周围神经电刺激植入术与脉冲射频治疗带状疱疹后眼神经痛的疗效

Clinical efficacy of peripheral nerve stimulation and pulsed radiofrequency for herpes zoster ophthalmicus

目的:探讨周围神经电刺激术与射频脉冲对带状疱疹后眼神经痛的疗效。方法:分析郑州大学第一附属医院疼痛科2016年1月至2019年1月带状疱疹后眼神经痛患者75例,根据治疗方案分为两组,PNS+PRF组(周围神经电刺激+脉冲射频)38例,PRF组(单纯脉冲射频)37例。采用重复测量方差分析两组VAS评分及睡眠情况,药物用量,并记录有无复发、并发症及不良反应。结果:两组术后较术前VAS评分均显著降低,睡眠质量均明显提高,药物用量逐渐降低。长期疗效中,PNS+PRF组VAS及PSQI评分低于PRF组,VAS评分在4周、3个月、6个月、1年、2年时分别为0.68±1.04比2.54±2.76、0.92±1.60比2.73±2.79、0.86±1.37比2.75±2.83、0.81±1.37比2.78±2.82、0.81±1.37比2.75±2.84(P<0.05),PSQI评分在2周、4周、3个月、6个月、1年、2年时分别为3.10±0.51比4.86±0.52、2.00±0.53比4.81±0.54、2.34±0.61比4.91±0.62、2.10±0.58比5.00±0.59、1.73±0.62比4.81±0.63、1.26±0.63比4.86±0.64(P<0.05)。PRF组的复发率(30%)显著高于PNS+PRF组(2.6%,P<0.05)。结论:周围神经电刺激与脉冲射频治疗带状疱疹后眼神经痛均安全有效,而周围神经电刺激联合脉冲射频治疗带状疱疹后眼神经痛效果更佳。

Objective To investigate the efficacy of peripheral nerve stimulation(PNS)and pulsed radiofrequency(PRF)in the treatment of patients with herpes zoster ophthalmicus.Methods Totally,75 cases of trigeminal postherpetic neuralgia was divided into two groups according to the treatment plan:38 cases in the PNS+PRF group,and 37 cases in the PRF group.The VAS and PSQI scores and the dosage of drugs in the two groups were recorded,and recurrences,complications,and adverse reactions were observed.Results The VAS scores in the two groups after treatment were significantly lower than those before the operation,the quality of sleep was significantly improved,and the dosage of drugs gradually decreased.In the long-term efficacy,the VAS and PSQI scores in the PNS+PRF group were significantly lower than those in the PRF group,the VAS scores were 0.68±1.04 vs.2.54±2.76,0.92±1.60 vs.2.73±2.79,0.86±1.37 vs.2.75±2.83,0.81±1.37 vs.2.78±2.82,0.81±1.37 vs.2.75±2.84 at 1st,3rd,6th month,and 1st,2nd year after treatment(P<0.05).The PSQI scores were 3.10±0.51 vs.4.86±0.52,2.00±0.53 vs.4.81±0.54,2.34±0.61 vs.4.91±0.62,2.10±0.58 vs.5.00±0.59,1.73±0.62 vs.4.81±0.63,1.26±0.63 vs.4.86±0.64 at 2nd week,1st,3rd,6th month,1st,2nd year after treatment(P<0.05).The recurrence rate in the PRF group(30%)was significantly higher than that in the PNS+PRF group(2.6%,P<0.05).Conclusion Both PNS and PRF treatments of herpes zoster ophthalmicus are safe and effective.However,the long-term effect of PNS combined with PRF therapy is more satisfactory.