脉冲射频联合自体富血小板血浆脊神经根周围注射治疗带状疱疹后遗神经痛临床观察

Clinical study on pulsed radiofrequency combined with autologous platelet-rich plasma injection around spinal nerve root in the treatment of postherpetic neuralgia

目的观察脉冲射频(PRF)联合自体富血小板血浆(PRP)脊神经根周围注射治疗带状疱疹后遗神经痛(PHN)临床效果。方法选取医院2020年1月-2022年5月收治的78例PHN患者,用随机数字表法将其分为对照组、研究组,各组均39例;对照组接受PRF治疗,研究组接受PRF联合自体PRP治疗;对比两组临床疗效、致痛因子水平、炎性因子水平、睡眠质量及不良反应发生情况。结果研究组总有效率(92.31%)较对照组(71.79%)高,差异有统计学意义(P<0.05);两组治疗前致痛因子水平、炎性因子水平、睡眠质量对比差异无统计学意义(P>0.05);研究组治疗1周,5-HT、MCP-1、PGE2、CRP、IL-6水平均较对照组低,且PSQI评分较对照组低,差异有统计学意义(P<0.05);组间不良反应发生率(5.13%/2.56%)对比差异无统计学意义(P>0.05)。结论PHN患者采用PRF联合自体PRP脊神经根周围注射治疗疗效较好,可降低致痛因子及炎性因子水平,改善睡眠质量,且安全性好。

Objective To observe the clinical effect of pulsed radiofrequency(PRF)combined with autologous platelet-rich plasma(PRP)injection around the spinal nerve root in the treatment of postherpetic neuralgia(PHN).Methods A total of 78 patients with PHN admitted to our hospital from January 2020 to May 2022 were selected and divided into control group and study group by random number table method,39 cases in each group.The control group received PRF treatment,while the study group received PRF combined with autologous PRP treatment.The clinical efficacy,levels of pain-causing factors,inflammatory factors,sleep quality and adverse reactions were compared between the two groups.Results The total effective rate of study group(92.31%)was higher than that of control group(71.79%),and the difference was statistically significant(P<0.05).There were no significant differences in the levels of pain-causing factors,inflammatory factors and sleep quality between the two groups before treatment(P>0.05).After 1 week of treatment,the levels of 5-HT,MCP-1,PGE2,CRP and IL-6 in the study group were lower than those in the control group,and the PSQI score was lower than that in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(5.13%/2.56%)(P>0.05).Conclusion PRF combined with autologous PRP injection around the spinal nerve root is effective in the treatment of PHN patients,which can reduce the levels of pain-causing factors and inflammatory factors,improve sleep quality,and has good safety.