针刺放血早期干预防治带状疱疹后遗神经痛临床疗效观察

Clinical Observation on Preventing Postherpetic Neuralgia by Acupuncture and Bleeding Therapy at the Acute Stage of Herpes Zoster

目的在带状疱疹急性期给予针刺放血早期干预,观察其镇痛及防治带状疱疹后遗神经痛的临床疗效。方法通过随机对照,将60名带状疱疹神经痛患者分别纳入针刺放血加维生素B1/B12治疗组(以下简称治疗组)和抗病毒镇痛加维生素B1/B12药物治疗组(以下简称对照组)各30例,并于治疗后第6、12、18天评价VAS评分进行疗效对比,并于治疗后比较带状疱疹后遗神经痛发生率。结果治疗后两组VAS评分均出现减少,治疗组在治疗后第6天和第12天VAS评分持续减少,与对照组比较有非常显著性差异(P<0.01);并延续至治疗后第18天,两组VAS评分比较仍有显著性差异(P<0.05);治疗后两组带状疱疹后遗神经痛发生率分别为3.4%和10.3%。结论带状疱疹急性期在同样应用维生素B1/B12基础上,针刺放血治疗较西医抗病毒镇痛治疗,在镇痛作用方面起效更快,疗效更好,并能有效地减少带状疱疹后遗神经痛的发生。

Objective To observe the clinical effect of bleeding and acupuncture therapy on relieving herpes zoster neuralgia （HZN） and preventing the occurrence of postherpetic neuralgia （PHN）. Methods Sixty patients with HZN were divided randomly into two groups. Thirty patients were mainly treated by bleeding and acupuncture therapy plus vitamin B1/B12 （the treatment group） , and the others by antiviral and analgesic, medication plus vitamin B1/B12 （the comparing group）. The therapeutic effect was evaluated by the score of VAS before the treatment and on the day of 6, 12, 18 of the therapeutic course, and the incidence of PHN after treatment was assessed. Results The score of VAS in both groups decreased during the therapeutic course. The score of VAS in the treatment group was lower significantly （P 〈0.01 ） than that in the comparing group, and by the end of the therapeutic course, it still continued （P 〈0.05）. The incidence of PHN in two groups after the treatment was 3.4% and 10.3% respectively. Conclusion At the acute phase of herpes zoster, basing on both applyed the same dose of vitamin B1/B12, the acupuncture and bleeding therapy is better than antiviral and analgesic medication in relieving HZN and preventing the occurrence of PHN.