Clinical Observation Of CT-guided Pulsed Radiofrequency In The Dorsal Root Ganglion Combined With Platelet-rich Plasma For PHN

Objective:To observe the clinical efficacy of CT guided pulsed radiofrequency in the treatment of post herpetic neuralgia in the dorsal root ganglion(DRG)combined with platelet-rich plasma.Methods:A total of 60 patients with postherpetic neuralgia who were hospitalized in the pain department of our hospital from September 2021 to September 2022 were randomly divided into a pulsed radio frequency combined with hormone group and a pulsed radio frequency combined with PRP group,with 30 patients in each group.The pain visual analogue score(VAS),Pittsburgh sleep quality score(PSQI),and the average temperature difference(?T℃)between the lesion area and the corresponding contralateral skin area on infrared thermography(ITI)were observed before and 1d,2w,4w,and 3 months after surgery in both groups,as well as the presence or absence of complications.Results:1."The portion of the patient’s general data that conforms to a normal distribution is expressed as a mean±standard deviation.Two independent sample t-tests are used for inter group comparisons.The remaining general data are counted data,expressed as a percentage.The?~2test is used for inter group comparisons.The preoperative and postoperative VAS scores,PSQI scores,and?T℃data of the two groups are all non normal distributions,expressed as a median(interquartile interval)[M(IQR)],"Non parametric rank sum test was used for inter group comparison,and Friedman rank sum test was used for intra group comparison.2.There was no statistically significant difference in the preoperative general condition of the two groups of patients(P>0.05).There was no statistically significant difference in preoperative VAS scores between the two groups(Z=-0.853,P=-0.394);There was no statistically significant difference in preoperative PSQI scores between the two groups(Z=-2.74,P=-0.784).3.VAS scores and PSQI scores of 1 day,2w,4w and 3 months after surgery were lower than those before surgery,with statistical significance(P<0.05).Comparison between the two groups showed no statistical significance in VAS scores at 1,2 and 4weeks after surgery(1 day,Z=-1.612,P=0.107;2w,Z=-1.651,P=0.099;4w,Z=-1.833,P=0.067);The VAS score at 3 months after surgery was statistically significant(Z=-2.556,P=0.011).There was no significant difference in PSQI scores at 1d,2w and4w after surgery(1d,Z=-1.955,P=0.051;2w,Z=-1.558,P=0.119;4w,Z=-0.611,P=0.541);The difference of PSQI score 3 months after surgery was statistically significant(Z=-2.084,P=0.037).4.There was no statistically significant difference in?T℃between the hormone group and the PRP group on the 1st day after surgery(Z=-3.77,P=-0.054);There was no statistically significant difference in?T℃between the hormone group and the PRP group 2 weeks after surgery(Z=-2.093,P=-0.056);The difference in?T℃between the hormone group and the PRP group at 4 weeks after surgery was statistically significant(Z=-4.628,P=-0.000);The difference in?T℃between the hormone group and the PRP group at 3 months after surgery was statistically significant(Z=-2.848,P=-0.004)Conclusion:CT guided pulsed radio frequency combined with hormone and platelet rich plasma injection can effectively treat post herpetic neuralgia,and the efficacy of pulsed radio frequency combined with platelet rich plasma is longer than that of traditional pulsed radio frequency combined with hormone.