穴位注射联合神经阻滞治疗急性期带状疱疹的疗效观察

Observation on therapeutic effect of acupoint injection combined with nerve block on acute herpes zoster

目的 观察穴位注射联合神经阻滞治疗急性期带状疱疹(AHZ)的疗效。方法 选择60例AHZ患者,采用随机数字表法分为A组与B组,每组30例。A组给予基础药物治疗, B组在A组基础上给予穴位注射+神经阻滞治疗。比较两组治疗前后视觉模拟评分法(VAS)评分,疱疹临床相关指标(起疱时间、结痂时间、脱痂时间),临床疗效及带状疱疹后遗神经痛(PHN)发生率。结果 B组起疱时间、结痂时间、脱痂时间分别为(5.30±1.37)、(9.50±1.94)、(15.03±1.97)d,均短于A组的(6.67±1.99)、(11.47±2.30)、(18.53±3.58)d,差异有统计学意义(P<0.05)。治疗前,两组VAS评分比较,差异无统计学意义(P>0.05)。治疗后,两组VAS评分较治疗前均明显降低, B组VAS评分(2.63±1.15)分低于A组的(3.67±0.80)分,差异有统计学意义(P<0.05)。治疗后,两组临床症状均有改善, B组痊愈率43.3%优于A组的16.7%,差异有统计学意义(P<0.05)。治疗结束后1个月, B组PHN发生率20.0%明显低于A组的46.7%,差异有统计学意义(P<0.05)。结论 AHZ早期使用穴位注射联合神经阻滞进行干预能够对缓解疼痛及预防后遗神经痛的发病起到积极作用,无明显不良反应,值得临床推荐。

Objective To observe the therapeutic effect of acupoint injection combined with nerve block on acute herpes zoster(AHZ).Methods 60 patients with acute herpes zoster were divided into group A and group B by random number table method,with 30 cases in each group.Group A was given basic drug treatment,and group B was given acupoint injection+nerve block treatment on the basis of group A.The visual analogue scale(VAS)score,herpes-related indicators(vesiculation time,crusting time,decrusting time)before and after treatment,clinical efficacy and incidence of postherpetic neuralgia(PHN)were compared between the two groups.Results The vesiculation time,crusting time,decrusting time of group B were(5.30±1.37),(9.50±1.94)and(15.03±1.97)d,which were shorter than(6.67±1.99),(11.47±2.30)and(18.53±3.58)d of group A,with a statistically significant difference(P<0.05).Before treatment,there was no significant difference in VAS score between the two groups(P>0.05).After treatment,VAS score in both groups was significantly lower than that before treatment;VAS score of(2.63±1.15)points in group B was lower than(3.67±0.80)points in group A;there was a statistically significant difference(P<0.05).After treatment,the clinical symptoms in both groups were improved,and the cure rate of 43.3%in group B was better than 16.7%in group A,with a statistically significant difference(P<0.05).1 month after treatment,the incidence of PHN in group B(20.0%)was significantly lower than that in group A(46.7%),with a statistically significant difference(P<0.05).Conclusion Early intervention of acupoint injection combined with nerve block in AHZ can play a positive role in relieving pain and preventing the onset of postherpetic neuralgia without obvious adverse reactions,and is worthy of clinical recommendation.