脉冲射频联合富血小板血浆治疗老年带状疱疹的临床研究

Clinical efficacy of pulsed radiofrequency combined with platelet-rich plasma in elderly patients with herpes zoster

摘要:

目的 观察超声引导下胸椎旁脉冲射频联合富血小板血浆（PRP）注射治疗老年胸段急性期带状疱疹性神经痛的临床疗效。方法 选取2019年1月—2020年6月在秦皇岛市第一医院住院治疗的80例老年胸段急性期带状疱疹性神经痛患者，随机分为实验组和对照组，每组40例。两组均接受相同的基础药物和超声引导下胸椎旁脉冲射频治疗，实验组、对照组分别联合PRP注射、神经阻滞治疗。记录两组治疗前后疼痛数字评分法（NRS）和匹兹堡睡眠质量指数（PSQI）评分；出院后普瑞巴林服用情况、皮损愈合时间及带状疱疹后神经痛（PHN）发生率。结果 实验组与对照组治疗前和治疗后1周、1个月、2个月、3个月的NRS评分和PSQI评分在不同时间、不同组间及变化趋势上比较，差异有统计学意义（P <0.05）。实验组普瑞巴林使用量和使用时间、皮损愈合时间及PHN发生率均低于对照组（P <0.05）。两组不良反应总发生率比较，差异无统计学意义（P >0.05）。结论 超声引导下胸椎旁脉冲射频联合PRP注射能有效缓解老年急性期带状疱疹性神经痛，同时可以促进带状疱疹皮损愈合，降低PHN发生率。

Abstract:

Objective To investigate the efficacy of ultrasound-guided pulsed radiofrequency on thoracic paravertebral nerve combined with platelet-rich plasma (PRP) for the treatment of acute thoracic herpetic neuralgia in the elderly patients.Methods A total of 80 elderly patients with acute thoracic herpetic neuralgia admitted to our hospital from January 2019 to June 2020 were selected and randomly divided into the test group (group P) and the control group (group N) with 40 cases in each group. On the basis of drug treatment and ultrasound-guided pulsed radiofrequency on thoracic paravertebral nerve, patients in group P were injected with PRP, and patients in group N were treated with nerve block. The numerical rating scale (NRS) and Pittsburgh sleep quality index (PSQI) scores before and after the treatment, the consumption of gabapentin, the healing time of the skin lesions and incidence of postherpetic neuralgia (PHN) were recorded.Results The NRS and PSQI scores significantly differed at different time points (before and 1 week, 1 month, 2 months and 3 months after the treatments) and between group P and N, with distinct change trends (P < 0.05). The dosage of pregabalin and the incidence of PHN were lower, while duration of pregabalin use, and the healing time of skin lesions were short in group P compared with group N (P < 0.05). There was no significant difference in the overall incidence of adverse reactions between the two groups (P > 0.05).Conclusions Ultrasound-guided pulsed radiofrequency on thoracic paravertebral nerve combined with PRP is a safe and effective treatment modality in alleviating acute herpetic neuralgia of the elderly, facilitating the healing of skin lesions and lowering the incidence of PHN.