桃红四物汤加减方联合脉冲射频治疗带状疱疹后遗神经痛

Modified Taohong Siwu Decoction Combined with Pulsed Radiofrequency in Treatment of Post-Herpetic-Neuralgia

目的:研究桃红四物汤加减方联合脉冲射频治疗带状疱疹后遗神经痛的疗效。方法:将144例带状疱疹后遗神经痛(post-herpetic-neuralgia,PHN)患者采用随机数字表法将患者分为观察组和对照组,各72例。对照组采用脉冲射频治疗,观察组采用脉冲射频联合桃红四物汤加减方治疗,1个月为1个疗程,治疗3个疗程。比较两组治疗前后疼痛视觉模拟量表(visual analogue scale,VAS)评分、匹兹堡睡眠质量指数量表(Pittsburgh sleep quality index,PSQI)评分、生活质量指数(dermatology life quality index,DLQI)评分、中医证候评分、血清神经肽Y(neuropeptide-Y,NPY)、β-内啡肽(β-endorphin,β-EP)、P物质(substance P,SP)和神经激肽-1(neurokinin-1,NK-1)水平,并比较两组治疗效果。结果:观察组有效率为97.22%(70/72),对照组有效率为86.11%(62/72),差异有统计学意义(P<0.05);治疗结束后,两组患者血清NPY、SP和NK-1水平较治疗前明显降低,β-EP水平较治疗前升高,其中观察组血清NPY、SP和NK-1水平低于对照组,β-EP水平高于对照组,差异有统计学意义(P<0.05);治疗结束后,两组患者VAS评分、PSQI评分、DLQI评分和中医证候评分较治疗前明显降低,且观察组VAS评分、PSQI评分、DLQI评分和中医证候评分低于对照组,差异有统计学意义(P<0.05)。结论:采用桃红四物汤加减方联合脉冲射频治疗带状疱疹后遗神经痛,疗效显著,患者疼痛程度与生活质量得到极大改善,可能是通过降低各类疼痛介质的表达来发挥作用。

Objective:To study the curative effect of modified Taohong Siwu Decoction combined with pulsed radiofrequency on herpes zoster neuralgia.Methods:144 patients with post-herpetic-neuralgia(PHN) were divided into observation group and control group by random number table method,72 cases in each.The control group was treated with pulsed radiofrequency,and the observation group was treated with pulsed radiofrequency combined with modified Taohong Siwu Decoction,with 3 courses of treatment in which 1 course lasted 1 month.Compare the visual analogue scale(VAS) score,Pittsburgh sleep quality index(PSQI) score,Dermatology life quality index(DLQI) score,TCM syndromes before and after treatment between the two groups Score,serum neuropeptide Y(NPY),β-endorphin(β-endorphin,β-EP),substance P(Substance P,SP) and neurokinin-1(Neurokinin-1,NK-1) Level,and compare the treatment effect of the two groups.Results:The effective rate in the observation group was 97.22%,and the effective rate in the control group was 86.11%,the difference was statistically significant(P<0.05);after treatment,the serum NPY,SP,and NK-1 levels of the two groups were significantly lower than before treatment The level of β-EP was higher than that before treatment.The levels of serum NPY,SP and NK-1 in the observation group were lower than those in the control group,and the level of β-EP was higher than that in the control group.The difference was statistically significant(P<0.05);the end of treatment Afterwards,the VAS score,PSQI score,DLQI score and TCM syndrome scores of the two groups were significantly lower than before treatment,and the VAS score,PSQI score,DLQI score and TCM syndrome score of the observation group were lower than the control group,the difference was statistically significant(P<0.05).Conclusion:The use of modified Taohong Siwu Decoction combined with pulsed radiofrequency to treat herpes zoster neuralgia has a significant effect,and the patient′s pain level and quality of life have been greatly improved,which may be achieved by reducing the expression of various pain mediators.