腹针结合基础针刺法治疗带状疱疹的临床疗效

Clinical efficacy of abdominal acupuncture combined with basic acupuncture in the treatment of herpes zoster

目的比较腹针结合基础针刺法与单纯西药治疗带状疱疹的临床疗效,为针灸临床治疗带状疱疹提供理论基础。方法选取2017年1月—2019年6月于兰州大学第一医院疼痛科门诊就诊的90例胸段带状疱疹患者为研究对象,依据双盲随机对照试验原则分为针灸组与西药组,每组45例。针灸组患者采用腹针结合基础针刺法治疗,西药组患者采用伐昔洛韦、普瑞巴林与甲钴胺胶囊联合治疗,2组均治疗4周。比较2组患者的临床疗效、皮损消退时间,治疗前后视觉模拟评分法(VAS)评分,随访3个月带状疱疹后遗神经痛(PHN)发病情况及治疗期间不良反应发生情况。结果针灸组患者疗效优于西药组,差异有统计学意义(Z=-2.190,P=0.029)。2组患者治疗前VAS评分比较,差异无统计学意义(P>0.05);2组患者治疗后1周、2周、3周、4周VAS评分低于治疗前,且针灸组治疗后同一时间点VAS评分低于西药组,差异均有统计学意义(P<0.05)。针灸组患者不良反应发生率为8.89%(4/45),低于西药组的46.67%(21/45),差异有统计学意义(χ^(2)=16.006,P<0.05)。针灸组患者PHN发生率为2.22%(1/45),明显低于西药组的15.56%(7/45),但差异无统计学意义(χ^(2)=1.235,P=0.266)。结论腹针结合基础针刺法治疗带状疱疹的临床疗效优于单纯西药治疗,同时有助于加快皮损消退,减轻患者疼痛,降低PHN及不良反应发生风险。

Objective To compare the clinical efficacy of abdominal acupuncture combined with basic acupuncture and western medicine in treating herpes zoster,and to provide a theoretical basis for the clinical treatment of herpes zoster with acupuncture.Methods A total of 90 patients with thoracic herpes zoster who visited the Department of Pain Rehabilitation of the First Hospital of Lanzhou University from January 2017 to June 2019 were selected as the study subjects and assigned to the acupuncture group and western medicine group following the principle of a double-blind randomized controlled trial,with 45 cases in each group.Patients in the acupuncture group received abdominal acupuncture combined with basic acupuncture,and patients in the western medicine group received valacyclovir,pregabalin,and mecobalamin capsules.Subjects in both groups underwent treatment for 4 weeks.The clinical efficacy,time to subsidence of skin lesions,visual analogue scale(VAS)score before and after treatment,the incidence of postherpetic neuralgia(PHN),and adverse reactions during treatment were compared between the two groups.Results The efficacy in the acupuncture group was greater than that of the western medicine group,and the difference was statistically significant(Z=-2.190,P=0.029).There was no significant difference in VAS scores before treatment between the two groups(P>0.05).The VAS scores at 1 week,2 weeks,3 weeks,and 4 weeks after treatment in the two groups were lower than those before treatment,and the VAS score at the same time point after treatment in the acupuncture group was lower than that in the western medicine group,and the differences were statistically significant(P<0.05).The incidence of adverse reactions in the acupuncture group was 8.89%(4/45),which was lower than 46.67%(21/45)in the western medicine group,and the difference was statistically significant(χ^(2)=16.006,P<0.05).The incidence of PHN in the acupuncture group was 2.22%(1/45),which was significantly lower than that in the western medicine group(15.56%,7/45),but the difference was not statistically significant(χ^(2)=1.235,P=0.266).Conclusion Abdominal acupuncture in combination with basic acupuncture is greater than that of western medicine alone in the treatment of herpes zoster and helps to accelerate the regression of skin lesions,relieve pain,and reduce the risk of PHN and adverse reactions.