| BackgroundHerpes zoster(HZ)usually occurs in the old and infirm with weakened defenses against diseases.After the healing of HZ rash,it is easy to giving patients refractory pain and sequelae that is postherpetic neuralgia(PHN).Patients with PHN suffer from this symptom for many years.Many of them are incapable of dressing,sleeping and other daily activities and are accompanied by severe anxiety and depression.Therefore,the research on the treatment of PHN has important clinical significance to benefit people.Pulsed radiofrequency(PRF)is a kind of neuromodulatory technology that applys electric impulses to stimulating nerves that produce pain,which can be used for the treatment of chronic pain caused by neuropathy.Compared with traditional therapeutic measures,PRF has unique advantages of less trauma,higher safety and better efficacy.In this study,Dorsal root ganglion(DRG)PRF was compared with the traditional thoracic paravertebral nerve block to observe and analyze the advantages and efficacy of the two treatment methods.It is hoped that it can relieve pain for patients with this kind of chronic neuropathic pain and provide a basis for new clinical treatment.ObjectvieTo observe and compare the safety and clinical effects of DRG-PRF combined with peripheral nerve block and paravertebral nerve block combined with other peripheral nerve block in the treatment of PHN,and to analyze the advantages of the two therapies.MethodsAccording to the admission time and the treatment method,60 patients with the chest or back PHN in the Department of Pain of Shandong Provincial Hospital from January 2016 to March 2018 were selected.Thirty PHN patients treated by DRG-PRF combined with peripheral nerve block therapy was enrolled as the treatment group.Thirty PHN patients that received paravertebral nerve block combined with other peripheral nerve block therapy were treated as the control group.The Numeric At the time of admission,discharge,and half a year after discharge,Rating scales scorese(NRS),the total daily oral gabapentin dose,the number of people taking other oral analgesics,the allodynia change,the sleep status,remission rate(RR)and postoperative complications were recorded.Multivariate ordered logistic regression analysis was performed on the factors that may affect the pain relief rate,such as treatment,gender,duration of disease,NRS at admission,diabetes and hypertension.Resu tsThere were no significant differences in gender,age,duration of disease,NRS scores,and number of involved nerve segments between the two groups(P>0.05).The NRS scores of both groups decreased at the time of discharge and half a year after discharge.The NRS scores of the treatment group was significantly lower than that of the control group,and the difference was statistically significant(P<0.05).The total remission rate of the treatment group was significantly higher than that of the control group,and the difference was statistically significant(P<0.05).The total daily oral gabapentin dose decreased half a year after discharge,and the total daily oral gabapentin dose of the treatment group decreased significantly compared with the control group at the time of half a year after discharge,the difference was statistically significant(P<0.05);The NRS scores of the allodynia in the treatment group and the control group were decreased at the time of discharge and half a year after discharge.There was no significant difference in the NRS scores of the allodynia between the treatment group and the control group at the time of half a year after discharge.The quality of sleep in the treatment group and the control group were improved,but the difference between the two groups was statistically significant(P<0.05).After treatment,the number of patients taking other analgesics was significantly reduced.The number of oral administration of analgesics in the treatment group was significantly lower than that in the control group(P<0.05).There were no complications such as local anesthetic poisoning,infection,dyspnea,nausea,vomiting,pneumothorax and spinal cord injury.Logistic regression analysis found that the significant factor affecting the PHN pain remission rate is the treatment.Conclusions1.DRG-PRF combined with peripheral nerve block and paravertebral nerve block combined with other peripheral nerve block have therapeutic effects on PHN patients,but DRG-PRF combined with peripheral nerve block is better than paravertebral nerve block combined with other peripheral nerve block in treatment effect and its treatment effect maintains obviously longer.2.The treatment methods of the two groups have high security,and there were no complications such as local anesthetic intoxication,infection,dyspnea,nausea and vomiting,pneumothorax and spinal cord injury.3.Efficacy is mainly related to the choice of treatment methods;Gender,age,duration of the disease,initial pain degree,high blood pressure,and diabetes are not factors that affect the remission rate of the patients. |
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