摘要：

目的 探讨针刺触发点治疗、硬膜外神经阻滞术和选择性背根神经节脉冲射频术3 种方法治疗带状疱疹后神经痛的临床疗效。方法 共60 例带状疱疹后神经痛患者随机分为3 组，分别予针刺触发点治疗（20 例）、硬膜外神经阻滞术（20 例）和选择性背根神经节脉冲射频术（20 例），治疗后均服用加巴喷丁，分别于治疗前和治疗后2、4、12 周采用数字评价量表（NRS）评价疼痛程度。结果 与治疗前相比，3 组患者治疗后2、4 和12 周NRS 评分均降低（均P = 0.000）。治疗后2 周，神经阻滞术组和脉冲射频术组NRS 评分均低于针刺触发点组（P = 0.013，0.000），脉冲射频术组NRS 评分亦低于神经阻滞术（P = 0.000）；至治疗后4 和12 周，脉冲射频术组NRS 评分仍低于针刺触发点组（P = 0.000，0.000）和神经阻滞术组（P = 0.000，0.000）。结论 选择性背根神经节脉冲射频术治疗带状疱疹后神经痛效果最佳，可以迅速缓解疼痛，改善患者工作和生活质量。

关键词: 神经痛, 带状疱疹后, 针刺镇痛, 神经传导阻滞, 脉冲射频（非MeSH 词）

Abstract:

Objective  To observe the clinical efficacy of acupuncture trigger point, nerve block and pulse radiofrequency in the treatment of postherpetic neuralgia (PHN). Methods  A total of 60 cases with PHN were randomly divided into 3 groups: acupuncture trigger point therapy (group A, N = 20), epidural nerve block (group B, N = 20) and selective dorsal root ganglion (DRG) pulse radiofrequency (group C, N = 20). All patients in 3 groups took gabapentin orally at the same time after treatment. Numerical Rating Scale (NRS) was used to record the degree of pain in 3 groups before and after treatment (2, 4 and 12 weeks after operation).  Results  Compared with before treatment, NRS scores in 3 groups were significanthly decreased at 2, 4 and 12 weeks after operation (P = 0.000, for all). There was no significant difference on NRS scores among 3 groups before treatment (P > 0.05, for all). Two weeks after operation, NRS scores in group B and C were significantly lower than that in group A (P = 0.013, 0.000), and NRS score in group C was significantly lower than that in group B (P = 0.000). Up to 4 and 12 weeks after operation, NRS score in group C was significantly lower than that in group A (P = 0.000, 0.000) and B (P = 0.000, 0.000), while there was no significant difference on NRS scores between group A and B (P > 0.05).  Conclusions  Selective dorsal root ganglion pulse radiofrequency is effective in the treatment of PHN, which can relieve the pain quickly and improve the work and life quality of patients.

Key words: