Effects of pulsed radiofrequency combined with ozone on zoster-associated pain: a systematic review and meta-analysis

Ding, Xiao-Tong1,#; Huang, Jin-Zhao2,#; Shen, Qiu-Song1; Wang, Rui-Yu3; Kan, Hou-Ming3,*

Author Information

1Kiang Wu Nursing College of Macau, Macao Special Administrative Region, China

2Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Jiangsu Province, China

3Medical Sciences Division, Faculty of Medicine, Macau University of Science and Technology, Macao Special Administrative Region, China

*Correspondence to: Hou-Ming Kan, PhD, 13685109335@163.com.

#Both authors contributed equally to this work.

Abstract

Pulsed radiofrequency combined with ozone therapy has been a newly proposed treatment method for zoster-associated pain in recent years. To explore the effectiveness of a regimen of pulsed radiofrequency combined with ozone for the treatment of zoster-associated pain. We searched commonly used English databases (the Cochrane Library, PubMed, CINAHL, Embase, and Web of Science) and Chinese databases (the CNKI, WanFang, CBM, and VIP databases) for randomized controlled trials. Two researchers independently screened the literature on the basis of the set conditions and extracted data from the included literature. The meta-analysis was conducted via Review Manager 5.4 software. A meta-analysis was conducted on 18 studies, with a total of 1496 participants (742 in the experimental group and 754 in the control group). The results revealed that the pulsed radiofrequency combined with ozone presented lower unidimensional pain scores (standardized mean difference [SMD] = −1.55, 95% confidence interval [CI] = [−2.04, −1.06]; heterogeneity: P < 0.00001, I2 = 94%; test effect: Z = 6.18, P < 0.00001), a lower pain rating index (mean difference [MD] = −2.65, 95% CI = [−3.86, −1.44]; heterogeneity: P = 0.001, I2 = 85%; test effect: Z = 4.29, P < 0.0001) and presented pain intensity scores (MD = −0.58, 95% CI = [−0.62, −0.54]; heterogeneity: P = 0.61, I2 = 0%; test effect: Z = 27.91, P < 0.00001), a lower Pittsburgh sleep quality index (MD = −1.62, 95% CI = [−2.94, −0.31]; heterogeneity: P < 0.00001, I2 = 93%; test effect: Z = 2.42, P = 0.02), and lower interleukin-6 expression levels (SMD = −1.94, 95% CI = [−2.91, −0.97]; heterogeneity: P < 0.00001, I2 = 93%; test effect: Z = 3.92, P < 0.0001), lower gabapentin consumption (MD = −146.92, 95% CI = [−189.93, −103.91]; heterogeneity: P = 0.23, I2 = 30%; test effect: Z = 6.70, P < 0.00001). Pulsed radiofrequency combined with ozone is an effective treatment for zoster-associated pain that can effectively alleviate patients’ pain and improve sleep quality, providing a new treatment option for zoster-associated pain in the future.

摘要

脉冲射频联合臭氧治疗是近年来提出的治疗带状疱疹相关性疼痛的新方法。旨在探讨脉冲射频联合臭氧方案治疗带状疱疹相关性疼痛的有效性。我们检索了常用的英文数据库（Cochrane图书馆、PubMed、CINAHL、Embase和Web of Science）和中文数据库（中国知网、万方数据库、中国生物医学文献数据库和维普数据库），查找相关随机对照试验。两名研究者根据预设条件独立筛选文献并提取纳入文献的数据。采用Review Manager 5.4软件进行Meta分析。共纳入18项研究进行Meta分析，涉及1496名受试者（试验组742人，对照组754人）。结果显示，脉冲射频联合臭氧治疗组的单维度疼痛评分更低（标准化均数差[SMD] = -1.55，95% 置信区间[CI] = [-2.04, -1.06]；异质性：P < 0.00001，I² = 94%；效应检验：Z = 6.18，P < 0.00001），疼痛评级指数更低（均数差[MD] = -2.65，95% CI = [-3.86, -1.44]；异质性：P = 0.001，I² = 85%；效应检验：Z = 4.29，P < 0.0001），现有疼痛强度评分更低（MD = -0.58，95% CI = [-0.62, -0.54]；异质性：P = 0.61，I² = 0%；效应检验：Z = 27.91，P < 0.00001），匹兹堡睡眠质量指数更低（MD = -1.62，95% CI = [-2.94, -0.31]；异质性：P < 0.00001，I² = 93%；效应检验：Z = 2.42，P = 0.02），白细胞介素-6表达水平更低（SMD = -1.94，95% CI = [-2.91, -0.97]；异质性：P < 0.00001，I² = 93%；效应检验：Z = 3.92，P < 0.0001），加巴喷丁用量更少（MD = -146.92，95% CI = [-189.93, -103.91]；异质性：P = 0.23，I² = 30%；效应检验：Z = 6.70，P < 0.00001）。脉冲射频联合臭氧是治疗带状疱疹相关性疼痛的有效方法，能够有效缓解患者疼痛，改善睡眠质量，为未来带状疱疹相关性疼痛的治疗提供了一种新的选择。