背根神经节脉冲射频联合臭氧穴位注射治疗带状疱疹后遗神经痛的临床观察

Clinical Observation of Dorsal Root Ganglion Pulsed Radiofrequency combined with Ozone Acupoint Injection in the Treatment of Postherpetic Neuralgia

目的:观察背根神经节脉冲射频联合臭氧穴位注射治疗带状疱疹后遗神经痛的临床效果及对患者免疫功能的影响。方法:将60例带状疱疹后遗神经痛患者采用随机数字表法随机分为两组,各30例。入院后两组患者均给予加巴喷丁常规药物治疗,对照组在此基础上加背根神经节脉冲射频治疗,治疗组在对照组基础上加臭氧穴位注射治疗。比较两组患者临床疗效、镇痛效果、生活质量、免疫功能指标及不良反应。结果:治疗组总有效率为96.67%(29/30),高于对照组的80.00%(24/30)(P<0.05)。治疗后两组患者NRS得分、CD8^+均下降,但治疗组下降幅度更大,SF-36得分、CD3^+、CD4^+均升高,但治疗组升高更明显(P<0.05)。对照组共出现不良反应2例,治疗组出现3例,差异无统计学意义(P>0.05)。结论:常规药物治疗基础上予背根神经节脉冲射频联合臭氧穴位注射治疗,较单纯背根神经节脉冲射频治疗可明显提高带状疱疹后遗神经痛患者临床疗效,提高镇痛效果及患者生活质量,其作用机制可能与改善患者免疫功能有关。

Objective: To investigate the clinical effect of dorsal root ganglion pulsed radiofrequency combined with ozone acupoint injection on postherpetic neuralgia(PHN). Methods: Sixty patients with PHN were divided into 2 groups using a random number table method, with 30 patients in each group. After admission, the patients in both groups were treated with conventional drugs such as gabapentine. On this basis, the patients in the control group were treated with pulse radiofrequency of dorsal root ganglion, and the patients in the observation group were treated with acuppoint injection of ozone on the basis of the control group. The clinical efficacy,analgesic effect, quality of life, immune function indexes and adverse reactions were compared between the two groups of patients. Results: The total effective rate in the observation group was 96.67%(29/30), which was higher than 80.00%(24/30) in the control group(P<0.05). After treatment, the NRS scores and CD8+in both groups decreased significantly, and SF-36, CD3+and CD4+were significantly increased, and the decrease was even greater in the observation group(P<0.05). There were no serious complications such as pneumothorax, spinal cord injury and intercostal artery injury in the two groups. There were 2 cases in the control group and 3 cases in the observation group, there was no significant difference between the two groups(P>0.05). Conclusion: Compared with dorsal root ganglion pulsed radiofrequency, combined with ozone acupoint injection therapy based on conventional drug therapy can significantly improve the clinical efficacy, analgesic effect and quality of life of patients with PHN. The mechanism of action may be related to improving the immune function of patients.