体外发散式冲击波治疗带状疱疹后遗神经痛短期疗效观察

Clinical observation on radiant shock wave in the treatment of postherpetic neuralgia

目的观察体外发散式冲击波治疗带状疱疹后遗神经痛的临床疗效。方法采用MP100型体外冲击波治疗系统治疗26例带状疱疹后遗神经痛患者,采用视觉模拟评分(VAS)和神经病理性疼痛量表(NPS)评价治疗前、治疗第2次时、治疗第1和第2个疗程时的临床效果。结果 26例患者中2例因治疗不便、2例因疗效欠佳而改用其他方法,其余22例均完成冲击波治疗。第1疗程结束时,疼痛症状不同程度缓解,VAS和NPS评分分别由治疗前的(8.41±1.11)和(1.88±0.59)分降至(6.15±1.23)和(1.38±0.60)分,治疗前后差异具有统计学意义(均P=0.000);第2疗程结束时,疼痛症状显著缓解,VAS和NPS评分持续下降,分别为(3.57±1.30)和(1.04±0.31)分,差异亦有统计学意义(均P=0.000)。结论体外发散式冲击波治疗可显著改善带状疱疹后遗神经痛患者的疼痛症状,是一种带状疱疹后遗神经痛保守治疗的有效方法。

Objective To evaluate the effect of radiant shock wave therapy(RSWT) on postherpetic neuralgia. Methods Twenty.six cases of postherpetic neuralgia were treated with RSWT around the pain point. Before and after the treatment, Visual Analogue Scale(VAS) and Neuropathic Pain Scale(NPS) were used to assess the therapeutic efficacy. Results Twenty.two cases completed RSWT. Two patients who were inconvenient to the clinic and another 2 patients attributed to poor curative effect were transfered to other treatments. After one course of treatment, 22 patients all presented obvious pain relief. The VAS and NPS scores reduced from 8.41 ± 1.11 and 1.88 ± 0.59 to 6.15 ± 1.23 and 1.38 ± 0.60 respectively, and the differences were statistically significant(P = 0.000, for all). After completing two courses of treatment, VAS score reduced to 3.57 ± 1.30 and NPS score reduced to 1.04 ± 0.31 in comparison with pre.treatment, and both of the differences were statistically significant(P = 0.000, for all). Conclusion Radiant shock wave therapy may alleviate the pain of patients with postherpetic neuralgia, which is a valuable method for conservative treatment of postherpetic neuralgia.