摘要
目的比较不同电脉冲密度脊髓电刺激(SCS)治疗带状疱疹后神经痛(PHN)的临床疗效。方法收集2017年8月至2018年12月,就诊于青岛市市立医院疼痛科的带状疱疹后神经痛患者30例,年龄50~70岁,性别不限,ASA分级为Ⅰ或Ⅱ级,视觉模拟评分(VAS)>7分。按随机数字表法将其随机分为传统脊髓电刺激组(CS组)、高电脉冲密度脊髓电刺激组(HD组)与低电脉冲密度脊髓电刺激组(LD组),每组10例。其中CS组在治疗过程中采用传统的治疗参数;HD组在治疗过程中采用高电脉冲密度,设定为10%~15%;LD组在治疗过程中,将电脉冲密度范围设定在相对较低的范围为4.8%~10%。记录3组患者治疗前及治疗后3 d、10 d、1个月、3个月和6个月时的简化麦吉尔(SF-MPQ)评分、疼痛警觉和意识问卷(PVAQ)评分、匹斯堡睡眠质量指数(PSQI)评分及VAS评分。结果与治疗前相比,3组患者SF-MPQ、PVAQ、PSQI与VAS评分治疗后均降低(P均<0.05);治疗后不同时点SF-MPQ评分比较,差异有统计学意义(F=473.430,P<0.05);3组间SF-MPQ评分比较,差异无统计学意义(F=1.285,P>0.05)。治疗后不同时点PVAQ评分比较,差异有统计学意义(F=738.401,P<0.05);3组间PVAQ评分比较,差异有统计学意义(F=11.449,P<0.05)。治疗后不同时点PSQI评分比较,差异有统计学意义(F=313.603,P<0.05);3组间PSQI评分比较,差异无统计学意义(F=3.363,P>0.05)。治疗后不同时点VAS评分比较,差异有统计学意义(F=279.450,P<0.05);3组间VAS评分比较,差异无统计学意义(F=0.945,P>0.05)。HD组患者的电极参数调整次数较LD和CS组低[(3.1±0.5)比(4.2±0.6)比(4.8±0.8)次/人,P均<0.05]。结论不同电脉冲密度均可有效缓解PHN临床症状,高电脉冲刺激可以更好地降低患者对疼痛异感的关注,并减少电极参数调整次数。
Objective To compare the efficacy of spinal cord stimulation(SCS)with different electric pulse density in the treatment of patients with postherpetic neuralgia(PHN).Methods Thirty patients with PHN,aged 50-70 years old,both sexes,ASAⅠorⅡ,visual analogue scale(VAS)>7,in Municipal Hospital of Qingdao from August 2017 to December 2018 were collected.All patients were randomly divided into three groups:conventional SCS group(group CS),high density electrical pulses SCS group(group HD)and low density of electrical pulses SCS group(group LD)according to random number table,10 cases in each group.Patients were received conventional SCS parameters in group CS.Patients were received high density electrical pulses(10%-15%)in group HD.Patients were received low density of electrical pulses(4.8%-10%)in group LD.Short-form McGill pain questionnaire(SF-MPQ),VAS,pain vigilance and awareness questionnaire(PVAQ)and Pittsburgh sleep quality index(PSQI)were used for evaluation of pain degree and sleep quality before the treatment and at 3 d,10 d,1 month,3 months and 6 months after the treatment.Results Compared with pretreatment,the SF-MPQ、PVAQ、PSQI and VAS were all decreased after the treatment(all P<0.05).There were significantly differences in SF-MPQ at each time point after the treatment(F=473.430,P<0.05);No difference was found in SF-MPQ among 3 groups(F=1.285,P>0.05).There were significantly differences in PVAQ at each time point after the treatment(F=738.401,P<0.05);There were significantly differences in PVAQ among 3 groups(F=11.449,P<0.05).There were significantly differences in PSQI at each time point after the treatment(F=313.603,P<0.05);No difference was found in PSQI among 3 groups(F=3.363,P>0.05).There were significantly differences in VAS at each time point after the treatment(F=279.450,P<0.05);No difference was found in PSQI among 3 groups(F=0.945,P>0.05).The times of electrode parameter regulation were higher in group HD than that in group LD and group CS[(3.1±0.5)vs.(4.2±0.6)vs.(4.8±0.8)times/case,all P<0.05].Conclusion The clinical symptoms of patients with PHN could be effectively relieved by SCS at different electric pulse densities,and the high density electrical pulses can reduce the patient's attention to allodynia,and reduce the times of electrode parameter regulation.
作者
王蕊
唐玉茹
高晓
于洋
陈付强
Wang Rui;Tang Yuru;Gao Xiao;Yu Yang;Chen Fuqiang(Department of Pain Management,Qingdao Municipal Hospital,Qingdao Pain Clinical Research and Treatment Center,Qingdao City,Shandong Province 266011,China;Qingdao Mental Health Center,Qingdao City,Shandong Province 266034,China)
出处
《中华疼痛学杂志》
2021年第2期166-172,共7页
Chinese Journal Of Painology
关键词
电刺激疗法
脊髓
电脉冲密度
神经痛
带状疱疹后
Electric stimulation therapy
Spinal cord
Duty cycle(frequency×pulse width)
Neuralgia,postherpetic
