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

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.