Evaluation Of The Effect Of Paravertebral Injection With Adriamycin And The Measurement Of Area By Software In Treating The PHN

Adriamycin, a broad-spectrum anthracycline antibiotic andanticancer therapeutic agent, has obvious neurotoxic effect andautofluorescence。It can selective destroy the sensory ganglion cells byretrograd axonal transport, causing nerve cells degeneration. Using thechemo-ganglionectomy on the corresponding DRG can relieve thepatients suffering from the postherpetic neuralgia. In the clinical, VASis the most usually used method to evaluate the therapeutic effect. Thearea change of the painful affected dermatome before and after thetreatment is described accurately and objectively to reflect thecharacteristic of the disease and pain development.Objective: 1. To compare the clinical curative effect by using a lowdos of 1％ADM with the traditional method. 2. The software ofImage-Pro Plus Version 5.0.1 is introduced to evaluate the painful areas.The figure and evaluation of traditional VAS obtained could illustratethe degree of the pain relief and the characteristic of the diseasedevelopment.Method: Patients with PHN were diagnosed according to the clinical.And exclusion criteria were another painful condition as severe as thePHN and other serious systemic diseases. Then the patients weredivided into experiment group(25) and control group(25) randomly.So50 patients of both sex were enrolled in our study, at an age of26-78 years.Several segments of vertegrae paracentesis were decidedaccording to the nerve innervation of the pain area. With the guided ofthe video display, the transfixion pin was pricked into the foramenintervertebrale via posterior approach through the side vertebra.Connect the neurostimulation instrument,and the e current flow wassetted to 0.3mA.The frequency was setted at 1Hz. And then the areas offeeling painful and muscle contraction was induced. On each segment,0.5％LID 2ml is needed. If there is no spinal analgesia after five minutes observation, patients in the control group were injected withMP for 1ml/10mg, and patients in the experiment group were injectedwith MP for 1ml/10mg and 0.5％ADM for 1ml.The painful area was measured by Image-Pro Plus Version 5.0.1and the pain intensity was measured by visual analoguescales(VAS)VAS at 1,3,7,14,30 days. The detailed method of the areameasurement was as follows: A piece of transparent membrane s wassticked on the patients' painful dermatome,andthe pain rang was drawup on the transparent membrane. Then take a picture of the dermatomewhich was input into the computer later. The figure was dealed by thesoftware Image-Pro Plus Version 5.0.1 to obtain the specific numericaldata. In order to observe the therapeutic efficacy, patients in experimentgroup must receive the follow- up visit for half a year. Compared withthe two groups, the data is dealt with by SPSS11.0 and draw theconclusion, measurement data to accord with normal distribution isdemonstrated by x±s, statistical method use t test and homogeneity testfor variance test(F test)and q test. numeration data and ranked data aredemonstrated by ratio and make corresponding conclusion.Result: 1. On the first day, patients of the two groups felt that the painrelieve obviously and There was no difference on the score ofVAS(P＞0.05).However, on the third day, patients of control group feltthat the degree of pain increased and most of them said that the feelingwas the same as pretherapy. Therefore they were not satisfied with theresult and requested to be treated again. Compared with patients ofcontrol group, the suffering of operation group patients relievedobviously. As time longer, the patients felt better. Most of them weresatisfied with the treatment and there was obvious difference on thescore of VAS(P＜0.05) between the two groups.(ChartⅠ)2. Patients of the two group felt that the painful area was reducedobviously on the first day, and there is no obvious difference (P＞0.05).But from the beginning of the third day,there is obviousdifference(P＜0.05).Most of the patients of control group felt as painfulas pretherapy while the other group felt better. There is much obviousdifference (P＜0.05)between the two groups. Furthermore, differencewas also existed in the patients of experiment group.Compared to the 1stday,there's a difference on the 3rd,7th and 14th day(P＜0.01), but thereis no difference between the 14th day and the 30th day(P＞0.05). (ChartⅡ,Ⅲ,Ⅴ)3. After the operation,we follow-up the experiment group patients forhalf a year.During this period, three patients recurred for the secondinterventional therapy. The rate of this effect achieved to84%. (ChartⅣ)Conclusion: 1. Compared with the traditional method, thechemo-ganglionectomy has an advantages of good therapeutic effect,smaller wound and low recurrence rate.2. Both the area measurement and VAS can objectively reflect the couldillustrate the degree of the pain relief and the development of thedisease after the treatment.3. The combination of the figure measured by Image-Pro Plus Version5.0.1 and evaluation of traditional VAS can accurately illustrate thedegree of the pain relief and the characteristic of the disease changes.