179: Analysis Of The Efficacy Of SCS Combined With Intraspinal Block In The Treatment Of PHN In Elderly

Topic: Clinical Science
Subtopic: Pain category (ICD-11), Chronic neuropathic pain, Neuromodulation (e.g. TMS, TDCS, FUS, SCS, MCS, DBS, vagus nerve stimulation), Treatment/management , Pain in special populations (e.g. neonates, children, teens, elderly, neurodegenerative diseases)

Background and Aims: To investigate the efficacy of SCS combined with intrathecal block in the treatment of PHN in elderly patients.

Methods: A total of 100 elderly PHN patients admitted to the hospital from April 2022 to April 2025 were selected and divided into a control group and a combination group according to the random number table method, with 50 cases in each group. The control group received intrathecal block therapy, while the combination group received SCS combined with intrathecal block therapy. The treatment efficacy, pain status, inflammatory markers, anxiety and depression levels, and sleep quality were compared between the two groups.

Results: The total effective rate of treatment in the combination group was higher than that in the control group (P < 0.05). After treatment, the Numerical Rating Scale (NRS) score, levels of tumor necrosis factor-α (TNF-α), interleukin-2 (IL-2), IL-6, C-reactive protein (CRP), and interferon-γ (INF-γ) in the combination group were lower than those in the control group (P < 0.05). Additionally, the Hospital Anxiety and Depression Scale (HADS) scores and Pittsburgh Sleep Quality Index (PSQI) score in the combination group were lower than those in the control group after treatment (P < 0.05).

Conclusions: The combination of SCS and intrathecal block therapy demonstrates superior efficacy in elderly PHN patients, effectively alleviating pain, reducing inflammatory levels, mitigating anxiety and depression, and improving sleep quality.

References: 1 Kong E,Hua T,Li J,et al.HSV-1 reactivation results in post-herpetic neuralgia by upregulating Prmt6 and inhibiting cGAS-STING[J].Brain,2024,147(7):2552-2565.
2 Lim DZJ,Tey HL,Salada BMA,et al.Herpes Zoster and Post-Herpetic Neuralgia-Diagnosis, Treatment, and Vaccination Strategies[J].Pathogens,2024,13(7):596.
3 俞锦舒，沈燕芸，许卫华.丹参酮联合普瑞巴林胶囊治疗老年带状疱疹后遗神经痛的临床研究[J].老年医学与保健，2024，30(6):1829-1832.
4 Roelands S,Lebrun C,Soetens F.Ultrasound-guided superficial cervical plexus block in the treatment of post-herpetic neuralgia[J].Pain Pract,2022,22(3):414-415.
5 周晓琴，蒋昌宇，方进龙，等.带状疱疹后遗神经痛治疗中神经阻滞联合脊髓电刺激治疗对患者睡眠质量和疼痛程度的影响[J].临床和实验医学杂志，2024，23(6):659-662.
6 李晓松，刘美娜，郝元涛，等.卫生统计学（第8版）[M].北京：人民卫生出版社，2017：384.
7 带状疱疹后神经痛诊疗共识编写专家组.带状疱疹后神经痛诊疗中国专家共识[J].中国疼痛医学杂志，2016，22(3):161-167.
8 Alicino C,Trucchi C,Paganino C,et al.Incidence of herpes zoster and post-herpetic neuralgia in Italy: Results from a 3-years population-based study[J].Hum Vaccin Immunother,2017,13(2):399-404.
9 万丽，赵晴，陈军，等.疼痛评估量表应用的中国专家共识(2020版)[J].中华疼痛学杂志，2020，16(3):177-187.
10 苏茜，刘玉萍，程幼夫，等.医院焦虑抑郁量表在健康体检中心应用的信度和效度研究[J].肿瘤预防与治疗，2020，33(6):519-524.
11 路桃影，李艳，夏萍，等.匹兹堡睡眠质量指数的信度及效度分析[J].重庆医学，2014，43(3):260-263.
12 Zhang X,Wang Z,Xian Y.Efficacy of local anaesthetic and steroid combination in prevention of post-herpetic neuralgia: A meta-analysis[J].Pak J Med Sci,2022,38(3Part-I):757-765.
13 马丽，夏建华，周晓鸣，等.放血疗法联合神经阻滞及臭氧注射治疗老年带状疱疹后遗神经痛患者的临床观察[J].老年医学与保健，2024，30(1):168-173.
14 Ahmed SA,Magdy AA,Abdullah MA,et al.The Effect of Erector Spinae Plane Block With and Without Addition of Magnesium on Relief of Pain from Post-herpetic Neuralgia[J].Pain Physician,2022,25(5):365-372.
15 Peksöz U,Öner Ü,Çelik M.The effectiveness of the erector spinae plane block using methylprednisolone and bupivacaine in post-herpetic neuralgia: Case series[J].Agri,2023,35(4):273-277.
16 张树丽，王理康，吴蓍妍等.臭氧穴位注射联合脊神经后支射频调节治疗胸背部带状疱疹后遗神经痛的疗效观察[J].世界中西医结合杂志，2023，18(2):314-318，323.
17 陈嘉芳，何龙，林鹏，等.短时程脊髓电刺激与双极脉冲射频治疗带状疱疹后神经痛的临床研究[J].中国疼痛医学杂志，2024，30(9):664-670.
18 Moritz C,Field-Fote EC,Tefertiller C,et al.Non-invasive spinal cord electrical stimulation for arm and hand function in chronic tetraplegia: a safety and efficacy trial[J].Nat Med,2024,30(5):1276-1283.
19 黎伟，彭彦怡，郭明.80例带状疱疹患者炎症因子，免疫球蛋白，T淋巴细胞亚群与后遗神经痛的关系[J].国际神经病学神经外科学杂志，2024，51(6):36-40.
20 徐纬，张祖勇，孙丹，等.调神针法对带状疱疹后遗神经痛患者疼痛程度，负性情绪和睡眠质量的影响[J].针刺研究，2024，49(5):499-505.
21 梁一男，杨平亮，冯宇峰.通络益气方联合椎管内阻滞治疗PNH的临床疗效及其对血清炎症因子,焦虑抑郁情绪的影响[J].世界中西医结合杂志，2020，15(10):1865-1868.
22 闫晗，王昆鹏，赵林，等.短时程高颈段脊髓电刺激治疗三叉神经下颌支带状疱疹性神经痛疗效观察[J].中国医科大学学报，2023，52(4):361-365.

Presenting Author: Tian wenhai
Submitting Author: tian wenhai

Senior Author: Tian wenhai

IASP 2026 Global Year theme of Neuropathic Pain: Yes