颊针联合椎旁神经阻滞治疗胸背部带状疱疹后神经痛的疗效观察

Therapeutic Effect of Buccal Acupuncture Combined with Paravertebral Nerve Block on Post-herpetic Neuralgia in Chest and Back

目的:观察颊针联合椎旁神经阻滞治疗胸背部带状疱疹后神经痛(PHN)的临床疗效。方法:选取2021年1月至2021年12月无锡市中医医院收治的PHN患者100例作为研究对象,按照随机数字表法随机分为对照组和观察组,每组50例。对照组采用基础药物配合椎旁神经阻滞治疗,观察组在对照组基础上联合颊针治疗。观察并记录2组患者治疗前及治疗1、2、3、4周后视觉模拟评分(VAS),治疗前后的健康调查简表(SF-36)评分、血清中神经元特异性烯醇化酶(NSE)水平、辅助T细胞1/2(Th1/Th2)水平、不良反应发生情况及总有效率。结果:治疗后2组患者VAS均低于治疗前,且观察组优于对照组(P<0.05)。2组患者的SF-36除生理功能外均较治疗前升高,且观察组优于对照组(P<0.05)。2组患者NSE水平明显低于治疗前,且观察组优于对照组(P<0.05)。2组患者γ干扰素(IFN-γ)水平明显高于治疗前,且观察组优于对照组(P<0.05),2组患者白细胞介素4(IL-4)、白细胞介素10(IL-10)水平明显低于治疗前,且观察组优于对照组(P<0.05)。2组均未发生明显不良反应(P>0.05),观察组总有效率优于对照组(P<0.05)。结论:颊针联合椎旁神经阻滞治疗胸背部PHN效果显著,能有效缓解疼痛,提升患者治疗期间的生命质量,降低神经细胞损伤,提高免疫力。

Objective:To observe the clinical effect of buccal acupuncture combined with paravertebral nerve block on post-herpetic neuralgia in the chest and back.Methods:A total of 100 patients with post-herpetic neuralgia treated in the Traditional Chinese Medicine Hospital of Wuxi from January to December in 2021 were randomized into an observation group(n=50)and a control group(n=50).The control group was treated with basic drugs combined with paravertebral nerve block,and the observation group was treated with buccal acupuncture on the basis of the therapy in the control group.The Visual Analogue Scale(VAS)scores before treatment and after treatment for 1,2,3,and 4 weeks were recorded.The 36-iterm Short-Form Health Survey(SF-36)score,serum level of neuron-specific enolase(NSE),and Th1/Th2 level were determined before and after treatment.The incidence of adverse reactions and total response rate in the two groups were recorded and calculated.Results:The VAS scores in both groups declined after treatment,and the observation group had lower VAS score than the control group(P<0.05).The SF-36 score(except the item of physiological function)rose after treatment,and the observation group had higher SF-36 score than the control group(P<0.05).The NSE level reduced after treatment in both groups,and the reduction was more significant in the observation group than in the control group(P<0.05).After treatment,both groups showed elevated interferon-gamma(IFN-γ)level and lowered interleukin-4 and-10(IL-4 and IL-10)levels(P<0.05),and the observation group had larger changes than the control group(P<0.05).Obvious adverse reactions occurred in neither group(P>0.05).The total response rate of the observation group was higher than that of the control group(P<0.05).Conclusion:Buccal acupuncture combined with paravertebral nerve block demonstrates a definite therapeutic effect on post-herpetic neuralgia in the chest and back.This therapy can relieve the pain,improve the quality of life during treatment,alleviate neuron damage,and enhance immunity of the patients.