腕踝针治疗带状疱疹后神经痛临床疗效及对血清炎症因子水平的影响

Clinical observation on wrist-ankle acupuncture in treatment of postherpetic neuralgia and its influence on inflammatory factors

目的:探讨腕踝针治疗带状疱疹后神经痛(postherpetic neuralgia,PHN)病人的临床疗效及对血清炎症因子水平的影响。方法:选取2023年5月至2024年3月就诊于福建中医药大学附属第二人民医院的88例PHN病人,采用随机数字表法分为观察组和对照组,每组44例,对照组给予普瑞巴林口服治疗,观察组接受腕踝针治疗,疗程均为4周。采用视觉模拟评分法(visual analogue scale,VAS)评估两组治疗前、治疗后7、14、28天的疼痛程度。比较两组治疗前、治疗4周后匹兹堡睡眠质量指数(Pittsburg sleep quality index,PSQI)、焦虑自评量表(self-rating anxiety scale,SAS)和抑郁自评量表(self-rating depression scale,SDS)评分及血清炎症因子水平变化情况,并对两组进行临床疗效评价;同时记录两组病人使用应急镇痛药物及不良反应发生情况。结果:观察组和对照组各脱落2例,各42例纳入分析。两组治疗后7、14、28天VAS评分均较治疗前显著降低(P<0.05),且观察组治疗后各时间点VAS评分均低于对照组(P<0.05)。两组治疗前PSQI评分、SAS评分、SDS评分及血清IL-6、TNF-α和CRP水平比较无显著差异,观察组治疗后PSQI评分、SAS评分、SDS评分及血清IL-6、TNF-α和CRP水平均显著低于对照组(P<0.05)。观察组临床总有效率为90.5%,对照组临床总有效率为83.3%(P>0.05)。治疗期间观察组服用应急镇痛药物5例,对照组服用应急镇痛药物11例(P>0.05)。观察组病人不良反应率为9.52%(4/42),显著低于对照组的28.57%(12/42)。结论:腕踝针治疗PHN病人疗效显著,可有效降低VAS评分、改善睡眠质量及调节负性情绪、抑制炎性因子水平、总体临床疗效不劣于对照组,且不良反应低于对照组,值得临床推广应用。

Objective:To explore the clinical effect of wrist-ankle acupuncture in the treatment of postherpetic neuralgia(PHN)and its impact on serum inflammatory factors.Methods:From May 2023 to March 2024,88 patients with PHN at the Second People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine were divided into an observation group and a control group with the random number table method,44 cases in each group.Patients in the control group were treated with Pregabalin,and patients in the observation group were given wrist-ankle acupuncture treatment for 4 weeks.Visual analogue scale(VAS)scores of the two groups were observed to evaluate the pain levels before treatment,as well as at 7 days,14 days,and 28 days after treatment.The Pittsburgh sleep quality index (PSQI) score, self-rating anxiety scale (SAS) score, self-rating depression scale (SDS) score and serum inflammatory factor level changes before and after treatment were compared. The clinical efficacy of the two groups was evaluated. Simultaneously, the use of emergency analgesics and the occurrence of adverse events during treatment were recorded. Results: With two drop-outs both in the observation group and control group, and 42 cases in each group were included in the analysis. The VAS scores of both groups significantly decreased on days 7, 14, and 28 after treatment compared to before treatment (P < 0.05), and the VAS scores of the observation group were significantly lower than those of the control group at all time points after treatment (P < 0.05). There were no significant differences in pre-treatment PSQI scores, SAS scores, SDS scores, and serum IL-6, TNF-α, and CRP levels between the two groups. However, after treatment, PSQI scores, SAS scores, SDS scores, and serum IL-6, TNF-α, and CRP levels in the observation group were significantly lower compared with the control group (P < 0.05). The total effective rate of the observation group was 90.5%, and 83.3% in the control group (P > 0.05). During the treatment, 5 cases in the observation group took emergencyanalgesic drugs, while 11 cases in the control group, with no significant difference (P > 0.05). The adverse reaction rate was 9.52% (4/42) in the observation group, which was significantly lower than 28.57% (12/42) of the control group. Conclusion: Wrist-ankle acupuncture is effective in the treatment of PHN patients, which can effectively reduce the VAS score, improve sleep quality, regulate negative emotions, and inhibit the level of inflammatory factors. The overall clinical efficacy is not inferior to the control group, and the adverse reactions are lower than the control group, so it is worthy of clinical application.