中药辨证施治联合超声引导下椎旁神经阻滞治疗带状疱疹后神经痛的疗效

Effect of TCM Syndrome Differentiation Combined with Ultrasound-guided Paravertebral Nerve Block on Postherpetic Neuralgia

目的 探讨中药辨证施治联合超声引导下椎旁神经阻滞治疗带状疱疹后神经痛的疗效。方法 选择2019年8月—2020年12月石家庄中医院收治的86例带状疱疹后遗神经痛患者为治疗对象,根据随机数字法分为对照组43例和观察组43例。对照组行超声引导下神经阻滞治疗。观察组行中药辨证施治治疗及超声引导下神经阻滞治疗。观察和比较两组患者治疗前和治疗后疼痛视觉模拟评分(VAS)及失眠严重程度指数量表(ISI)评分;比较两组患者治疗后的治疗效果;观察和比较两组患者治疗后细胞炎症因子肿瘤坏死因子(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-2(IL-2)的改变;以及观察和比较两组患者不良反应发生情况。结果 治疗前VAS及ISI评分比较无明显差异(P>0.05),治疗1个月后观察组VAS及ISI评分均明显低于对照组,差异均具有统计学意义(P<0.05)。观察组治疗后总有效率明显高于对照组,差异有统计学意义(P<0.05)。治疗后两组细胞炎症因子均较治疗前降低,且治疗组细胞炎症因子TNF-α、IL-6、IL-1β下降幅度大于对照组,两组比较差异有统计学意义(P<0.05)。观察组不良反应发生率明显低于对照组,差异有统计学意义(P<0.05)。结论 相较于单纯超声引导下椎旁神经阻滞治疗,中药辨证施治治疗联合超声引导下神经阻滞治疗更能有效改善患者疼痛症状及睡眠质量,提高总的有效治疗效果,并能明显抑制细胞炎症因子的释放以及改善预后。

Objective To investigate the efficacy of TCM syndrome differentiation combined with ultrasound-guided paravertebral nerve block in the treatment of postherpetic neuralgia.Methods A total of 86 patients with postherpetic neuralgia admitted to Shijiazhuang hospital of traditional Chinese medicine from August 2019 to December 2020 were selected as the treatment objects.According to the random number method,they were divided into control group(n=43)and observation group(n=43).The control group was treated with ultrasound-guided nerve block.The observation group was treated with TCM syndrome differentiation and ultrasound-guided nerve block.Visual analogue scale(VAS)and insomnia severity index(ISI)scores before and after treatment were observed and compared between the two groups.The therapeutic effect of the two groups after treatment was compared.The changes of tumor necrosis factor(TNF-α),interleukin-6(IL-6)and interleukin-2(IL-2)were observed and compared between the two groups after treatment.And to observe and compare the incidence of adverse reactions between the two groups.Results There was no significant difference in VAS and ISI scores before treatment(P>0.05),but after one month of treatment,VAS and ISI scores of the observation group were significantly lower than those of the control group,and the differences were statistically significant(P<0.05).After treatment,the total effective rate of the observation group was significantly higher than that of the control group,and the difference was statistically significant(P<0.05).After treatment,the cellular inflammatory factors in the two groups were decreased compared with those before treatment,and the decreases of TNF-α,IL-6 and IL-1βin the treatment group were greater than those in the control group,and the differences between the two groups were statistically significant(P<0.05).The incidence of adverse reactions in the observation group was significantly lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Compared with ultrasound-guided paravertebral nerve block alone,TCM syndrome differentiation combined with ultrasound-guided nerve block can effectively improve the pain symptoms and sleep quality of patients,improve the overall effective treatment effect,and significantly inhibit the release of cellular inflammatory factors and improve the prognosis.