基于神经调控的电针法治疗疱疹后神经痛临床观察

Clinical observation on the treatment of postherpetic neuralgia by neuromodulation electro-acupuncture

目的探讨疱疹后神经痛(postherpetic neuralgia,PHN)患者采用电针针刺督脉穴、夹脊穴、背俞穴的治疗效果,比较三种穴位的疗效差异。方法将入组的120例PHN患者随机分成A、B、C、D四组,每组30例。其中,A组口服普瑞巴林胶囊治疗;B、C、D三组在A组的基础上分别加用电针针刺督脉穴、夹脊穴、背俞穴治疗。观察和比较治疗前后四组患者的疼痛情况视觉模拟评分(visual analogue scale,VAS)、失眠情况匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)评分。结果A、B、C、D四组总有效率分别为80.0%、96.7%、96.7%、93.3%。B、C、D三组总有效率显著高于A组(P<0.05),而B、C、D三组之间比较,差异无统计学意义(P>0.05)。A、B、C、D四组在T_(1)至T_(4)时间点的VAS、PSQI评分均显著低于同组T_(0)时间点(P<0.05),B、C、D三组较A组更优(P<0.05);四组在T_(1)、T_(2)、T_(3)、T_(4)相同时间点的VAS、PSQI评分比较,B、C、D三组显著低于A组(P<0.05);B、C、D三组间比较差异无统计学意义(P>0.05)。结论电针针刺治疗督脉穴、夹脊穴、背俞穴联合普瑞巴林治疗在改善PHN患者疼痛、失眠方面效果显著,疗效均优于单独口服普瑞巴林;电针针刺在脊神经分布范围内均有效。

Objective To investigate the therapeutic effect of electroacupuncture on Du meridian,Jiaji acupoint and Beishu acupoint in patients with postherpetic neuralgia(PHN),and to compare the therapeutic effect of three acupoints.Methods The total 120 PHN patients were randomly divided into four groups:A,B,C and D,with 30 patients in each group.Among them,group A was treated with pregabalin capsule orally;group B,C and D were treated with electroacupuncture at Du meridian,Jiaji acupoint,Beishu acupoint respectively on the basis of group A.Visual analogue scale(VAS)for pain and Pittsburgh sleep quality index(PSQI)for insomnia in all four groups before and after treatment were recorded and compared.Results The total effective rates of group A,B,C and D were 80.0%,96.7%,96.7%and 93.3%,respectively.The total effective rate of group B,C and D was significantly higher than that of group A(P<0.05),while there was no statistical significance among groups B,C and D(P>0.05).VAS and PSDI score among the four groups at T_(1) to T_(4) were significantly lower than those of the same group at T0 time point(P<0.05),and group B,C and D were better than group A(P<0.05).VAS and PSQI score of group B,C and D were significantly lower than group A at the same time points of T_(1),T_(2),T_(3) and T_(4)(P<0.05).There was no significant difference among groups B,C and D(P>0.05).Conclusion Electroacupuncture treatment of Du meridian,Jiaji acupoint and Beishu acupoint combined with pregabalin has a significant effect on improving PHN patients'pain and insomnia,and is superior to oral pregabalin alone.Electroacupuncture is effective in the distribution range of spinal nerve.