壮医药线点灸结合针刺治疗急性期带状疱疹疗效评价及对其镇痛机制的探讨

Clinical Evaluation of Zhuang Medicine Medicated Thread Dotted Moxibustion and Acupuncture in the Treatment of Acute Herpes Zoster and Discussion on Analgesia Mechanism

目的:评估壮医药线点灸结合针刺在急性期带状疱疹治疗方面的效果,并探讨其镇痛机制。方法:选取急性期带状疱疹患者72例,依照就诊次序随机分为观察组和对照组,每组36例。观察组给予壮医药线点灸结合针刺疗法,对照组给予常规针刺疗法,共治疗10天。比较两组证候改善情况(止疱时间、结痂时间、脱痂时间)、视觉模拟量表(visual analogue score,VAS)评分和血清白细胞介素6(interleukin-6,IL-6)、白细胞介素8(interleukin-8,IL-8)、P物质(substance P,SP)的含量,以及临床疗效、不良反应和神经后遗痛(postherpetic neuralgia,PHN)发生率。结果:观察组止疱时间、结痂时间、脱痂时间明显短于照组(P<0.05)。治疗后,两组VAS评分,血清IL-6、IL-8及SP含量均降低(P<0.05),且观察组下降程度大于对照组(P<0.05)。观察组总有效率[94.29%(33/35)]高于对照组[74.28%(26/35)](P<0.05)。两组均无明显不良反应发生,观察组治疗后第1、2、3个月PHN发生率均明显低于对照组(P<0.05)。结论:壮医药线点灸治疗带状疱疹可明显改善患者临床症状,降低PHN发生率,其镇痛机制可能与降低血清因子IL-6、IL-8及SP含量有关。

Objective:To assess therapeutic effects of Zhuang medicine medicated thread dotted moxibustion and acupuncture in the treatment of acute herpes zoster,and discuss the analgesia mechanism.Methods:All 72 patients were chosen,and randomized into the observation group and the control group according to the visiting order,36 cases in each group.The observation group was given Zhuang medicine medicated thread dotted moxibustion and acupuncture,and the control group accepted conventional acupuncture,for ten days.To compare the improvements of the syndromes(the time of ceasing blister,the time of scabbing and the time of decrustation),VAS scores,the contents of IL-6,IL-8 and SP,clinical effects,the incidence of adverse reaction and PHN between both groups.Results:The observation group was apparently shorter than the control group in the time of ceasing blister,the time of scabbing and the time of decrustation(P<0.05).After the treatment,VAS scores,the contents of IL-6,IL-8 and SP were decreased in both groups(P<0.05),and the decrease of the observation group was greater than that of the control group(P<0.05).Total effective rate of the observation group was[94.29%(33/35)],higher than[74.28%(26/35)]of the control group(P<0.05).No obvious adverse reaction happened in both groups,the incidences of PHN at the first,second and third month of the observation group were lower than these of the control group after treatment notably(P<0.05).Conclusion:Zhuang medicine medicated thread dotted moxibustion in the treatment of herpes zoster could notably improve clinical symptoms,decrease the incidence of PHN,and its mechanism might be related to lowering the contents of IL-6,IL-8 and SP.