不同针灸方法治疗带状疱疹(急性期)疗效的比较

Comparison of Therapeutic Effects of Different Types of Acupuncture Interventions on Herpes Zoster in Acute Stage

目的:比较不同针灸方法治疗带状疱疹(急性期)的疗效。方法:通过多中心临床随机对照试验,将189例急性期带状疱疹患者随机分为5组:基础针刺组、铺棉灸组、火针组、叩刺拔罐组、西药组。基础针刺组取阿是穴(围刺)、夹脊(电针)、支沟(电针)、后溪(电针),铺棉灸组、火针组、叩刺拔罐组在基础针刺组的基础上分别施以铺棉灸、火针、叩刺拔罐,西药组口服盐酸伐昔洛韦胶囊(300mg/次,2次/d)、维生素B1(10mg/次,3次/d),均每日治疗1次,共治疗10d。比较不同方法治疗前后疱疹评价指标(包括止疱时间、结痂时间、脱痂时间)、疼痛强度的变化和综合疗效。结果:在疱疹止疱时间、结痂时间、脱痂时间和综合疗效方面,5组之间的差异均无统计学意义(P>0.05);5组患者疼痛强度比较,治疗第1-6天差异无统计学意义(均P>0.05),治疗第7-10天4个针灸组均明显低于西药组(P<0.05),而4个针灸组间比较差异仍无统计学意义(P>0.05);各组治疗结束时的疼痛强度与本组治疗前比较,差异均有统计学意义(P<0.05)。结论:4种针灸疗法治疗带状疱疹(急性期)疗效基本相当,在疱疹止疱、结痂、脱痂时间及综合疗效等方面与西药疗法无明显差异,但在治疗第7天以后镇痛效果优于西药。

Objective To compare the therapeutic effects of different types of acupuncture therapy on herpes zoster （a- cute stage）. Methods A total of 189 cases of acute herpes zoster outpatients and inpatients were recruited in the present multi- centers （3 hospitals） randomized controlled clinical trials. They were divided into （computer-aided random allocation） ..basic acu- puncture （n = 36）, cotton moxibustion （n=35）, fire needle （n = 43）, tapping-cupping （n = 39） and medication （n = 36） groups. Ashi-points （around the locus）, Jiaji （EX-B 2）, Zhigou （SJ 6） and Houxi （SI 3） were used in this study. For patients of the acu- puncture group, the abovementioned acupoints were punctured with filiform needles （encircled needling around the affected loci） and also stimulated with electroacupuncture （EA）. For patients of the cotton moxibustion group, thin defated dry cotton pieces put over the Ashi-point were ignited, 3 times altogether, followed by EA and encircled needling stimulation which were the same to those in the basic acupuncture group. Patients of the fire needle group were treated by pricking the herpes （3--5 in number） with a hot-red needle, followed by EA and encircled needling treatment. Patients of the tapping-cupping group were treated by tapping Ashi-points repeatedly with a percussopunctator and cupping over the pricked region, followed by EA and encircled needling treat- ment. Patients of the medication group were treated by oral administration of Valaciclovir Hydrochlordide （300 mg/time, twice a day） and vitamin B1 （10 mg/time, t. i. d. ） for 10 days. The acupuncture-moxibustion treatment was given once daily for 10 days. The time of blister-occurrence cease, scab formation and decrustation was recorded, and pain degree was evaluated using visual analog scale （VAS）. The therapeutic effect was assessed according to the related standards. Results There were no significantdifferences among the 5 groups in the time of blister-occurrence cease, scab formation and decrustation, and in the therapeutic effect（ P〉0. 05）. The VAS scores of the 5 groups were decreased gradually and apparently along with the treatment （ P〈0. 05）, suggesting a pain relief after the treatment. In comparison with the medication group, the VAS scores of the basic acupuncture group, cotton moxibustion group, fire needle group and tapping-cupping group were significantly lower from the 7th day on following the treatment （P〈0.05）. Conclusion Acupuncture plus encircled needling and acupuncture plus encircled needling combined with cotton-moxibustion, or with fire needle stimulation, or with tapping and cupping are effective in the treatment of herpes zoster at the acute stage, being comparable to the medication in the clinical curative effect and improvement of blisters, and better than medication in pain relief.