桃红四物汤治疗带状疱疹后遗神经痛疗效及对Th1/Th2细胞因子的变化研究

Effect of Taohong Siwu Decoction(桃红四物汤)on Postherpetic Neuralgia and Its Effect on Th1/Th2 Cytokines

目的研究桃红四物汤治疗带状疱疹后遗神经痛的疗效及对辅助性T细胞1/辅助性T细胞2(Helper T cell 1,Th1/Helper T cell 2,Th2)细胞因子的变化影响。方法选取琼海市中医院内二科2021年1月—2022年6月收治的78例带状疱疹后遗神经痛患者为对象,采用随机数字表法分为常规组(营养神经、止痛等常规治疗)和汤剂组(常规治疗联合桃红四物汤)。比较治疗前、治疗8周后疼痛介质、Th1/Th2细胞及疼痛评分、匹兹堡睡眠质量指数(Pittsburgh Sleep Quality Index,PSQI)评分的差异。结果汤剂组总有效率为92.31%(36/39),高于常规组的74.36%(29/39),差异具有统计学意义(P<0.05)。两组治疗前疼痛介质、Th1/Th2细胞因子比较,差异无统计学意义(P>0.05)。与治疗前比较,两组β-内啡肽(β-Endorphin,β-EP)、5-羟色胺(5-hydroxytryptamine,5-HT)、白细胞介素-2(Interleukin-2,IL-2)治疗后升高,且汤剂组治疗后更高(P<0.05)。白细胞介素-6(Interleukin-6,IL-6)、白细胞介素-10(Interleukin-10,IL-10)下降,且汤剂组治疗后更低(P<0.05)。两组治疗前疼痛评分、PSQI评分比较,差异无统计学意义(P>0.05)。与治疗前比较,两组疼痛评分、PSQI评分下降,且汤剂组治疗后更低(P<0.05)。结论桃红四物汤治疗带状疱疹后遗神经痛可调节β-EP、5-HT、Th1/Th2细胞因子的表达水平,减轻疼痛程度,改善睡眠质量。

Objective To study the efficacy of Taohong Siwu Decoction(桃红四物汤)in the treatment of postherpetic neuropain and its effect on the changes of helper T cell 1/helper T cell 2(Th1/Th2)cytokines.Methods Seventy-eighty patients with postherpetic neuralgia were selected from January 2021 to June 2022 in the Second Department of Traditional Chinese Medicine Hospital of Qionghai.They were randomly divided into routine group(routine treatment of nourishing nerves,pain relief,etc.)and decoction group(routine treatment combined with Taohong Siwu Decoction).The differences of pain mediators,Th1/Th2 cells,pain scores and Pittsburgh Sleep Quality Index(PSQI)scores before and after 8 weeks of treatment were compared.Results The total effective rate of the decoction group was 92.31%(36/39),higher than that of the conventional group[74.36%(29/39)],with a statistically significant difference(P<0.05).There was no significant difference in pain mediators or Th1/Th2 cytokines between the two groups before treatment(P>0.05).Compared with that before treatment,the levels of β-endorphin(β-EP),5-hydroxytryptamine(5-HT)and interleukin-2(IL-2)in the two groups increased after treatment,and the levels were higher in the decoction group after treatment(P<0.05).The levels of tnterleukin-6(IL-6)and interleukin-10(IL-10)were decreased,and the levels were obviously lower in the decoction group after treatment(P<0.05).There was no significant difference in pain score or PSQI score between the two groups before treatment(P>0.05).Compared with those before treatment,the pain score and PSQI score of the two groups decreased,and those of the decoction group were lower after treatment(P<0.05).Conclusion Taohong Siwu Decoction can regulate the expressions ofβ-EP,5-HT and Th1/Th2 cytokines,reduce the degree of pain and improve the quality of sleep in patients with postherpetic neuropain.