Comparing the efficacy and safety of short-term spinal cord stimulation and pulsed radiofrequency for zoster-related pain: A systematic review and meta-analysis.
Comparing the efficacy and safety of short-term spinal cord stimulation and pulsed radiofrequency for zoster-related pain: A systematic review and meta-analysis.
复制标题
比较短期脊髓刺激和脉冲射频治疗带状疱疹相关疼痛的疗效和安全性：一项系统回顾和荟萃分析。
DOI：
10.1097/md.0000000000029073
复制
发表时间：
2022-03-18
期刊：
影响因子：
1.6
通讯作者：
Sun, Tao
中科院分区：
文献类型：
--
作者：
Xue, Song;Yang, Wen-jie;Cao, Zhen-xin;Sun, Tao
关键词：
脉冲射频（PRF）是临床上治疗带状疱疹相关疼痛的常用方法。但PRF治疗复发率高、不良反应多。最近的研究表明，短期脊髓刺激（stSCS）可以有效缓解带状疱疹相关的疼痛。由于缺乏证据，尚不清楚 stSCS 在治疗带状疱疹相关疼痛的疗效方面是否优于 PRF。本研究旨在比较 stSCS 和 PRF 对于带状疱疹相关疼痛的疗效和安全性。我们检索了从建库到2021年1月的7个电子数据库。本次荟萃分析纳入了相关随机对照试验。提取数据并评价纳入试验的方法学质量后，采用RevManV.5.3对结局指标进行统计分析。这项荟萃分析包括 6 项试验，总共 509 名患者。与 PRF 组相比，stSCS 组疼痛强度较低（标准化平均差=-0.83，95%CI [-1.37，-0.30]，P=.002），睡眠质量更好（平均差=-1.43，95%CI [-2.29，-0.57]，P=.001），疼痛评级指数较低，不良事件发生率较低（RR=0.32， 95% CI [0.12, 0.83], P<.05)。然而，PRF 和 stSCS 治疗带状疱疹后神经痛的疗效在缓解率（RR=1.10，95% CI [0.82，1.48]，P=.51）和完全缓解率（RR=1.05，95% CI [0.66，1.68]，P=.84）方面是一致的。本研究中，stSCS 比 PRF 表现出更好的镇痛效果和更高的安全性。我们的荟萃分析结果表明，stSCS 可能是治疗带状疱疹相关疼痛的一种可行且安全的侵入性治疗方法。然而，还需要高质量、大样本的随机对照试验来进一步验证我们的结论。
Pulsed radiofrequency (PRF) is a commonly used method for the treatment of zoster-related pain in the clinic. However, PRF therapy has a high recurrence rate and many adverse reactions. Recent studies have shown that short-term spinal cord stimulation (stSCS) can effectively alleviate zoster-related pain. Due to the lack of evidence, it is unclear whether stSCS is superior to PRF in the efficacy of treating zoster-related pain. This study aimed to compare the efficacy and safety of stSCS and PRF for zoster-related pain. We searched seven electronic databases from the establishment of the database to January 2021. Related randomized controlled trials were included in this meta-analysis. After extracting the data and evaluating the methodological quality of the included trials, the outcome indicators were statistically analyzed by using RevManV.5.3. This meta-analysis included 6 trials with a total of 509 patients. Compared with PRF group, stSCS group showed lower pain intensity (standardized mean difference=-0.83, 95%CI [-1.37, -0.30], P=.002), better sleep quality (mean difference=-1.43, 95%CI [-2.29, -0.57], P=.001), lower pain rating index scores, and less incidence of adverse events (RR=0.32, 95%CI [0.12, 0.83], P<.05). However, the efficacies of PRF and stSCS for treating postherpetic neuralgia were consistent in the response rate (RR= 1.10, 95% CI [0.82, 1.48], P=.51) and the complete remission rate (RR=1.05, 95% CI [0.66, 1.68], P=.84). In this study, stSCS showed a better analgesic effect and higher safety than PRF. Our meta-analysis results suggested that stSCS may be a feasible and safe invasive treatment for zoster-related pain. However, high-quality, randomized controlled trials with large sample sizes are needed to further verify our conclusions.