脊神经背根脉冲射频联合硬膜外神经阻滞治疗带状疱疹后神经痛的临床观察

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目的:采用新型微创脊神经背根脉冲射频联合硬膜外神经阻滞治疗带状疱疹后神经痛,探讨两种方法结合治疗带状疱疹后神经痛的临床疗效,观测它和生活质量之间关系,从而为PHN治疗提供借。方法以泸州医学院附属中医院疼痛科2011年12月~2012年12月符合标准的带状疱疹后神经痛患者60例作为研究对象。并随机将其划分成硬膜外神经阻滞复合加巴喷丁和硬膜外神经阻滞复合加巴喷丁+脊神经背根脉冲射频组。进行五次A、B两组患者的视觉模拟评分,自评抑郁量表以及焦虑自评量表评分。结果①VAS评分、抑郁评分院与T0比较,A组和B组T1~T4时VAS评分、抑郁评分显著降低。和A组相比,B组T1~T4各时点VAS评分、抑郁评分显著降低。②焦虑评分院与T0比较,A组和B组T1~T4时焦虑评分显著降低;与A组比较,B组T2~T4各时点焦虑评分显著降低。结论①两种方案治疗PHN均有效,但联合脊神经背根脉冲射频疗效更好。②PHN患者的抑郁和焦虑评分随着疼痛的缓解降低。“,”Objective A new minimally invasive dorsal root pulsed radiofrequency treatment combined with epidural nerve block postherpetic neuralgia, explore the relationship between clinical efficacy neuralgia, observing that the two methods and quality of life after combined treatment of herpes zoster , by providing for the treatment of PHN. Methods Affiliated Hospital of Luzhou Pain in December 2011 - after the period December 2012-compliant herpetic neuralgia 60 patients for the study. And randomly divided into epidural nerve block combined gabapentin (A group, n=30) and epidural nerve block combined gabapentin+dorsal root pulsed radiofrequency (group B, n=30). Five times A, B groups were visual analog scale, self-rating depression scale and self-rating anxiety scale score. Results ①VAS score, depression score: Compared with T0, A group A and group B T1-T4 when the VAS score, depression scores were significantly reduced. And A group compared to group B T1-T4 VAS scores at each time point and depression scores were significantly reduced. ②Anxiety Rating: Compared with T0, A group A and group B T1-T4 anxiety scores were significantly reduced; compared with group A, group B T2-T4 time points anxiety scores were significantly reduced. Conclusion ①The treatment of PHN two options are valid, but the joint dorsal root pulsed radiofrequency than single use of epidural nerve block combined with better efficacy of gabapentin therapy can significantly improve the quality of life of patients. ②PHN patients with depression and anxiety scores as pain relief is reduced.
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