背根神经节脉冲射频刺激联合普瑞巴林治疗对三叉神经痛的疗效及患者血清CGRP、5-HT水平的影响

Effect of pulsed radiofrequency stimulation of the dorsal root ganglion combined with pregabalin on trigeminal neuralgia and levels of patients’ serum CGRP and 5-HT

摘要:

目的：观察不同电压背根神经节脉冲射频术（primary trigeminal neuralgia，PRF）联合普瑞巴林治疗三叉神经痛的临床疗效及对患者血清降钙素基因相关肽（calcitonin gene related peptide，CGRP）、5-羟色胺（5-hydroxytryptamine，5-HT）水平的影响，为探讨其可能机制打下前期基础。方法：纳入90例原发性三叉神经痛患者，随机分为3组。对照组：口服普瑞巴林；标准电压组和高电压组：在口服普瑞巴林的基础上联合标准电压或高电压背根神经节PRF治疗。观察疼痛强度（pain intensity，PI）、生活满意度指数B（life satisfaction index B，LSI-B）评分、匹兹堡睡眠质量指数（Pittsburgh sleep quality index，PSQI）及患者血清CGRP、5-HT水平变化。结果：3组疼痛强度评分、睡眠质量总分、生活满意度指数、血清CGRP、5-HT水平均得到改善，高压PRF组改善幅度均明显优于其余2组（P<0.05）。结论：背根神经节PRF刺激联合普瑞巴林治疗对改善睡眠质量、提高生活质量、缓解患者疼痛症状和调节三叉神经痛发病相关的因子水平效果更佳。

Abstract:

Objective：To observe the clinical efficacy of pulsed radiofrequency（PRF） of the dorsal root ganglia at different voltage levels combined with pregabalin in the treatment of trigeminal neuralgia and its effects on serum levels of calcitonin gene-related peptide（CGRP） and 5-hydroxytryptamine（5-HT） in patients with trigeminal neuralgia，and to lay a primary foundation for exploring its possible mechanism. Methods：Ninety patients with primary trigeminal neuralgia were randomly divided into three groups. Con－trol group：oral pregabalin；standard-voltage and high-voltage PRF group：combined with standard-voltage or high-voltage PRF of the dorsal root ganglia in addition to oral pregabalin. Changes in pain intensity（PI），life satisfaction index B（LSI-B），Pittsburgh sleep quality index（PSQI），and patients’ serum levels of CGRP and 5-HT were evaluated. Results：PI score，total sleep quality score，LSI，and serum levels of CGRP and 5-HT were improved in all three groups，significantly greater in the high-voltage PRF group than in the other two groups（P<0.05）. Conclusion：PRF stimulation of the dorsal root ganglia combined with pregabalin is more effective in improving sleep quality and quality of life，relieving patients’ pain symptoms，and regulating the levels of factors related to the patho－genesis of trigeminal neuralgia.