Meta-analysis of clinical efficacy and safety of stellate ganglion block in the treatment of postherpetic neuralgia
MU Qiang1 CHAI Junlong1 LYU Honglin1 REN Da1 LIU Wenhua1 HUANG Yuanxin2 WANG Lin2#br#
1.Department of Pain, Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine, Hebei Province, Cangzhou 061012, China;
2.Department of Pain, Affiliated Hospital of Guizhou Medical University, Guizhou Province, Guiyang 550001, China
Abstract Objective To evaluate the efficacy and safety of stellate ganglion block in the treatment of postherpetic neuralgia. Methods The randomized controlled trials of stellate ganglion block in the treatment of postherpetic neuralgia were searched in PubMed, The Cochrane Library, Embase, CNKI, CBM, VIP, and Wangfang Data from inception to April 2021. The selected literatures were evaluated according to the Cochrane bias risk assessment tool, and then the RevMan 5.4 version of the software was used for meta-analysis. Results A total of eight literatures were screened. Meta-analysis showed that the total effective rate of treatment in experimental group was higher than that in control group (OR = 4.50, 95%CI: 2.18 to 9.27, P < 0.0001), and the pain score after treatment in experimental group was lower than that in control group (MD = -0.66, 95%CI: -0.87 to -0.45, P ＜ 0.000 01). There was no significant difference in the incidence of adverse reactions between the two groups (OR = 0.58, 95%CI: 0.27 to 1.22, P = 0.15). Conclusion Stellate ganglion block is a safe and effective treatment for postherpetic neuralgia, which can obviously improve the total effective rate and relieve pain symptoms.
MU Qiang1 CHAI Junlong1 LYU Honglin1 REN Da1 LIU Wenhua1 HUANG Yuanxin2 WANG Lin2. Meta-analysis of clinical efficacy and safety of stellate ganglion block in the treatment of postherpetic neuralgia[J]. 中国医药导报, 2022, 19(19): 103-106.
[1] Andrei G，Snoeck R. Advances and Perspectives in the Management of Varicella-Zoster Virus Infections [J]. Molecules，2021，26（4）：1132.
[2] Sun X，Wei Z，Lin H，et al. Incidence and disease burden of herpes zoster in the population aged ≥50 years in China：Data from an integrated health care network [J]. J Infect，2021，82（2）：253-260.
[3] 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.
[4] Dong X，Liu Y，Yang Q，et al. Comparison of therapeutic effects of continuous epidural nerve block combined with drugs on postherpetic neuralgia [J]. Int J Neurosci，2020， 131（4）：1-9.
[5] Aggarwal A，Suresh V，Gupta B，et al. Post-herpetic Neuralgia：A Systematic Review of Current Interventional Pain Management Strategies [J]. J Cutan Aesthet Surg，2020，13（4）：265-274.
[6] 姜媛，刘彩霞，陈文琦.星状神经节阻滞在皮肤病中的应用[J].中国麻风皮肤病杂志，2019，35（10）：628-632.
[7] 蒋文臣，郑宝森.星状神经节阻滞[J].实用疼痛学杂志，2007，3（2）：106-114.
[8] 常国祥，柏化丽.超声引导星状神经节阻滞联合加巴喷丁治疗老年头面部带状疱疹后神经痛[J].实用老年医学，2015，29（8）：632-634.
[9] 邓鹏程.星状神经节阻滞联合药物治疗带状疱疹后遗三叉神经痛临床疗效[J].实用心脑肺血管病杂志，2019，27（S1）：98-100.
[10] 丁远远，姚鹏.星状神经节阻滞联合加巴喷丁治疗头面部带状疱疹后神经痛的疗效观察[J].中国医科大学学报，2014，43（12）：1125-1128，1130.
[11] 张忠杰，黄海兰，姚旌.星状神经节阻滞联合药物治疗带状疱疹后遗三叉神经痛临床疗效[J].贵州医科大学学报，2016，41（10）：1208-1211.
[12] 纪均，黄慧敏，姜虹.加巴喷丁联合星状神经节超激光照射治疗头面部带状疱疹后神经痛的疗效分析[J].外科理论与实践，2011，16（6）：581-584.
[13] 路华杰，赵焰.星状神经节阻滞对上肢带状疱疹后神经痛病人康复效果观察[J].中国疼痛医学杂志，2019，25（12）：956-958，960.
[14] 吴从月.星状神经节阻滞联合加巴喷丁治疗头面部PHN的临床疗效和安全性分析[J].海峡药学，2013，25（6）：74-76.
[15] 杨勇，鄢建勤，郭曲练，等.加巴喷丁联合星状神经节阻滞治疗头面部带状疱疹性神经痛的临床观察[J].中国疼痛医学杂志，2010，16（3）：131-134.
[16] Chen F，Chen F，Shang Z，et al. White matter microstructure degenerates in patients with postherpetic neuralgia [J]. Neurosci Lett，2017，656：152-157.
[17] Bennett GJ，Watson CP. Herpes zoster and postherpetic neuralgia：Past，present and future [J]. Pain Res Manag，2009，14（4）：275-282.
[18] Gierthmühlen J，Braig O，Rehm S，et al. Dynamic of the somatosensory system in postherpetic neuralgia [J]. Pain Rep，2018，3（6）：e668.
[19] Baron R，Binder A，Wasner G. Neuropathic pain：diagnosis，pathophysiological mechanisms，and treatment [J]. Lancet Neurol，2010，9（8）：807-819.
[20] Jeon Y. Therapeutic potential of stellate ganglion block in orofacial pain：a mini review [J]. J Dent Anesth Pain Med，2016，16（3）：159-163.
[21] Wang QX，Wang XY，Fu NA，et al. Stellate ganglion block inhibits formalin-induced nociceptive responses：mechanism of action [J]. Eur J Anaesthesiol，2005，22（12）：913-918.
[22] Beal B，Moeller-Bertram T，Schilling JM，et al. Gabapentin for once-daily treatment of post-herpetic neuralgia：a review [J]. Clin Interv Aging，2012，7：249-255.
[23] Bockbrader HN，Wesche D，Miller R，et al. A comparison of the pharmacokinetics and pharmacodynamics of pregabalin and gabapentin [J]. Clin Pharmacokinet，2010，49（10）：661-669.
[24] Kim HJ，Ahn HS，Lee JY，et al. Effects of applying nerve blocks to prevent postherpetic neuralgia in patients with acute herpes zoster：a systematic review and meta-analysis [J]. Korean J Pain，2017，30（1）：3-17.
[25] Zhang M，Gao CX，Ma KT，et al. A Meta-Analysis of Therapeutic Efficacy and Safety of Gabapentin in the Treatment of Postherpetic Neuralgia from Randomized Controlled Trials [J]. Biomed Res Int，2018，2018：1-10.
