目的 探讨A型肉毒毒素（BTX-A）联合脉冲射频（PRF）治疗带状疱疹后神经痛（PHN）的疗效及安全性。 方法 收集PHN患者共80例。随机分为观察组（B组）和对照组（C组）。B组行BTX-A皮内注射联合PRF治疗，C组行利多卡因皮内注射联合PRF治疗。采用数字疼痛评分（NRS）、简化麦吉尔疼痛问卷（SF-MPQ）和睡眠质量评分（QS）评估患者术前、术后1、3、7 d、术后1、2、3个月的疼痛程度和睡眠质量。收集患者术后的不良反应。检测患者术前与术后3 d血清中的白细胞介素-1β（IL-1β）和降钙素基因相关肽（CGRP）水平。 结果 B组和C组在术后各时间点的NRS评分、SF-MPQ评分、QS评分与术前相比均显著下降（P < 0.05）。与C组相比，B组在术后1、2、3个月的NRS、SF-MPQ评分评分显著降低（P < 0.05）；B组在术后2、3个月的QS评分显著降低（P < 0.05）。术后3个月B组疼痛缓解的有效率（90%）与C组（56.7%）比较，差异有统计学意义（P < 0.05）。两组均未发生严重不良反应。两组患者术后3 d血清中的IL-1β和CGRP含量均较术前显著下降，B组IL-1β和CGRP的下降程度较C组更显著（P < 0.05）。 结论 BTX-A联合PRF治疗PHN可以有效减轻其疼痛程度、改善睡眠质量，安全性高。

Objective Exploring the efficacy and safety of botulinum toxin type A （BTX?A） combined with pulsed radiofrequency（PRF） in the treatment of postherpetic neuralgia（PHN）. Methods A total of 80 patients with PHN were collected. They were randomly divided into experimental group （Group B）and control group （Group C）， Group B was treated with BTX?A intradermal injection combined with PRF， and Group C was treated with lidocaine intradermal injection combined with PRF. Numeric pain score （NRS）， Simplified McGill Pain Questionnaire （SF?MPQ）and Sleep Quality Score （QS）were used to assess the patients' pain level and sleep quality preoperatively， 1， 3， and 7 days postoperatively， and 1， 2， and 3 months postoperatively. The patients' postoperative adverse reactions were collected. Interleukin?1β （IL?1β）and calcitonin gene?related peptide （CGRP）levels in patients' serum were measured preoperatively and 3 days postoperatively. Results The NRS scores， SF?MPQ scores， and QS scores of group B and group C were significantly lower at all postoperative time points compared to preoperative ones （P < 0.05）. The NRS and SF?MPQ score were significantly lower in group B at 1， 2， and 3 months postoperatively compared with group C（P < 0.05）； and group B had significantly lower QS scores at 2 and 3 months postoperatively （P < 0.05）. The effective rate of pain relief at 3 months postoperatively in group B （90%） was statistically significant （P < 0.05） compared with group C （56.7%）. No serious adverse reactions occurred in either group. The levels of IL?1β and CGRP in serum of patients in both groups were significantly decreased at 3 days after surgery compared with the preoperative period， and the degree of decrease of IL?1β and CGRP in group B was more significant than that in group C （P < 0.05）. Conclusion BTX?A combined with PRF treatment for PHN can effectively reduce its pain level， improve the quality of sleep， and is safe.