神经痛的疗效和安全性。

方法

将 164 例中老年急性 HZ 患者随机分为脉冲射频联合臭氧注射组(A 组)和脉冲射频组(B 组)。采用数字评分量表(NRS)评分和术前及术后 1 天、2 周、4 周、12 周和 24 周时加巴喷丁(mg/d)的平均剂量评估治疗效果。记录两组患者临床显著带状疱疹后神经痛(PHN)的发生率和并发症。

结果

两组患者的 NRS 评分和术后加巴喷丁剂量均较治疗前明显降低,且 A 组的 NRS 评分和术后加巴喷丁剂量明显低于 B 组。A 组在第 4、12、24 周时 PHN 的发生率明显低于 B 组。两组患者治疗后均无不良反应发生。

结论

臭氧注射联合脉冲射频治疗中老年急性 HZ 神经痛疗效确切,可减轻患者疼痛,降低 PHN 发生率和药物剂量,提高生活质量,其疗效优于单纯脉冲射频治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b1e9/11236272/b081cf0ce080/ajp-40-469-g001.jpg

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