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Title:
Comparison of the Effects of Three Different Methods in the Treatment of Intercostal Postherpetic Neuralgia
Authors:  Zhenwu Zhang, M.M., Diyang Ling, M.M., Qiong Wu, M.D., Yan Zhao, M.D., Juan Zhang, M.D., and Zheyin Wang, M.M.
  Objective: To investigate the therapeutic effects of simple drug therapy, B-ultrasound guided paravertebral block (PVB), and plasma thermocoagulation of dorsal root ganglion (DRG) in the treatment of intercostal postherpetic neuralgia (iPHN).
Study Design:
A total of 120 patients with acute iPHN were divided into oral administration therapy group (group A), thoracic paravertebral block (TPVB) therapy group (group B), and DRG block combined with low-temperature plasma thermocoagulation therapy group (group C). Group A was treated with anti-viral therapy combined with analgesic drugs, group B with B-ultrasound-guided TPVB on the basis of group A, and group C with DRG block combined with low-temperature plasma thermocoagulation on the basis of group A. We analyzed the pain scores by using numeric rating scales (NRSs) at weeks 1, 2, 3, and 4 after treatment and sleep quality at weeks 2 and 4 after treatment. Finally, the drug-related adverse reactions or complications were recorded.
Results:
At weeks 1, 2, 3, and 4 after treatment the NRS scores of groups B and C were significantly lower than that of group A, and the NRS score of group C was slightly lower than that of group B. The difference was statistically significant. After weeks 2 and 4 of treatment, the sleep quality of groups B and C were prominently better than that of group A, and the sleep quality of group C was better than that of group B; the difference was statistically significant. There were no postoperative complications in groups B and C. However, some patients in group C experienced hypoesthesia in the skin that received thermocoagulation, but no influence on life and no painful numbness. Collectively, no significant difference was identified in the incidence of adverse reactions or complications among the 3 groups.
Conclusion:
All 3 treatment methods have certain clinical efficacy for iPHN, which can effectively relieve the pain caused by herpes zoster and improve sleep. Among them, DGR block combined with low-temperature plasma thermocoagulation may have better clinical application significance.
Keywords:  herpes zoster, intercostal postherpetic neuralgia, low-temperature plasma thermocoagulation, nerve block, oral administration, shingles
   
   
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