脉冲射频联合普瑞巴林治疗带状疱疹后神经痛的疗效及对血清炎症因子和免疫水平的影响*

Efficacy of pulsed radiofrequency combined with pregabalin in the treatment of postherpetic neuralgia and its effects on serum inflammatory factors and immune levels

摘要:

目的?探讨脉冲射频联合普瑞巴林治疗带状疱疹后神经痛（PHN）的疗效及对血清炎症因子和免疫水平的影响。方法?选取2019年1月—2020年1月辽宁省人民医院收治的PHN患者100例为研究对象，随机分为观察组（脉冲射频联合普瑞巴林治疗）和对照组（脉冲射频治疗），每组50例。采用视觉模拟评分法（VAS）和匹兹堡睡眠质量评分法（PSQI）评价两组治疗前后疼痛程度和睡眠质量。采用酶联免疫吸附试验检测两组治疗前后血清疼痛介质指标（血清β-内啡肽、神经降压肽、降钙素基因相关肽、神经生长因子诱导蛋白）和血清炎症因子（肿瘤坏死因子-α、白细胞介素-6、白细胞介素-8和C反应蛋白）水平。采用液相免疫散射速率比浊法检测血清免疫球蛋白IgG、IgA、IgM及补体C3、C4水平。采用FACS Calibur流式细胞仪检测治疗前后CD3+、CD4+、CD8+和NK细胞水平，并依据数值计算CD4+/CD8+比值。结果?观察组治疗前后VAS、PSQI评分的差值高于对照组（P?<0.05）。观察组治疗前后血清疼痛介质指标、炎症因子、免疫球蛋白的差值高于对照组（P?<0.05）。观察组治疗前后CD3+、CD4+、CD4+/CD8+比值和NK细胞的差值高于对照组（P?<0.05）。结论?脉冲射频联合普瑞巴林治疗PHN可有效缓解患者疼痛，改善睡眠，减轻炎症反应，促进机体免疫功能恢复。

Abstract:

Objective To investigate the efficacy of pulsed radiofrequency combined with pregabalin in the treatment of postherpetic neuralgia and its effects on serum inflammatory factors and immune levels.?Methods?A total of 100 patients with postherpetic neuralgia admitted to our hospital from November 2019 to December 2020 were selected as the study subjects and randomly divided into the observation group (n?=?50 patients, pulsed radiofrequency combined with pregabalin therapy) and control group (n?=?50 patients, pulsed radiofrequency therapy). Visual Analogue Scale (VAS) and Pittsburgh Sleep Quality Index (PSQI) were used to evaluate the pain and sleep quality of the two groups before and after treatment. Levels of the serum pain mediators, including serum β-endorphin (β-EP), neurotensin (NT), calcitonin gene-related peptide (CGRP), and nerve growth factor inducible protein (VGF), as well as the levels of the serum inflammatory factors which included tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), interleukin-8 (IL-8) and C-reactive protein (CRP) of the two groups were measured by enzyme-linked immunosorbent assay (ELISA) before and after treatment. Serum levels of C3, C4, IgG, IgA and IgM were measured by immune scatter turbidimetry. The contents of CD3+, CD4+, and CD8+, as well as the levels of NK cells before and after treatment were measured by FACS Calibur flow cytometer, and the CD4+/CD8+ ratio was calculated based on the value.?Results?The differences in VAS and PSQI scores before and after treatment were higher in the observation group than those in the control group (P < 0.05). The differences in serum pain mediators, inflammatory factors and immunoglobulin before and after treatment in the observation group were also greater than those in the control group (P < 0.05). Additionally, the differences in levels of CD3+, CD4+, CD4+/CD8+ ratio and NK cells before and after treatment in the observation group were as well larger than those in the control group (P?