线香灸配合刺络拔罐治疗带状疱疹急性期的疗效评价及其镇痛机制探讨

Effect of joss stick moxibustion combined with pricking and cupping for acute herpes zoster and its mechanism of analgesia

目的:观察线香灸配合刺络拔罐与常规西药治疗带状疱疹急性期的临床疗效差异,并初步探讨其镇痛机制。方法:选取带状疱疹急性期患者70例,随机分为观察组和对照组,观察组脱落2例,对照组脱落1例,最终观察组33例、对照组34例纳入统计。观察组穴取疱疹局部阿是穴,采用线香灸配合刺络拔罐治疗,隔日1次,7次为一疗程,治疗1个疗程;对照组采用口服阿昔洛韦、维生素B1、甲钴胺片,连续治疗14 d,并配合注射干扰素,连续6 d。观察两组患者治疗前、治疗后疱疹评价指标(止疱时间、结痂时间、脱痂时间)及疼痛强度变化,检测外周疱疹局部血清P物质(SP)含量的变化情况,并评定两组综合疗效情况。结果:治疗中观察组的止疱时间、结痂时间及脱痂时间均明显早于对照组(均P<0.05);两组患者治疗后疼痛缓解程度比较,差异无统计学意义(P>0.05),但治疗后观察组疼痛开始缓解时间及疼痛持续时间均较对照组改善(均P<0.05);两组患者治疗后外周血SP含量与治疗前比较均有不同程度下降(均P<0.01),且观察组的下降程度较对照组明显(P<0.05);治疗后观察组的总有效率为87.9%(29/33),与对照组的总有效率85.3%(29/34)比较,差异无统计学意义(P>0.05),而两组痊愈率比较,观察组优于对照组[66.7%(22/33)vs 58.8%(20/34),P<0.05]。结论:线香灸配合刺络拔罐可有效治疗带状疱疹,与常规西药处理比较,具有起效快、镇痛效果好等优点,其机制可能与较大程度地降低外周血清中的SP含量有关。

Objective To observe the effects of conventional western medication and joss stick moxibustion combined with pricking and cupping for herpes zoster in acute stage, and to explore its analgesic mechanism. Methods Seventy patients with acute herpes zoster were randomized into an observation group （33 cases after 2 dropping） and a control group （34 cases after 1 dropping）. Patients in the observation group were treated with joss stick moxibustion combined with pricking and cupping at local ashi points for 7 times, once every other day. Oral acyclovir, vitamin B~ and mecobalamin tablets were applied in the control group for continuous 14 days, and interferon injection was used for continuous 6 days, etc. The herpes evaluation indexes of blister stopping time, scab time and decrnstation time as well as pain intensity were observed before and after treatment. Peripheral serum substance P （SP） content of herpes local situation was detected. The comprehensive effects were evaluated. Results The blister stopping time, scab time and decrustation time in the observation group were shorter than those in the control group （all P〈 0.05）. There was no statistical significance for pain relief degree between the two groups （P〉 0.05）. The pain beginning to ease time and duration time in the observation group were better than those in the control group （both P〈 0.05）. The contents of SPin the two groups decreased after treatment （both P〈 0.01）, and it was better in the observation group （P〈 0.05）. The total effective rate of the observation group after treatment was 87.9% （29/33）, and that of the control group was 85.3% （29/34）, which were not statistically significant （P〉 0.05）. The cured rate of the observation group was better than that of the control group [66.7% （22/33） vs 58.8% （20/34）, P〈 0.05]. Conclusion Joss stick moxibustion combined with pricking and cupping are effective for herpes zoster, which have quicker and good analgesic effects than conventional western medication. Its mechanism may be related to reducing the content of SP more fast and to a larger degree.