中医外治法治疗带状疱疹后遗神经痛的疗效观察

Observation on the efficacy of external therapy of traditional Chinese medicine in the treatment of postherpetic neuralgia

目的探讨带状疱疹后遗神经痛(PHN)应用中医外治法治疗的疗效。方法60例PHN患者,采用随机数字表法分为观察组与对照组,各30例。对照组口服普瑞巴林胶囊治疗,观察组予以中医外治法(火针刺络拔罐+脊柱关节突针刀松解术+针刺选穴)治疗。比较两组临床疗效、不良反应发生情况及治疗前后疼痛情况、P物质(SP)水平、汉密尔顿抑郁量表(HAMD)评分、阿森斯失眠量表(AIS)评分、皮肤病生活质量指数(DLQI)评分。结果观察组临床总有效率为93.33%,高于对照组的70.00%,差异有统计学意义(P<0.05)。治疗后,两组视觉模拟评分法(VAS)评分、疼痛持续时间评分、疼痛间隔时间评分均低于治疗前,且观察组VAS评分(1.27±0.31)分、疼痛持续时间评分(0.58±0.11)分、疼痛间隔时间评分(0.85±0.13)分均低于对照组的(3.06±0.32)、(1.25±0.29)、(1.51±0.30)分,差异有统计学意义(P<0.05)。治疗后,两组SP水平均低于治疗前,且观察组SP水平(45.12±6.80)pg/ml低于对照组的(60.25±7.42)pg/ml,差异有统计学意义(P<0.05)。治疗后,两组HAMD评分、AIS评分、DLQI评分均低于治疗前,且观察组HAMD评分(5.33±1.02)分、AIS评分(3.62±0.70)分、DLQI评分(5.12±1.05)分低于对照组的(7.05±1.17)、(6.45±0.92)、(10.71±2.03)分,差异有统计学意义(P<0.05)。治疗期间两组未见明显不良反应。结论PHN患者应用中医外治法治疗可改善疼痛、抑郁、失眠症状,提高患者生活质量,安全可靠。

Objective To discuss the efficacy of external therapy of traditional Chinese medicine in the treatment of postherpetic neuralgia(PHN).Methods A total of 60 cases of PHN patients were divided into observation group and control group by random numerical table,with 30 cases in each group.The control group was treated with oral pregabalin capsules,and the observation group was treated with external therapy of traditional Chinese medicine(fire needle acupuncture and cupping+acupotomy of spinal articular process+acupuncture point selection).Both groups were compared in terms of clinical efficacy,pain,occurrence of adverse reactions substance P(SP)level,Hamilton Depression Scale(HAMD)score,Athens Insomnia Scale(AIS)score,Dermatology Life Quality Index(DLQI)score before and after treatment.Results The total clinical effective rate in the observation group was 93.33%,which was higher than 70.00%in the control group,and the difference was statistically significant(P<0.05).After treatment,the visual analogue scale(VAS)score,pain duration score and pain interval score in both groups were lower than those before treatment in this group;the VAS score(1.27±0.31)points,the pain duration score(0.58±0.11)points,and the pain interval score(0.85±0.13)points in the observation group were lower than(3.06±0.32),(1.25±0.29),and(1.51±0.30)points in the control group;the differences were all statistically significant(P<0.05).After treatment,the levels of SP in the two groups were lower than those before treatment in this group,and the SP level(45.12±6.80)pg/ml in the observation group was lower than(60.25±7.42)pg/ml in the control group,and the difference was statistically significant(P<0.05).After treatment,the HAMD score,AIS score and DLQI score in both groups were lower than those before treatment in this group;the HAMD score(5.33±1.02)points,AIS score(3.62±0.70)points and DLQI score(5.12±1.05)points of the observation group were lower than(7.05±1.17),(6.45±0.92),(10.71±2.03)points of the control group;the differences were all statistically significant(P<0.05).During treatment,no obvious adverse reactions occurred in the two groups.Conclusion External therapy of traditional Chinese medicine is safe and reliable for PHN patients,and can improve the symptoms of pain,depression and insomnia,and improve the quality of life of patients.