眶上神经脉冲射频联合神经阻滞治疗带状疱疹后神经痛的疗效及对疼痛缓解的影响

Efficacy of supraorbital nerve pulsed radiofrequency combined with nerve block in treating postherpetic neuralgia and its impact on pain relief

摘要:

目的 探讨眶上神经脉冲射频联合神经阻滞治疗带状疱疹后神经痛的临床疗效及对疼痛缓解的影响。方法 选取2021年3月—2024年3月凉山彝族自治州中西医结合医院接收的92例带状疱疹后神经痛患者作为研究对象。通过随机数字表法将患者分为对照组（神经阻滞治疗）和观察组（在对照组基础上使用眶上神经脉冲射频），每组46例。比较两组患者临床疗效、疼痛程度［带状疱疹简明疼痛评估量表（ZBPI）评分、视觉模拟评分法（VAS）］、血清学指标［血清物质P（SP）、β-内啡肽（β-EP）、高迁移率族蛋白B1（HMGB1）、白细胞介素-1β（IL-1β）、白细胞介素-6（IL-6）、神经肽Y（NPY）及降钙素基因相关肽（CGRP）］，以及不良反应的发生情况。结果 观察组总有效率高于对照组（P <0.05）。观察组治疗前后ZBPI评分、VAS评分差值均大于对照组（P <0.05）。观察组治疗前后SP下降幅度及β-EP升高幅度均大于对照组（P <0.05）。观察组治疗前后HMGB1、IL-1β及IL-6水平均下降幅度均大于对照组（P <0.05）。观察组治疗前后NPY下降幅度及CGRP升高幅度均大于对照组（P <0.05）。观察组与对照组不良反应总发生率比较，差异无统计学意义（P >0.05）。结论 眶上神经脉冲射频联合神经阻滞可显著缓解带状疱疹后神经痛患者的疼痛，促进神经功能恢复，降低炎症反应，治疗安全，有利于临床推广应用。

Abstract:

Objective To investigate the clinical efficacy of supraorbital nerve pulsed radiofrequency combined with nerve block in treating postherpetic neuralgia and its impact on pain relief.Methods From March 2021 to March 2024, 92 patients with postherpetic neuralgia treated at our hospital were enrolled as study subjects. Using a random number table method, they were divided into a control group (n = 46, receiving nerve block therapy) and an observation group (n = 46, receiving supraorbital nerve pulsed radiofrequency in addition to nerve block). Clinical efficacy, pain levels [assessed by the Zoster Brief Pain Inventory (ZBPI) and Visual Analog Scale (VAS) ], serological indicators [serum substance P (SP), β-endorphin (β-EP), high mobility group box 1 (HMGB1), interleukin-1β (IL-1β), interleukin-6 (IL-6), neuropeptide Y (NPY), and calcitonin gene-related peptide (CGRP) ], and adverse reactions were compared between the two groups.Results The total effective rate in the observation group was higher than that in the control group (P < 0.05). The differences in ZBPI and VAS scores before and after treatment were greater in the observation group than in the control group (P < 0.05). The decrease in SP and the increase in β-EP from before to after treatment were more pronounced in the observation group (P < 0.05). The reductions in HMGB1, IL-1β, and IL-6 from before to after treatment were greater in the observation group than in the control group (P < 0.05). The decrease in NPY and the increase in CGRP from before to after treatment were also more significant in the observation group (P < 0.05). No significant difference was observed in the total incidence of adverse events between the two groups (P > 0.05).Conclusion The combination of supraorbital nerve pulsed radiofrequency and nerve block therapy exhibits significant efficacy in mitigating pain intensity in postherpetic neuralgia patients, enhances the recovery of neural function, attenuates inflammatory responses, and maintains a favorable safety profile, thereby proving suitable for clinical implementation.