腧穴热敏灸联合二味拔毒散治疗中老年带状疱疹临床研究

Clinical Study on Treatment of Elderly Herpes Zoster with Moxibustion on Heat-sensitive Acupoints Combined with Erwei Badu Powder

目的探讨腧穴热敏灸联合二味拔毒散治疗中老年肝经郁热型带状疱疹的疗效和机制。方法将65例肝经郁热型带状疱疹中老年患者随机分为治疗组35例和对照组30例,2组均予口服龙胆泻肝汤、阿昔洛韦片常规治疗,治疗组加用腧穴热敏灸联合二味拔毒散外搽,对照组外搽二味拔毒散,共治疗10 d。治疗前后观察症状、体征积分,检测T淋巴细胞亚群、血清白细胞介素-2(IL-2)水平,评价临床疗效,并随访带状疱疹后遗神经痛(PHN)发生情况。结果治疗组与对照组有效率分别为85.71%(30/35)、66.67%(20/30),治疗组疗效优于对照组(P<0.05),且PHN发生率低于对照组(P<0.01)。2组患者CD4、CD4/CD8、IL-2较治疗前显著升高,CD8显著降低(P<0.05),治疗组各项指标均优于对照组(P<0.05)。结论腧穴热敏灸联合二味拔毒散治疗中老年肝经郁热型带状疱疹疗效优于单用二味拔毒散,尤其在改善神经痛、睡眠及减少PHN发生方面效果显著,其机制可能与升高CD4、CD4/CD8、IL-2,提高机体细胞免疫力有关。

Objective To study the curative effect and mechanism of moxibustion on heat-sensitive acupoints combined with Erwei Badu Powder in the treatment of elderly herpes zoster （HZ） with type of stagnant heat of liver channel. Methods Sixty-five patients with HZ were randomly divided into treatment group （35 cases） and control group （30 cases）. Two groups were orally given Longdan Xiegan Decoction and aciclovir conventionally, the treatment group was given moxibustion additionally on heat-sensitive acupoints combined with Erwei Badu Powder, and the control group was only given external application of Erwei Badu Powder for 10 days. The symptom scores, levels of T lymphocyte subsets and serum interleukin-2 （IL-2） were observed before and after treatment, the curative effect was evaluated, and PHN was followed up. Results The effective rate was 85.71%（30/35） in the treatment group and 66.67%（20/30） in the control group. The curative effect of treatment group surpassed the control group （P〈0.05）. Incidence of PHN was lower （P〈0.01）. The levels of CD4, CD4/CD8, and IL-2 increased and the level of CD8 decreased significantly in two groups compared with those before treatment （P〈0.05）. All indexes were better in the treatment group than those in the control group （P〈0.05）. Conclusion The curative effect of moxibustion on heat-sensitive acupoints combined with Erwei Badu Powder in treatment of elderly HZ is better than that of Erwei Badu Powder only, particularly in reducing the occurrence of PHN, improving neuralgia and insomnia. The mechanism may be related to increasing levels of CD4, CD4/CD8 and IL-2, and improvement of body’s cell-mediated immunity.