超微针刀结合加巴喷丁治疗带状疱疹后遗神经痛临床研究

Clinical Study on Ultramicro Acupotomy Combined with Gabapentin in the Treatment of Post-Herpetic Neuralgia

目的:通过观察和评价超微针刀结合加巴喷丁对带状疱疹后遗神经痛的治疗效果,并与单纯服用加巴喷丁药物治疗进行比较,寻求一种针对带状疱疹后遗神经痛更加安全有效的治疗方法。方法:将62例带状疱疹后遗神经痛患者随机分成观察组和对照组,每组31例。观察组运用超微针刀结合加巴喷丁进行治疗,超微针刀隔日1次,每周3次,加巴喷丁每日服用。对照组运用口服加巴喷丁进行治疗,每日3次。两组疗程均为4周。采用整体临床疗效、VAS疼痛评分、焦虑自评量表(SAS)评分、Th1/Th2细胞因子与血清炎症因子水平,对治疗前后两组情况进行比较。结果:整体临床疗效比较:观察组优于对照组(P<0.05);观察组在治疗第2、4周后的VAS评分均显著低于对照组(均P<0.01);观察组在治疗第2、4周后的SAS评分均显著低于对照组(均P<0.01);两组治疗后比较IL-1β水平较治疗前均降低,但差异无统计学意义(P>0.05);两组治疗后IL-2水平均较治疗前上升,差异有统计学意义(P<0.05),且观察组治疗结束后IL-2值高于对照组(P<0.05)。结论:超微针刀结合加巴喷丁治疗能明显减轻带状疱疹后遗神经痛患者的疼痛,改善此类患者的焦虑抑郁状态,提高IL-2值,较单纯服用加巴喷丁临床疗效更佳。

Objective:To observe and evaluate the therapeutic effect of ultra fine acupotomy combined with Gabapentin on post-herpetic neuralgia,and to find a more safe and an effective treatment for post-herpetic neuralgia.Methods:62 patients with post-herpetic neuralgia were randomly divided into the observation group(n=31)and the control group(n=31).The control group was treated with Gabapentin(three times a day for four weeks);on which basis,the observation group was treated with ultramicro acupotomy(once every other day,three times a week for four weeks).The clinical effect,VAS pain scores,SAS scores,Th1/Th2 cytokines and serum inflammatory factors were compared before and after the treatment in the two groups.Results:The overall clinical efficacy of the observation group was higher than that of the control group(P<0.05).The VAS scores after 2w and 4w of the treatment were significantly lower in the observation group than those in the control group(P<0.01).The SAS scores after 2w and 4w of the treatment were significantly lower in the observation group than those in the control group(P<0.01).The level of IL-1βwas lower after the treatment in the two groups,but there was no statistical difference between before and after the treatment(P>0.05).The level of IL-2 was higher after the treatment than that before the treatment in the two groups(P<0.05);of which the observation group was significantly higher than the control group(P<0.05).Conclusion:The combination of ultramicro acupotomy and Gabapentin can significantly reduce the pain of patients with post-herpetic neuralgia,it can improve the state of anxiety and depression of the patients and improve the value of IL-2.The therapy is better than the clinical effect of Gabapentin alone.