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选择性神经根脉冲射频联合普瑞巴林治疗不宁腿综合征的临床疗效

The clinical efficacy of selective nerve root pulsed radiofrequency combined with pregabalin in the treatment of restless legs syndrome

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【作者】 朱谦赵晶苗羽沙萌闫龙涛申思敏樊碧发

【Author】 ZHU Qian;ZHAO Jing;MIAO Yu;SHA Meng;YAN Longtao;SHEN Simin;FAN Bifa;Peking Union Medical College,Chinese Academy of Medical Sciences;Department of Pain Medicine China-Japan Friendship Hospital;Department of Anesthesia,China-Japan Friendship Hospital;Department of pain Medicine,Gaoyang County Hospital;Department of Pain Medicine,The First Affiliated Hospital of Kunming Medical University;

【通讯作者】 樊碧发;

【机构】 北京协和医学院中国医学科学院中日友好医院疼痛科中日友好医院麻醉科河北省保定市高阳县医院疼痛科昆明医科大学第一附属医院疼痛科

【摘要】 目的:观察选择性神经根脉冲射频术联合普瑞巴林治疗不宁腿综合征(restless legs syndrome,RLS)的临床疗效及安全性。方法:收集中日友好医院2019年1月1日至2021年6月30日间RLS病人51例,按照治疗方式不同分为三组:普拉克索(PRA)组19例,普瑞巴林(PRE)组17例及联合治疗(COM)组15例。PRA组给予口服普拉克索每日0.125 mg,PRE组给予口服普瑞巴林每日300 mg;COM组给予普瑞巴林每日150 mg,并对责任神经根行脉冲射频治疗。收集治疗前及治疗后7天国际RLS研究小组严重程度评分(International RLS Study Group rating scale, IRLS)、不适程度数字评分法(numerical rating scale, NRS)评分、入睡质量评分、助眠药物使用情况的变化及各组病人并发症和不良反应的发生率。结果:治疗后三组病人IRLS和NRS评分及助眠药物使用率均较治疗前显著降低,入睡质量评分升高。COM组的IRLS和NRS评分下降最为明显(P <0.01)、助眠药物使用率最低(P <0.01)。PRA组主要的不良反应为头痛和恶心,PRE组和COM组主要的不良反应为头晕和恶心,未出现围术期并发症。PRE组恶心与嗜睡最为明显(P <0.05),COM组的头晕和恶心的发生率最低(P <0.05)。结论:选择性神经根脉冲射频术联合普瑞巴林治疗RLS的临床疗效良好,可明显改善病人不适症状,从而改善入睡质量且安全性良好。

【Abstract】 Objective: To observe the clinical efficacy and safety of selective nerve root pulsed radiofrequency combined with pregabalin in the treatment of restless legs syndrome(RLS). Methods: Fifty-one patients with RLS from January 1, 2019 to June 30, 2021 were collected and divided into three groups according to the treatment: Pramipexole group(group PRA, n = 19); Pregabalin group(group PRE, n = 17) and combined treatment with group(group COM, n = 15). Group PRA was given with pramipexole 0.125 mg/day, group PRE was given pregabalin 300 mg/day; group COM was given with pregabalin 150 mg/day, combined with selective nerve root pulsed radiofrequency. The changes of international RLS study group rating scale(IRLS),numerical rating scales(NRS) of discomfort, sleep quality score and the use of sleeping drugs before and 7 days after treatment were recorded, and the frequencies of complications and adverse reactions were recorded. Results:The IRLS score, NRS score and the use rate of sleeping drugs in the three groups decreased significantly after treatment compared with before treatment, and the sleep quality score was increased significantly after treatment compared with before treatment. Among the three groups, the decrease of the IRLS score and NRS score was most obvious in the group COM(P < 0.01), and the use rate of sleeping drugs in the group COM was also the lowest(P < 0.01). The major adverse reactions in group PRA were headache and nausea. The major adverse reactions in group PRE and group COM were dizziness and nausea. Among them, nausea and somnolence in group PRE was the most obvious(P < 0.05), and the incidence of dizziness and nausea in group COM was the lowest(P < 0.05).Conclusion: Selective nerve root pulsed radiofrequency combined with pregabalin can rapidly alleviate discomfort,enhance patients’ quality of sleep, and has good safety, which was effective in treatment of RLS.

【基金】 国家临床重点专科建设项目资助(2014-zdzk-002)
  • 【文献出处】 中国疼痛医学杂志 ,Chinese Journal of Pain Medicine , 编辑部邮箱 ,2021年11期
  • 【分类号】R741
  • 【被引频次】2
  • 【下载频次】136
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