针刺联合西药治疗带状疱疹的临床观察及其对血浆P物质的影响

Clinical Observation of Acupuncture Associated with Western Medicines on Herpes Zoster and Its Effect on Substance P

目的研究针刺联合西药疗法对带状疱疹患者皮损、神经痛及外周血浆P物质含量的影响。方法将60例入选患者随机分为两组。对照组给予西药治疗(抗病毒药物、营养神经药物及止痛药物);试验组在对照组的基础上加用针刺疗法。采用止疱时间、完全结痂时间及皮损痊愈时间评估皮损恢复情况;用视觉模拟评分法(VAS)评估疼痛缓解情况;同时记录PHN的发生率;并测量治疗前后外周血浆P物质的含量。结果试验组止疱时间、完全结痂时间、皮损痊愈时间均比对照组短(P<0.05);两组治疗后的VAS指数及外周血浆P物质含量均较治疗前显著性下降(P<0.01);且试验组下降的更明显(P<0.01);同时试验组PHN发生率明显低于对照组(P<0.05)。结论针刺联合西药疗法能加快带状疱疹患者皮损的恢复和疼痛的缓解,其作用机理可能与促进外周血浆P物质含量的下降有关。

Objective To investigate the effect of acupuncture associated with western medicines on rash,neuralgia and the level of substance P in peripheral blood plasma in patients with herpes zoster.Methods 60 patients were randomly divided into two groups.The control group was treated with western medicines（includes：antiviral,analgesic,and trophic nerve）,and the study group was treated with acupuncture plus western medicines.Time without new vesicles,time to total crusting and healing were used to assess the recovery of the rash.Visual analogue scale（VAS）was utilized to assess the degree of easement of pain.The incidences of post-herpetic neuralgia（PHN）were observed.The levels of substance P in peripheral blood plasma were measured before and after the treatment.Results Time without new vesicles,time to total crusting and healing of the study group was significantly shortened than the control group（p0.05）.In two groups,both of the VAS index and the level of substance P in peripheral blood plasma were significantly decreased after treatment（p0.01）.However,this changes of study group were more significant comparing with control group（p0.01）.Furthermore,the incidence of PHN in study group was much lower than control group（p0.05）.Conclusion Acupuncture associated with foreign medicines can accelerate the healing of the rash and relieve the zoster-associated pain.The mechanism might be realized with the decreasing of the level of substance P.