龙胆泻肝加减方联合火针对肝经郁热型带状疱疹的临床研究

Clinical Study on Modified Longdan Xiegan Formula Combined with Fire Needling in Treating Herpes Zoster of Stagnant Heat in Liver Meridian Type

目的:观察龙胆泻肝加减方联合火针治疗肝经郁热型带状疱疹患者的临床疗效。方法:选择2021年2月—2022年2月在保定市第一中医院治疗的带状疱疹患者100例,以随机数字表法分组,50例患者为对照组,给予患者龙胆泻肝加减方治疗,50例患者为研究组,给予患者龙胆泻肝加减方联合火针治疗,治疗前后检测两组患者血清水痘-带状疱疹病毒IgM抗体(VZV-IgM)、补体C3、C4、免疫球蛋白M(IgM)、核因子κB(NF-κB)、神经降压素(NT)、神经生长因子诱导蛋白(VGF)、神经激肽-1(NK-1)、降钙素基因相关肽(CGRP)、Th17/Treg细胞比例、NOD样受体热蛋白结构域相关蛋白3(NLRP3)水平,记录两组患者止疱、结痂以及脱痂时间,给予患者McGill疼痛M卷表(SF-MPQ)中现时疼痛强度评分(PPI)、视觉模拟评分(VAS)评价,采用贝克焦虑量表(BAI)、皮肤病生活质量指标调查表(DLQI)评价患者焦虑情绪及生活质量,比较对照组及研究组患者临床疗效。结果:研究组患者VZV-IgM较对照组降低(P<0.05),研究组IgM、补体C3、C4含量较对照组明显升高(P<0.05),研究组患者NF-κB、NLRP3、Th17/Treg较对照组降低(P<0.05),研究组SOD较对照组明显升高(P<0.05),研究组患者VGF、NK-1、CGRP较对照组明显降低(P<0.05),研究组NT较对照组明显升高(P<0.05),研究组患者VAS、PPI评分较对照组降低(P<0.05),研究组结痂、止疱及脱痂时间短于对照组(P<0.05),研究组BAI、DLQI评分较对照组降低(P<0.05),研究组患者总有效率为98.00%(49/50)高于对照组的90.00%(45/50)(P<0.05)。结论:龙胆泻肝加减方联合火针对肝经郁热型带状疱疹患者,可降低抗体水平,提升患者免疫功能及补体水平,减少炎症及氧化应激反应,改善疼痛介质指标,缓解患者疼痛及焦虑情绪,改善临床症状,提升患者生活质量及临床疗效。

Objective:To observe the clinical effect of modified Longdan Xiegan Formula combined with fire needling in treating herpes zoster of stagnant heat in Liver meridian.Methods:A total of 100 patients with herpes zoster were randomly divided into the control group and the study group,with 50 patients in each group.The control group was treated with modified Longdan Xiegan Decoction;on which basis,the study group was also treated with fire needling.Serum levels of varicella-zoster virus IgM antibody(VZV-IgM),complement C3,complement C4,immunoglobulin M(IgM),nuclear factor kappa B(NF-κB),neurotensin(NT),nerve growth factor-inducible protein(VGF),neurokinin-1(NK-1),calcitonin gene-related peptide(CGRP),Th17/Treg cell ratio,and NOD-like receptor pyrin domain-related protein 3(NLRP3)were detected before and after the treatment in the two groups.Time of blister stopping,scab formation and descrustation were recorded in the two groups.Scores of present pain intensity(PPI)and visual analogue scale(VAS)in the McGill Pain M Scale(SF-MPQ)were evaluated,and anxiety state and life quality were assessed by Baker Anxiety Inventory(BAI)and Dermatology Life Quality Indicators(DLQI).Clinical efficacy was compared between the two groups.Results:VZV-IgM was lower in the study group than that in the control group(P<0.05);IgM,complement C3 and complement C4 were significantly higher in the study group than those in the control group(P<0.05);NF-κB,NLRP3 and Th17/Treg were lower in the study group than those in the control group(P<0.05);SOD was significantly higher in the study group than that in the control group(P<0.05);VGF,NK-1 and CGRP were significantly lower in the study group than those in the control group(P<0.05);NT was significantly higher in the study group than that in the control group(P<0.05).The scores of VAS and PRI were lower in the study group than those in the control group(P<0.05).The time of blister stopping,scab formation and descrustation was shorter in the study group than that in the control group(P<0.05).The scores of BAI and DLQI were lower in the study group than those in the control group(P<0.05).The total effective rate was 98.00%(49/50)in the study group,which was higher than 90.00%(45/50)in the control group(P<0.05).Conclusion:Modified Longdan Xiegan Decoction combined with fire needling can reduce antibody levels,improve patients’immune function and complement levels,reduce inflammation and oxidative stress,improve pain mediator indicators,and relieve pain and anxiety in patients with herpes zoster of stagnant heat in Liver meridian.The therapy can improve clinical symptoms and life quality of the patients.