刺血拔罐联合CT引导下脉冲射频治疗带状疱疹后遗神经痛的疗效观察OA

Objective To observe the clinical efficacy of pricking-cupping bloodletting plus CT-guided pulsed radiofrequency for postherpetic neuralgia(PHN).Method One hundred PNH patients were randomized,using the envelope method,to pulsed radiofrequency and comprehensive groups,with 50 cases in each group.The pulsed radiofrequency group received treatment with CT-guided pulsed radiofrequency and the comprehensive group,pricking-cupping bloodletting in addition.Time for pain relief to begin,time for redness and swelling to subside,the Pittsburgh sleep quality index(PSQI)score,the pain visual analogue scale(VAS)score and the dermatology life quality index(DLQI)score were recorded and plasma levels of transient receptor potential cation channel subfamily V member 1(TRPV1),calcitonin gene related peptide(CGRP)and β-Endorphin(β-EP),venous blood TRPV1 mRNA and somatosensory evoked potential were measured in the two groups.The clinical therapeutic effect and the recurrence rate in the recovered patients were compared between the two groups.Result Time for pain relief to begin and time for redness and swelling to subside were shorter in the comprehensive group than in the pulsed radiofrequency group(P＜0.05).After treatment,the VAS,PSQI and DLQI scores decreased in the two groups compared with before(P＜0.05)and were lower in the comprehensive group than in the pulsed radiofrequency group(P＜0.05).After treatment,plasma TRPV1 and venous blood TRPV1 mRNA decreased in the two groups compared with before(P＜0.05)and were lower in the comprehensive group than in the pulsed radiofrequency group(P＜0.05).After treatment,somatosensory evoked potential and plasma CGRP levels decreased in the two groups compared with before(P＜0.05)and were lower in the comprehensive group than in the pulsed radiofrequency group(P＜0.05).After treatment,plasma β-EP levels increased in the two groups compared with before(P＜0.05)and was higher in the comprehensive group than in the pulsed radiofrequency group(P＜0.05).The total efficacy rate was higher in the comprehensive group than in the pulsed radiofrequency group(P＜0.05).The recurrence rate had no statistically significant difference between the comprehensive and pulsed radiofrequency groups at three months after treatment(P＞0.05).The recurrence rate was lower in the comprehensive group than in the pulsed radiofrequency group at six months after treatment(P＜0.05).Conclusion Pricking-cupping bloodletting plus CT-guided pulsed radiofrequency is more effective in treating PHN.It can relieve the pain,improve sleep and reduce the recurrence.