麦粒灸联合针刺治疗中老年带状疱疹后遗神经痛40例临床观察

Middle Aged Patients with Postherpetic Neuralgia Treated with Grain-moxibustion Combined with Acupuncture: A Clinical Observation on 40 Cases

目的观察麦粒灸联合针刺治疗中老年带状疱疹后遗神经痛患者的临床疗效及安全性。方法将80例中老年带状疱疹后遗神经痛患者随机分为观察组和对照组各40例。对照组采用常规针刺、电针夹脊穴及阿是穴围刺治疗,观察组在对照组基础上加用麦粒灸。两组每日治疗1次,5次为1个疗程,疗程间休息2天,共治疗4个疗程。治疗前及治疗5、10、15、20次后采用视觉模拟疼痛(VAS)评分、汉密尔顿焦虑量表(HAMA)评分评价患者疼痛及焦虑症状,计算患者疼痛缓解百分数并评价临床疗效。记录两组患者治疗期间的不良反应。对治愈的患者,在治疗结束后3个月内随访其疼痛复发情况。结果观察组临床疗效总有效率为94.74%,对照组为92.11%,两组比较差异无统计学意义(P>0.05)。治疗组治疗5、10、15、20次后,VAS评分、HAMA评分及疼痛缓解百分数均较前一时间点显著改善(P<0.05),且观察组VAS评分及疼痛缓解百分数治疗后各时间点均优于对照组(P<0.05),观察组治疗5、10次后HAMA评分优于对照组(P<0.05)。两组治疗期间均未发生不良反应。治愈患者随访3个月均未发生疼痛复发。结论麦粒灸联合针刺对中老年带状疱疹后遗神经痛患者症状安全有效,且远期疗效稳定。

Objective To observe the clinical effect and safety of grain-moxibustion combined with acupuncture for treating middle aged patients with postherpetic neuralgia（ PHN）. Methods Eighty middle aged PHN patients were randomized into an observation group and a control group with 40 cases in each group. Both groups were treated by routine acupuncture,paravertebral points electroacupuncture,and Ashi points surround needling. Observation group was added with grain-moxibustion. Both groups were treated once every day,five days for one course with twoday break between courses,for totally 4 courses. Patients＇ pain and anxiety symptoms were evaluated adopting Visual Analogue Score（ VAS） and Hamilton Anxiety Scale（ HAMA）. Percentage of patients＇ pain relief was calculated and the clinical effect was evaluated before treatment and after treatment for 5,10,15,or 20 times. The side effect in both groups during treatment was recorded. The recovered patients were followed up in 3 months after the last treatment course to see if pain recurrence. Results The total clinical effect rate was 94. 74% in observation group,and92. 11% in control group with no statistically significant difference between the two groups（ P〉0. 05）. After being treated for 5,10,15,and 20 times,scores of VAS and HAMA,and pain relief percentage in the observation group improved obviously compared with those at earlier time points（ P〈0. 05）. Scores of VAS and pain relief percentage in observation group were superior to those in control group at each time point after treatment（ P〈0. 05）. Scores of HAMA in observation group were superior to those in control group after treatment for 5 and 10 times. There was no side effect in both groups during treatment. There was no pain recurrence among cured patients in 3 months follow-up.Conclusion Grain-moxibustion combined with acupuncture is effective and safe in improving PHN patients＇ symptoms. The long-term effect is stable.