身痛逐瘀汤与多虑平联合在带状疱疹后遗神经痛中应用研究

Study on Application of Shentong Zhuyu Decoction Combined with Doxepin in the Treatment of Postherpetic Neuralgia

目的:探讨带状疱疹后遗神经痛(PHN)应用身痛逐瘀汤与多虑平联合治疗的临床效果。方法:选取我院2015年3月—2016年3月收治的114例PHN患者,按照随机数字表法均分为两组。对照组:给予常规西药(多虑平)治疗;观察组:在此基础上给予身痛逐瘀汤治疗。记录比较两组连续治疗3个疗程后疗效,治疗前后视觉模拟量表(VAS)评分、汉密顿抑郁量表17项(HAMD-17)评分,治疗前后血清P物质(SP)、白细胞介素10(IL-10)及白细胞介素2(IL-2)水平,治疗期间不良反应情况。结果:观察组总有效率为92.73%明显高于对照组的77.78%(P<0.05);两组治疗后VAS、HAMD-17评分与治疗前比较,均显著降低(P<0.01),且观察组下降幅度更为显著(P<0.01);两组治疗后SP、IL-10及IL-2水平与治疗前比较,均显著改善(P<0.01),且观察组改善程度更为显著(P<0.01);两组治疗期间不良反应率比较,差异无统计学意义(P>0.05)。结论:PHN应用身痛逐瘀汤与多虑平联合治疗能迅速改善患者临床症状,提高生活质量,疗效显著,安全可靠,具有较高临床参考价值。

Objective：To study the clinical effect of the combined therapy of Shentong Zhuyu Decoction combined with doxepin in the treatment of postherpetic neuralgia（PHN）. Methods：114 cases of PHN patients treated in our hospital from March 2015 to March 2016 were selected and divided into two groups with the method of random number table. The control group was given conventional Western Medicine（doxepin）treatment,on the basis of which,the observation group received the treatment of Shentong Zhuyu Decoction. Then the curative effect after 3 courses of continuous treatment,visual analog scale（VAS）scores,Hamilton depression rating table 17（HAMD-17）score,the serum levels of substance P（SP）,leukocyte mediated element 10（IL-10）and leukocyte mediated element 2（IL-2）level before and after the treatment and adverse reactions during the treatment between the two groups were recorded and compared. Results：The total effective rate of the observation group was 92.73%,which was significantly higher than 77.78% of the control group（P〈0.05）;after the treatment,HAMD-17 and VAS scores the two groups decreased significantly when compared with those before the treatment（P〈0.01）,and the decrease degree in the observation group was more significant（P〈0.01）;after the treatment,levels of SP,IL-10 and IL-2 significantly improved compared with those before the treatment（P〈0.01）,and the improvement degree of the observation group was more significant than that of the two groups（P〉0.01）;the adverse reaction rates of the two groups were no significant difference statistically（P〈0.05）. Conclusion：The application of Shentong Zhuyu Decoction combined with doxepin in the treatment of PHN can rapidly improve the clinical symptoms of patients,improve the quality of life,with remarkable curative effect,safely and reliably,which has a high clinical reference value.