脊柱整复联合背根神经节脉冲射频治疗腰部急性带状疱疹的临床观察

目的探讨带状疱疹的发病机制，观察在脊柱整复的基础上联合背根神经节脉冲射频治疗腰部急性带状疱疹的临床疗效。方法将144例腰部带状疱疹急性期的患者随机分为4组：A组（n=36）为单纯口服药物治疗组，B组（n=36）为脊神经背根神经节脉冲射频联合口服药物治疗组，C组（n=36）为脊柱整复联合口服药物治疗组，D组（n=36）在脊柱整复基础上进行脊神经背根神经节脉冲射频治疗联合口服药物治疗。观察并比较4组术前、术后1周、4周、8周及12周的VAS评分情况、睡眠受疼痛影响程度及带状疱疹后遗神经痛的发病率。结果4组患者治疗后VAS评分较治疗前均明显下降（P<0.05）。治疗后的各时间点，B、C、D组患者的VAS评分及睡眠受疼痛影响程度与A组相比均有明显下降（P<0.05），其中C组和D组VAS评分下降更为显著（P<0.01）。曲马多缓释胶囊用量也随之明显减量，而且B、C、D组患者治疗后带状疱疹后遗神经痛的发病率显著下降（P<0.05）。结论采用脊柱整复联合背根神经节脉冲射频治疗腰部带状疱疹安全有效，不仅可迅速缓解患者神经痛症状，改善患者睡眠质量和生活质量，而且显著降低了带状疱疹后遗神经痛的发病率，是治疗带状疱疹的一种新的有效办法。

Clinical observation on the treatment of acute lumbar herpes zoster by chiropractic combined with pulsed radiofrequency ablation of dorsal root ganglion

ObjectiveTo investigate the pathogenesis of herpes zoster, observe the clinical effect of treating acute lumbar herpes zoster with pulsed radiofrequency ablation of dorsal root ganglion on the basis of chiropractic. Methods In this study, 144 patients of acute lumbar herpes zoster were randomly divided into 4 groups. Group A (n=36) was treated with oral medication alone, Group B (n=36) was treated by pulsed radiofrequency ablation of dorsal root ganglion combined with oral medication, Group C (n=36) was treated by chiropractic combined with oral medication, Group D (n=36) was treated by pulsed radiofrequency ablation of dorsal root ganglion combined with oral medication on the basis of chiropractic. VAS scores were observed before the treatment, and 1 week, 4 weeks, 8 weeks and 12 weeks after surgery. ResultsThe results showed that the VAS scores of the 4 groups after treatment were significantly reduced compared with those before treatment (P<0.05). At each time point after treatment, compared to Group A, VAS scores and sleep disturbance degreed in Group B, C and D were significantly lower (P<0.05); while VAS scores in Group C and D were significantly reduced more (P<0.01). Tramadol sustained-release capsule dosage also significantly reduced. Moreover, the incidences of postherpetic neuralgia in Group B, C and D were significantly reduced after treatment (P<0.05). ConclusionIt is safe and effective to treat acute lumbar herpes zoster with chiropractic combined with pulsed radiofrequency ablation of dorsal root ganglion. It can not only rapidly alleviate the symptoms of neuralgia, but also significantly improve the qualities of sleep and life of patients, and significantly reduce the incidence of postherpetic neuraligia.