弧刃针联合口服镇痛药物治疗胸背部带状疱疹后神经痛的效果

Efficacy of arc-edge needle with oral analgesic medicine treatment for patients with thoracodorsal postherpetic neuralgia

目的观察弧刃针联合口服镇痛药物治疗胸背部带状疱疹后神经痛(PHN)的临床疗效。方法收集2015年1月至2018年3月于河南省中医院疼痛科门诊就诊的胸背部PHN患者共65例,性别不限,年龄50~83岁,按随机数字表法分成口服加巴喷丁与曲马多组(OD组)(n=32)和口服药物与弧刃针组(KOD组)(n=33)。OD组口服加巴喷丁、神经妥乐平和盐酸曲马多缓释片;KOD组在口服药物的基础上对疼痛区域行弧刃针皮下刺扫治疗。观察治疗前及治疗后7、14、28d疼痛程度和睡眠质量的变化。采用视觉模拟评分(VAS)及睡眠质量综合评定治疗效果,并记录并发症和不良反应的发生率。结果两组治疗后7、14、28d时VAS评分均较治疗前明显降低,睡眠质量均较治疗前明显增加(P<0.01);KOD组在治疗后7、14、28d时VAS评分较OD组同期降低更明显,睡眠质量较OD组同期升高更明显(P<0.01)。治疗28d后KOD组、OD组临床优良率分别为91%(30/33例)、63%(19/30例)。结论弧刃针联合口服镇痛药物较单用口服镇痛药物治疗胸背部带状疱疹后神经痛临床效果更显著,可以迅速缓解疼痛症状、改善患者睡眠质量。

Objective To observe the efficacy of arc-edge needle (AEN) combined with oral analgesic medicine treatment for patients with thoracodorsal postherpetic neuralgia (PHN). Methods Sixty-five patients of both sexes, with PHN, aged 50-83 years, from January 2015 to March 2018 in the Pain Clinic of Henan Traditional Chinese Medicine Hospital, were randomly divided into two groups. The patients were treated with gabapentin, neurotropin tablet and tramadol hydrochloride sustained release tablet in oral analgesic medicine group (group OD, n=32);while the patients were treated with arc-edge needle (AEN) sweeping subcutaneously in the painful area combined with oral medicine in combined arc-edge needle group (group KOD, n=33). VAS and sleep quality were observed before and at 7, 14 and 28 days after the treatment. The efficacy was assessed by visual analogue scale (VAS) and quality of sleep (QS), and the incidence rate of complications and adverse reactions were recorded. Results The VAS was significantly lower and the QS score significantly higher at the time of 7, 14 and 28 days after the treatment than those before the treatment in the two groups (P<0.01), and VAS and QS score were better in group KOD than those in group OD (P<0.01). After the treatment, the clinical excellent and good rate was 91%(30/33 cases) in group KOD at 28 d after the treatment, 63%(19/30 cases) in group OD. Conclusion Arc-edge needle with oral analgesic medicine is effective and better than oral analgesic medicine alone, for the treatment of thoracodorsal postherpetic neuralgia with quickly relieving patients' pain and improving their sleep quality.