| Objective:To evaluate the clinical efficacy and prognostic factors associated with ultrasound-guided high-voltage pulsed radiofrequency(PRF)in the dorsal root ganglion(DRG)combined with ozone injection versus ozone injection alone in the treatment of postherpetic neuralgia(PHN),and to provide a basis for the treatment of PHN in clinical practice.Methods:One hundred and nineteen patients with PHN were assigned into two groups: ozone therapy alone(Group A,n = 59)and combination therapy with PRF and ozone(Group B,n = 60).In group A,only the ozonated water was injected in DRG.In Group B,the PRF was applied to the target dorsal root ganglions(DRG).Then the ozonated water(11.5 μg/ml)was injectedthrough the inner cannula.The effect of treatment was assessed at the pre-treatment and 5 days post-treatment by visual analogue scale(VAS),mechanical pain threshold,pittsburgh sleep quality index(PSQI),hamilton depression scale-24(HAMD)Treatment effects were assessed.The treatment effects were assessed by VAS scores,PSQI,and HAMD at the 1,3,and 6 months after treatment during the follow-up period.The difference was considered statistically significant at P < 0.05.Results:1.VAS score: Compared with before treatment,the VAS score of both groups at different time points was significantly reduced,and compared with group A,the VAS score of group B was significantly reduced on day 5,January,March,and June,and the difference was statistically significant(P <0.05).2.Mechanical pain threshold: there was no significant difference in the pre-treatment difference between the two groups.Compared with the pre-treatment treatment,the von Frey measurement of the two groups was significantly reduced(P < 0.05),but there was no significant difference in the difference after treatment between the two groups(P > 0.05).3.PSQI value: before treatment,the difference between the two groups was not statistically significant,and the two groups after treatment were significantly reduced on the 5th day,January,March and 6 of the two groups.Compared with Group A,Group B’s PSQI score was significantly lower at 5days and 1 month after treatment(P < 0.05).4.HAMD value: The HAMD value was significantly reduced in both groups after treatment compared with before treatment.Compared with the time points after treatment in group A,the HAMD score of group B was significantly lower at 5 days and 6 months after treatment(P < 0.05).5.The total efficacy rate: At post-treament、1 month and 3 months,the total effective rate of group A was significantly lower than that of group B(P< 0.05).6.Group A: The results of univariate Logistic regression showed that the differences between the good prognosis group and the poor prognosis group were statistically significant(P < 0.05)for age,duration of disease,history of diabetes,and site of onset;The results of multivariate Logistic regression analysis showed that long duration of disease(OR: 1.059,95% CI0.994-1.128,P = 0.076)was an independent risk factor for poor prognosis at3 months and history of diabetes(OR: 16.392,95% CI 2.477-108.493,P =0.004)was an independent risk factor for poor prognosis at 1 month.Group B: the results of univariate Logistic regression showed that the difference between the good prognosis group and the poor prognosis group in terms of disease duration and site of onset was statistically significant(P < 0.05);The results of multivariate Logistic regression analysis showed that long disease duration(OR: 0.958,95% CI 0.928-0.989,P = 0.008)was an independent risk factor for poor prognosis at 1 month,and PHN of the lower extremity(OR:12.687,95% CI 1.214-132.615,P = 0.034)was an independent risk factor for poor prognosis at 6 months.Conclusions:High-voltage pulsed radiofrequency combined with ozone injection treatment and ozone injection treatment alone over a 6-month period significantly reduced pain and depression levels and improved sleep quality in patients with PHN.The treatment effect of the combined treatment group was superior in relieving pain,reducing depression level,and improving quality of life.The factors associated with the prognosis of the combined treatment group were long duration of disease and lower extremity PHN,and the factors associated with the prognosis of the ozone treatment group were long duration of disease and history of diabetes mellitus.Therefore,it is recommended to treat PHN as soon as it is diagnosed. |
