自体富血小板血浆皮内注射治疗带状疱疹后神经痛患者的疗效

Efficacy of intracutaneous injection of autologous platelet-rich plasma in the treatment of patients with postherpetic neuralgia

目的评价自体富血小板血浆(PRP)皮内注射治疗带状疱疹后神经痛患者的效果。方法收集2020年6月至2020年12月青岛大学附属青岛市市立医院疼痛科诊治的带状疱疹后神经痛患者40例,年龄、性别不限,视觉模拟评分(VAS)≥4分,按照随机数字表法将其随机分为PRP注射组和药物注射组,每组20例。两组患者均在疼痛区选择15~20个注射点,各点行皮内注射0.4~0.6 ml,1次/3 d,2次为1个疗程。PRP注射组注射自体富血小板血浆共8 ml,药物注射组注射药物,配方为甲钴胺(1 mg∶2 ml)+复方倍他米松(2 mg∶1 ml)+2%利多卡因5 ml。记录两组患者治疗前及治疗后7 d、3个月时VAS评分、健康调查简易问卷(SF-36)评分及健侧与患侧热像图温度差。结果两组患者一般资料及治疗前VAS评分、SF-36评分、健侧与患测温度差,差异均无统计学意义(P均>0.05)。与治疗前比较,两组患者治疗后7 d、3个月时VAS评分均降低,SF-36评分均升高(P均<0.05);治疗后7 d、3个月时,PRP注射组较药物注射组VAS评分低[(2.6±0.9)分比(3.2±0.8)分,(1.7±1.1)分比(3.8±1.9)分,P均<0.05]。与治疗前比较,PRP注射组治疗后3个月时健侧与患侧温度差较小[(0.28±0.10)℃比(0.84±0.13)℃,P<0.05];PRP注射组治疗后3个月时健侧与患侧温度差较药物注射组小[(0.28±0.10)℃比(0.80±0.76)℃,P<0.05]。两组患者均未见严重不良反应和并发症。结论PRP皮损区皮内注射治疗带状疱疹后神经痛疗效确切,较药物注射治疗效果更佳。

Objective To explore the efficacy of intracutaneous injection of autologous platelet-rich plasma(PRP)in the treatment of patients with postherpetic neuralgia.Methods Forty patients with postherpetic neuralgia,both sexes and age,admitted to the Department of Pain Management,Qingdao Municipal Hospital Affiliated to Qingdao University,from June 2020 to December 2020,were randomly divided into PRP treatment group and drug treatment group,20 cases in each group.Patients were injected in 15-20 points with intracutaneous PRP of total 8 ml in the pain area in the PRP treatment group,while patients were injected intracutaneous conventional drugs in the drug treatment group(mecobalamin 1 mg/2 ml+compound betamethasone 2 mg/1 ml+2%lidocaine 5 ml),once every 3 days,twice as a course of treatment.Visual analogue scale(VAS),SF-36 score of quality of life and temperature difference of infrared thermal image between healthy side and affected side were recorded before the treatment,7 days and 3 months after the treatment.Results There was no significant difference in the general information,VAS,SF-36 quality of life score and the temperature difference of the healthy and affected sides before the treatment between the two groups(all P>0.05).VAS was lower and SF-36 was higher at 7 days and 3 months after the treatment than those before the treatment(all P>0.05);VAS was even lower in PRP treatment group than that in the drug treatment group at 7 days and 3 months after the treatment[(2.6±0.9)vs.(3.2±0.8),(1.7±1.1)vs.(3.8±1.9),all P<0.05].The temperature difference was smaller at 3 months after the treatment than that before the treatment in PRP treatment group[(0.28±0.10)vs.(0.84±0.13),P<0.05];and it was even smaller in the PRP treatment group than that in the drug treatment group at 3 months after the treatment[(0.28±0.10)vs.(0.80±0.76),P<0.05].No serious adverse reactions and complications were found in the two groups.Conclusion Intracutaneous injection of PRP in the lesion skin areas is effective in the treatment of patients with postherpetic neuralgia,which is better than intracutaneous drug injection.