摘要目的:观察重复经颅磁刺激(rTMS)联合背根神经节脉冲射频(RF)治疗急性期带状疱疹神经痛的临床疗效。方法:采用随机数字表法将84例带状疱疹神经痛患者(病程≤7 d)分为对照组、rTMS组、RF组及观察组，每组21例。所有患者均给予加巴喷丁、伐昔洛韦、甲钴胺等药物口服，rTMS组在此基础上辅以rTMS治疗，每周治疗5 d，连续治疗2周，RF组于入组后第15天时辅以背根神经节RF治疗，观察组则给予rTMS及RF联合治疗(方法同上)。于治疗前、治疗后3 d、7 d、16 d、30 d、60 d时分别采用疼痛视觉模拟评分法(VAS)、汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、生活质量评估量表(QOL-SF36)及匹兹堡睡眠质量指数(PSQI)量表对各组患者进行疗效评定。结果:治疗后3 d、7 d、16 d、30 d、60 d时观察组疼痛VAS、HAMA、HAMD、QOL-SF36及PSQI评分均较治疗前明显改善( P<0.05)。与同期对照组比较，观察组疼痛VAS、HAMA、HAMD、QOL-SF36及PSQI评分在治疗后16 d、30 d、60 d时均明显改善( P<0.05)；与同期rTMS组比较，观察组疼痛VAS、HAMA及HAMD评分在治疗后16 d、30 d、60 d时均显著改善( P<0.05)；与同期RF组比较，观察组疼痛VAS、HAMA、HAMD及PSQI评分在治疗后30 d、60 d时均显著改善( P<0.05)。 结论:rTMS联合背根神经节RF治疗能有效缓解早期带状疱疹神经痛患者疼痛症状，减轻焦虑、抑郁程度，显著改善患者睡眠及生活质量，该联合疗法值得临床推广、应用。

abstractsObjective:To observe the clinical efficacy of combining repeated transcranial magnetic stimulation (rTMS) with radiofrequency ablation (RF) of dorsal root ganglia in treating herpes zoster infection and neuralgia.Methods:Eighty-four individuals with a herpes zoster infection who had suffered from neuralgia for no more than 7 days were divided randomly into a control group, an rTMS group, an RF group, and an observation group, each of 21. All were treated with gabapentin, valciclovir and mecobalamin. The rTMS group received rTMS treatment, 5 days per week, for 2 consecutive weeks. The RF group received RF treatment of the dorsal root ganglia on the 15th day after enrollment, while the observation group received only the medication. Before the experiment as well as after 3, 7, 16, 30 and 60 days, all of the subjects self-assessed their discomfort using a pain visual analog scale (VAS). The Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), Quality of Life Assessment Scale (QOL-SF36), and Pittsburgh Sleep Quality Index (PSQI) were also administered.Results:The average VAS, HAMA, HAMD, QOL-SF36, and PSQI scores of the observation group improved continuously and significantly during and after the treatment. Beyond 16 days all of those results were significantly better than the control group′s averages, and the observation group′s average VAS, HAMA and HAMD results were also significantly better than those of the rTMS group. The observation group′s average VAS, HAMA, HAMD and PSQI scores had improved significantly more than the RF group′s averages beyond 30 days.Conclusion:Combining rTMS and dorsal root ganglion RF can effectively alleviate the early pain symptoms of herpes zoster infection and neuralgia, relieve anxiety and depression, and significantly improve sleep and life quality. Such therapy is worthy of clinical promotion and application.