A clinical study of C arm-guided selective spinal nerve block combined with low-temperature plasma radiofrequency ablation of dorsal root ganglion in the treatment of zoster-related neuralgia.

Background: This study evaluated the analgesic efficacy and psychological response of low-temperature plasma ablation of dorsal root ganglion (DRG) combined with selective spinal nerve block in patients with acute or subacute zoster-related neuralgia (ZRN). Methods: Totally 90 ZRN patients were randomly and evenly divided into three groups. Treatment was given to Group A using C arm-guided selective spinal nerve block (C-SSVB), Group B using C-SSVB and pulsed radiofrequency (PRF), and Group C using C-SSVB and low-temperature plasma ablation of the DRG. The outcomes were examined using the Visual Analog Scale (VAS). Anxiety and depression of patients were evaluated using the Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS). Quality of life was assessed using the Pittsburgh Sleep Quality Index (PSQI) and postoperative Satisfaction scale. In addition, data on adverse events and medication usage rates were collected. Results: The 90 patients were eligible for this study. The three treatments reduced VAS scores with no significant difference between groups A and B at the same time points; however, group B tended to have numerically lower VAS scores. Comparatively, group C had significantly reduced VAS scores on day 1 and 1 month after treatment compared with the other two groups. In terms of the decreasing SAS, SDS and PSQI scores, all the three treatments improved the anxiety, depression and sleep quality of the patients. In addition, significant alleviation in anxiety was found in group C compared with group A at all- time points. However, there was no statistically significant difference among the three groups in treatment-related adverse events that mainly focused on puncture pain at the surgical-site, skin numbness and medication usage rates. Conclusions: C-SSVB and LTPRA of DRG will be considered as a promising treatment option for ZRN patients if those results can be confirmed after further validation.

Effectiveness of acupuncture therapy for postherpetic neuralgia: an umbrella review protocol.

INTRODUCTION: Several systematic reviews and meta-analysis indicate that acupuncture and related therapies may be a valuable adjunctive technique to pharmacological interventions for pain management of postherpetic neuralgia (PHN). However, the robustness of the results of these studies has not been evaluated. The aim of this proposed umbrella review is to provide more reliable evidence of the effectiveness of acupuncture therapy for PHN based on medical references for healthcare decision makers. METHODS AND ANALYSIS: PubMed, EMBASE, The Cochrane Library, Web of Science, Chinese BioMedical Literature Database, VIP Database for Chinese Technical Periodicals, China National Knowledge Infrastructure and Wan fang Database will be used to retrieve reviews. The time of publication will be limited from inception to March 2021. Two reviewers will screen all retrieved articles independently to identify their eligibility and extract the data. The quality will be assessed independently by two trained reviewers using Assessment of Multiple Systematic Reviews-2 for methodological quality, Risk of Bias in Systematic Review for level of bias, Preferred Reporting Items for Systematic Reviews and Meta-Analysis for reporting quality and Grading of Recommendations Assessment, Development and Evaluation for the quality of evidence. Any disagreements will be settled by discussion or the involvement of a third reviewer. ETHICS AND DISSEMINATION: The protocol of this review does not require ethical approval because the research will be based on publicly available data. The findings will be disseminated through publication in peer-reviewed international journals or presentation in academic conference. PROSPERO REGISTRATION NUMBER: CRD42020173341. REPORTING CHECKLIST: PRISMA-P, 2015.

[Therapeutic effect and mechanism of silver needle heat conduction therapy combined with loxoprofen sodium patch in patients with knee osteoarthritis].

OBJECTIVE: To observe the clinical efficacy of silver needle heat conduction therapy combined with loxoprofen sodium patch in the treatment of knee osteoarthritis (KOA). METHODS: A total of ninety-two patients with KOA were randomly and equally divided into loxoprofen sodium group and silver needle heat conduction therapy + loxoprofen sodium (combination) group, with 46 cases in each group. Patients of the combination group were treated with silver needle heat conduction therapy combined with loxoprofen sodium patch, while those of the loxoprofen sodium group were treated with loxoprofen sodium patch. The treatment was conducted for 4 weeks. The Western Ontario McMaster Universities Osteoarthritis Index (WOMAC), bone metabolism index ï¼»including bone gla protein (BGP), bone-specific alkaline phosphatase (BALP), tartrate resistant acid phosphatase isomer (TRACP)-5bï¼½, and inflammation factors ï¼»including the tumor necrosis factor-α (TNF-α), transforming growth factor-ß (TGF-ß), interleukin-1ß (IL-1ß)ï¼½ were observed before and after treatment. The therapeutic effect was assessed after the treatment. RESULTS: After the treatment, the total scores of WOMAC, the levels of serum TRACP-5b, TNF-α and IL-1ß were significantly decreased (P<0.01), while the levels of serum BGP, BALP, and TGF-ß were significantly increased (P<0.01) in the two groups compared with their own pre-treatment. Silver needle plus loxoprofen sodium was more effective in reducing WOMAC score, TRACP-5b, TNF-α, IL-1ß level (P<0.01), and up-regulating BGP, BALP, and TGF-ß level (P<0.01) than loxoprofen. Of the 46 cases in the loxoprofen sodium and combination groups, 33 and 41 were effective, with the effective rate being 71.7% and 89.1%, respectively. The comprehensive therapeutic effect of the combination group was significantly superior to that of the loxoprofen group (P<0.05). CONCLUSION: Silver needle heat conduction therapy combined with loxoprofen sodium can effectively treat KOA, its mechanism may be related to alleviating inflammation and improving bone metabolism.