摘要
目的探究中药汤剂联合火针治疗带状疱疹后遗神经痛(Postherpetic neuralgia,PHN)的临床效果。方法选取2023年3月—2024年3月期间宝鸡市中心医院收治的98例PHN患者,依据随机数字表法分为西药组与中药组,每组各49例。西药组给予标准医药治疗与火针治疗,中药组给予身痛逐瘀汤加减联合火针治疗。治疗4周后,观察比较两组患者临床疗效、不良反应情况,治疗前后中医证候积分、疼痛情况[疼痛视觉模拟评分(Visual analogue scale,VAS)、持续时间]、应激指标[β-内啡肽(β-endorphin,β-EP)、皮质醇(Cortisol,Cor)和总抗氧化能力(Total antioxidant capacity,TAC)]与睡眠状况[匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PQSI)、睡眠障碍评定量表(Sleep dysfunction rating scale,SDRS)]变化。结果治疗后中药组治疗总有效率93.88%(46/49)明显高于西药组79.59%(39/49),差异有统计学意义(P<0.05)。治疗后两组患者中医主症、次症评分均较治疗前降低,差异有统计学意义(P<0.05);且中药组中医主症、次症评分均明显低于西药组,差异有统计学意义(P<0.05)。治疗第2周及治疗结束时,两组患者疼痛VAS评分与持续时间均较治疗前逐渐降低,差异有统计学意义(P<0.05);且中药组疼痛VAS评分与持续时间均低于西药组,差异有统计学意义(P<0.05)。治疗后两组患者β-EP水平均较治疗前升高,Cor和TAC水平均较治疗前降低,差异有统计学意义(P<0.05);且中药组β-EP水平较西药组明显升高,Cor和TAC水平均较西药组明显降低,差异有统计学意义(P<0.05)。治疗后两组患者PQSI和SDRS评分均较治疗前降低,差异有统计学意义(P<0.05);且中药组睡眠状况评分明显低于西药组,差异有统计学意义(P<0.05)。治疗期间,两组患者不良反应发生率比较,差异无统计学意义(χ^(2)=0.445,P>0.05)。结论身痛逐瘀汤联合火针治疗PHN效果显著,可有效改善临床症状,缓解疼痛,调节机体应激状态,从而改善睡眠,且不良反应少。
Objective To explore the clinical effect of traditional Chinese medicine(TCM)decoction combined with fire needles on the treatment of postherpetic neuralgia(PHN).Methods 98 PHN patients admitted to Baoji Central Hospital from March 2023 to March 2024 were selected as the research subjects.According to the random number table method,the patients were divided into the Western medicine group and TCM group,with 49 patients in each group.Specifically,the Westerm medicine group received standard medicine therapy and fire needle therapy,while the TCM group was treated with modified Shentong Zhuyu decoction combined with fire needle therapy.After four weeks of treatment,the clinical effects and adverse reactions were observed and compared.Additionally,variations in the TCM symptom score,pain status including pain visual analog scale(VAS)and duration,stress indicators containingβ-endorphin(β-EP),cortisol(Cor)and total antioxidant capacity(TAC),and sleep status such as Pittsburgh sleep quality index(PQSI)and sleep dysfunction rating scale(SDRS)before and after treatment were compared between both groups.Results After treatment,the total effective rate of treatment in the TCM group was 93.88%(46/49),which was higher than 79.59%(39/49)in the Western medicine group(P<0.05).After treatment,the scores of primary symptoms and secondary symptoms in the two groups were decreased,and the difference was statistically significant(P<0.05).Meanwhile,the scores of primary symptoms and secondary symptoms in the TCM group were lower than those in the Western medicine group(P<0.05).At the end of the second treatment week,the pain VAS score and duration were reduced gradually in both groups(P<0.05).The pain VAS score and duration in the TCM group were lower or shorter than those in the Western medicine group respectively(P<0.05).After treatment,theβ-EP levels in both groups significantly grew,while the Cor and TAC levels significantly declined,(P<0.05).Additionally,after treatment,compared to the Western medicine group,theβ-EP level in the TCM group was significantly increased,while the Cor and TAC levels remarkably decreased(P<0.05).After treatment,the PQSI and SDRS scores of both groups were reduced(P<0.05).The sleep status scores in the TCM group were notably lower than those in the Western medicine group(P<0.05).During the treatment,there was no statistical difference in the adverse reaction incidence in both groups(χ^(2)=0.445,P>0.05).Conclusion While exerting a remarkable effect on treating PHN,Shentong Zhuyu decoction combined with fire needles can improve clinical symptoms,relieve pain,and regulate the body's stress status,thereby enhancing sleep quality,with few adverse reactions.
作者
康乐
张敏
易海玲
李青青
杨曦
郭雅涛
KANG Le;ZHANG Min;YI Hai-ling;LI Qing-qing;YANG Xi;GUO Ya-tao(Dermatology Department of Baoji Central Hospital,Baoji Shaanxi 721000;Dermatology Department of Baoji Hospital of Traditional Chinese Medicine,Baoji Shaanxi 721000)
出处
《世界中西医结合杂志》
2025年第2期314-319,共6页
World Journal of Integrated Traditional and Western Medicine
基金
2022年陕西省卫生健康科研基金项目(2022E110)。
关键词
带状疱疹后遗神经痛
气滞血瘀证
中药汤剂
火针
postherpetic neuralgia
syndrome of qi stagnation and blood stasis
traditional Chinese medicine decoction
fire needle
