针刺联合拔罐放血疗法对早期带状疱疹疼痛及相关因子的影响

Effects of acupuncture combined with cupping and bloodletting on early herpes zoster pain and related factors

目的观察针刺联合拔罐放血对早期带状疱疹(EHZ)患者疼痛及相关因子的影响。方法将我院112例EHZ患者随机分成对照组与观察组各56例。对照组给予泛昔洛韦治疗,观察组在对照组治疗基础上给予针灸联合拔罐放血治疗。比较两组临床疗效,止疱、结痂、脱痂时间,治疗前后疼痛视觉模拟评分(VAS),检测P物质(SP)、T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD8^(+))水平。结果治疗后,观察组总有效率高于对照组(P<0.05);两组VAS值、SP水平与治疗前比较均下降(P<0.05),且观察组治疗后VAS值、SP水平低于对照组(P<0.05);观察组止疱、结痂、脱痂时间均少于对照组(P<0.05)。治疗后两组CD3^(+)、CD4^(+)水平与治疗前比较均增加,CD8^(+)水平与治疗前比较均下降(P<0.05),且观察组治疗后CD3^(+)、CD4^(+)水平均高于对照组,CD8^(+)水平低于对照组(P<0.05);观察组后遗神经痛发生率低于对照组(P<0.05)。结论针刺联合拔罐放血对早期带状疱疹患者疗效确切,降低疼痛程度,促进病情恢复,降低后遗神经痛发生率,可能机制与疼痛因子水平下降、免疫功能恢复有关。

Objective To observe the effect of acupuncture combined with cupping and bloodletting on pain and related factors in patients with early herpes zoster(EHZ).Methods A totoal of 112 EHZ patients were randomly divided into control group and observation group,56 cases in each group.Control group was given famciclovir treatment,and observation group was given acupuncture combined with cupping and bloodletting on the basis of control group.The two groups were compared in terms of clinical efficacy,time of blistering,scab formation and scab removal,Visual Analogue Scale(VAS)scores before and after treatment,and the levels of substance P(SP)and T lymphocyte subsets(CD3^(+),CD4^(+),CD8^(+))were detected.Results After treatment,the total effective rate of observation group was higher than that of control group(P<0.05);the VAS scores and SP levels of both groups were decreased compared with those before treatment(P<0.05),and were lower in observation group than control group(P<0.05);the time for blistering,scab formation and removal of the scab in observation group was shorter than control group(P<0.05);after treatment,CD3^(+)and CD4^(+)levels in both groups were increased compared with those before treatment,and were higher in observation group than control group(P<0.05),CD8^(+)level was decreased compared with that before treatment(P<0.05),and was lower in observation group than control group(P<0.05);the incidence of postherpetic neuralgia in observation group was lower than control group(P<0.05).Conclusion Acupuncture combined with cupping and bloodletting is effective in early herpes zoster patients,which can reduce the degree of pain,promote the recovery of the disease,and reduce the incidence of postherpetic neuralgia.The possible mechanism is related to the decrease of pain factors level and the recovery of immune function.