Effect Of Pulsed Radiofrequency On Plasma Cytokines And T Lymphocyte Subsets In Patients With Post-Herpetic Neuralgia

PART ONE Effects of Pulsed Radiofrequency in Combination of Nerve Blocked Drugs Therapy on Cytokines in Pos-therpetic Neuralgia Patients' PlasmaObjective To investigate the effects of pulsed radiofrequency(PRF)in combination with nerve blocked drugs therapy(NBT)on IL-6,substance P and P-endorphin in post-herpetic neuralgia patients' plasma.Methods 60 PHN patients were randomly divided into 4 groups(n=15 each):control therapy group(C group),nerve blocked drugs therapy group(TD group),pulsed radiofrequency group(RF group),and combined therapy group(RN group).After the admission,all patients completed routine examinations such as coagulation conventional examination,and treated by basic common drugs orally(gabapentin capsules 0.9g/d,tramadol Hcl sustain-released tablets 0.2g/d).C group received the conventional oral drugs,while TD group received the injection of mixed nerve block drugs(contained mecobalamin injection 1ml,betamethasone compound injection 1mg,extracts from rabbit skin inflamed by vaccine virus for injection 6ml,1%ropivacaine hydrochloride 2ml,0.9%physiological saline llml.)5ml.RF group received pulsed radiofrequency therapy(Baylis PM230,42?,120s,1min interv)3 times,while RN group received the mixed injection drug after radiofrequency therapy.The 4ml blood samples were collected from elbow vein at the admission and the 12h after operation.The plasma expressions of IL-6,substance P and ?-endorphin were measured by enzyme-linked immunosorbent assay(ELISA),while the other observations were recorded(the visual analog score of pain,VAS at rest and activity,the VAS score of pain induced by cotton swab,drugs and operation adverse reactions such as nausea,vomiting,pruritus astraction,puncture point swollen and bleeding).Results Compared with the admission,the VAS of all groups decreased(P<0.05),and those in group RN decreased the most.Compared with group C,the contents of IL-6,substance P in groups TD,RF and RN were lower(P<0.05),while the contents of ?-endorphin in groups TD,RF and RN were higher(P<0.05).Besides,there were no significant differences in drug and adverse reactions among all the groups(P>0.05).Conclusion Pulsed radiofrequency in combination with nerve blocked drugs therapy can effectively relieve the pain and hyperalgesia of PHN patients via increasing the contents of ?-endorphin and decreasing the contents of IL-6,substance P.PART TWO Effects of Nerve Pulsed Radiofrequency on T lymphocyte Subsets and Inflammatory Cytokine in Post-herpetic Neuralgia Patients'PlasmaObjective To investigate the effects of pulsed radiofrequency(PRF)on T lymphocyte subsets and inflammatory cytokine tumor necrosis factor a in post-herpetic neuralgia patients' plasma.Methods 30 PHN patients were randomly divided into two groups(n=15 each):control theraby py group(group C)and pulsed radiofrequency group(group RF).After admission,all patients were completed routine examinations such as coagulation conventional examination,and all were treated basic common drugs orally(gabapentin capsules 0.9g/d,tramadol Hcl sustain-released tablets 0.2g/d).C group received the conventional oral drugs,while RF group received pulsed radiofrequency therapy(Baylis PM230,42?,120s,1min interv)3 courses of treatments.The 2ml blood samples were collected from elbow vein at the admission,and the 12h after operation.The plasma expressions of TNF-a were measured by enzyme-linked immunosorbent assay(ELISA),while the other indicators were recorded(the visual analog score of pain VAS,at rest and activity,operation adverse reactions such as nausea,vomiting,pruritus ion,puncture point swollen and bleeding).2ml blood samples were collected from elbow vein at the time of admission and 7d after operation,and then flow cytometer was used to measure the T lymphocyte subsets(total T lymphocytes,Helper T cells,Cytotoxic T cells,CD4+/CD8+,B lymphocytes and NK cells).Results Compared with the admission,VAS scores and plasma TNF-? levels in the two groups were lower(P<0.05),and the RF group decreased obviously.Compared to the treatment at before,the proportion of NK cells in group C was higher than before.Compared to group C,the total T and Th cells in RF group were higher than before(P<0.05),while B cells and NK cells were lower than before(P<0.05);compared to the group C,total T cells and Th cells in RF group increased much more(P<0.05),and NK cells decreased more.There was no significant difference in adverse drug reactions between the two groups.Conclusion The function of T lymphocyte subsets in PHN patients is in disorder.Pulsed radiofrequency therapy can improve immune function by reducing B and NK cells,while increase the total T and Th cells.It can also effectively alleviate the pain in PHN patients by reducing the expression of TNF-? in plasma.