CT引导下背根神经节脉冲射频联合亚甲蓝交感神经注射治疗带状疱疹后神经痛的疗效：一项回顾性研究
The Efficacy of CT-Guided Pulsed Radiofrequency of the Dorsal Root Ganglion Combined with Methylene Blue Sympathetic Injection on Herpes-Zoster Neuralgia: A Retrospective Study.
作者信息
Chen Jie, Deng Jiajia, Wang Ruxiang, Ma Ling
机构信息
General Surgery Department, The Second People's Hospital, Jia Shan County, Jiaxing, People's Republic of China.
Department of Anesthesiology and Pain Research Center, Affiliated Hospital of Jiaxing University, Jiaxing, People's Republic of China.
出版信息
J Pain Res. 2025 Jul 11;18:3551-3564. doi: 10.2147/JPR.S516413. eCollection 2025.
OBJECTIVE
This study aimed to investigate the efficacy of Computed Tomography (CT) Guided Pulsed Radiofrequency (PRF) of the Dorsal Root Ganglion (DRG) combined with Methylene Blue (MB) sympathetic injection in acute herpes zoster neuralgia.
BACKGROUND
MB is a nitric oxide synthesis inhibitor that has been reported to exert analgesic and anti-inflammatory properties. In this study, MB was injected to the thoracic or lumbar sympathetic nerve to inhibit sympathetic nerve conduction or destroy nerve endings. This is the first report for thoracic or lumbar sympathetic nerve MB injection.
MATERIALS AND METHODS
64 patients in study were divided into two groups: PRF combined with sympathetic nerves MB injection group (group A; n = 32,); PRF group (group B; n = 32). The therapeutic effects of each group were compared using the Numeric Rating Scale (NRS) scores and the average doses of Pregabalin (mg/d) immediately after surgery (T1) and at one month (T2), three months (T3), six months (T4), nine months (T5), and twelve months (T6) post-operation. The incidence of postherpetic neuralgia (PHN) and complications in the two groups were observed and enrolled.
RESULTS
No significant differences in general conditions between the two groups. Compared with the preoperative baseline scores (T0), the NRS at T1 to T6 were significantly decreased in both groups. NRS was lower at T1 to T6 in the group A compared with the same times points in group B (P< 0.05). The incidences of PHN in group A were significantly lower at T3 to T6 compared with group B. The daily doses of pregabalin was lower in the A group than B group at T1 to T5, and it was not significantly different at T6 between the two groups. Finally, no adverse complications were recorded in both groups.
CONCLUSION
CT-Guided PRF Combined with MB sympathetic Injection in the treatment of HZ neuralgia is safe and effective, reducing PHN.
目的
本研究旨在探讨计算机断层扫描（CT）引导下背根神经节（DRG）脉冲射频（PRF）联合亚甲蓝（MB）交感神经注射治疗急性带状疱疹神经痛的疗效。
背景
MB是一种一氧化氮合成抑制剂，据报道具有镇痛和抗炎特性。在本研究中，将MB注射到胸或腰交感神经以抑制交感神经传导或破坏神经末梢。这是首次关于胸或腰交感神经MB注射的报道。
材料与方法
64例研究对象分为两组：PRF联合交感神经MB注射组（A组；n = 32）；PRF组（B组；n = 32）。使用数字评分量表（NRS）评分以及术后即刻（T1）、术后1个月（T2）、3个月（T3）、6个月（T4）、9个月（T5）和12个月（T6）时加巴喷丁的平均剂量（mg/d）比较每组的治疗效果。观察并记录两组带状疱疹后神经痛（PHN）的发生率和并发症。
结果
两组一般情况无显著差异。与术前基线评分（T0）相比，两组T1至T6时的NRS均显著降低。A组T1至T6时的NRS低于B组相同时间点（P<0.05）。A组T3至T6时PHN的发生率显著低于B组。A组T1至T5时加巴喷丁的每日剂量低于B组，两组T6时无显著差异。最后，两组均未记录到不良并发症。
结论
CT引导下PRF联合MB交感神经注射治疗HZ神经痛安全有效，可降低PHN。
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