Clinical Study Of Combined Stellate Ganglion Block In The Treatment Of Craniofacial Acute Herpes Zoster

Objective: The objective of this research is to investigate the effectiveness and safety of the treatment of craniofacial acute herpes zoster(HZ)through ultrasound-guided stellate ganglion block combined with pregabalin,whose influence on Interleukin-6(IL-6)and C-Reactive Protein(CRP),the prevention against post-herpetic neuralgia(PHN)are also studied in this research.Meanwhile,this research wishes to provide reference for clinical combination treatment of herpes zoster.Methods: Based on the random number table,68 craniofacial acute herpes zoster patients are divided into two groups,i.e.,group P(n=34)and group S(n=34).All patients are treated with valaciclovir for antiviral therapy.Patients in group P are treated with pregabalin 150mg/ twice a day.When the visual analogue score(VAS)is less than 3,i.e.,VAS≤3,75 mg pregabalin is reduced every other day.On the basis of the treatment plan of group P,patients in group S are treated with 4ml 0.2% ropivacaine for ipsilateral ultrasound-guided stellate ganglion block(US-guided SGB)with 3 times per week for a total of 3 times.After the treatment,if VAS≥4,patients in both groups are treated with tramadol hydrochloride sustained-release tablets.The characteristics of herpes,the duration of pain,and the changes of VAS,Pittsburgh sleep quality index(PSQI),and EQ-visual analogue score(EQ-VAS)are recorded before and after treatment.Blood samples are taken before and after treatment to detect the levels of IL-6 and CRP.The use of analgesics(pregabalin and tramadol hydrochloride sustained-release tablets),the incidence of acute herpetic neuralgia(AHN),subacute herpetic neuralgia(SHN),and post-herpetic neuralgia(PHN),and the occurrence of adverse reactions are recorded after the treatment.Results: Compared with group P,the stopping blister time,the 50% scab formation time,the ulcer healing time,and the pain duration in group S are significantly shorter than those in group P(P<0.05),and the amount of analgesics is significantly reduced(P<0.05).The VAS score,PSQI score,and EQ-VAS score in both groups decrease compared with those before treatment(P<0.05),but the decreasing in group S is more significant than that in group P(P<0.05).The quality of sleep and life is significantly improved.After treatment,the levels of serum inflammatory factors IL-6 and CRP in both groups decrease significantly(P<0.05),but the decreasing in group S is more significant than that in group P(P<0.05).Compared with group P,the incidence of AHN,SHN,and PHN in group S is significantly lower than that in group P(P<0.05).There are no serious adverse reactions in both groups during the study period(P>0.05).Conclusion: The effectiveness of ultrasound-guided stellate ganglion block combined with pregabalin in the treatment of craniofacial acute herpes zoster is better than the treatment with pregabalin alone.Combined therapy can accelerate the healing process of herpes,reduce pain intensity,shorten pain time,reduce analgesics use,improve the quality of sleep and life,reduce acute inflammatory reaction,and reduce the incidence of PHN.This conclusion provides a clinical basis for combined therapy.