Wang Huan, Zhang Dandan, Wang Shiyu, Wang Hui, Nie Huiyong
Department of Pain Management, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'An, China.
Department of Geriatric Cardiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'An, China.
Front Neurol. 2024 Aug 29;15:1425796. doi: 10.3389/fneur.2024.1425796. eCollection 2024.
This study aimed to compare the efficacy of pulsed radiofrequency (PRF) to dorsal root ganglia (DRG) in treating acute herpetic neuralgia (AHN) and postherpetic neuralgia (PHN) in the thoracic segment.
A total of 243 patients with thoracic herpes zoster-related pain (AHN or PHN) from January 2020 to September 2022 were retrospectively analyzed. They were divided into two groups based on the timing of PRF after herpes zoster onset: an acute herpetic neuralgia group (within 90 days) and a postherpetic neuralgia group (more than 90 days). All patients were treated with PRF at the thoracic DRG. The Visual Analog Scale (VAS), the Athens Insomnia Scale (AIS), the Generalized Anxiety Disorder-7 items (GAD-7), and the Patient Health Questionnaire-9 items (PHQ-9) scores were assessed before and at 1 week, 1 month, 3 months, 6 months, and 12 months after surgery, and the results were then compared between the two groups.
Postoperative scores of VAS, AIS, GAD-7, and PHQ-9 in both groups were significantly lower than preoperative scores ( < 0.001). From 1 month to 12 months after surgery, the AHN group showed significantly lower VAS, AIS, GAD-7, and PHQ-9 scores compared to the PHN group ( < 0.001). In the AHN group, there was a gradual improvement in these scores from 1 week to 12 months post-surgery. Conversely, the PHN group's scores began to worsen slowly from 1 week to 12 months post-surgery. Over time, the difference in scores between the two groups also increased gradually.
PRF to the DRG is an effective treatment for patients with AHN or PHN who do not respond well to conventional treatments. For AHN patients, PRF to the DRG significantly enhances early pain control, improves sleep and psychological status, and may even prevent the development of PHN.
本研究旨在比较脉冲射频（PRF）作用于胸段背根神经节（DRG）治疗急性带状疱疹性神经痛（AHN）和带状疱疹后神经痛（PHN）的疗效。
回顾性分析2020年1月至2022年9月共243例胸段带状疱疹相关性疼痛（AHN或PHN）患者。根据带状疱疹发作后PRF治疗的时间分为两组：急性带状疱疹性神经痛组（90天内）和带状疱疹后神经痛组（90天以上）。所有患者均接受胸段DRG的PRF治疗。在手术前以及术后1周、1个月、3个月、6个月和12个月评估视觉模拟量表（VAS）、雅典失眠量表（AIS）、广泛性焦虑障碍7项量表（GAD - 7）和患者健康问卷9项量表（PHQ - 9）得分，然后比较两组结果。
两组术后VAS、AIS、GAD - 7和PHQ - 9得分均显著低于术前得分（<0.001）。术后1个月至12个月，AHN组的VAS、AIS、GAD - 7和PHQ - 9得分显著低于PHN组（<0.001）。在AHN组，术后1周至12个月这些得分逐渐改善。相反，PHN组的得分从术后1周开始至12个月缓慢恶化。随着时间推移，两组得分差异也逐渐增大。
DRG的PRF治疗对于对传统治疗反应不佳的AHN或PHN患者是一种有效的治疗方法。对于AHN患者，DRG的PRF显著增强早期疼痛控制，改善睡眠和心理状态，甚至可能预防PHN的发生。
