深刺夹脊穴结合等电势电针围刺治疗带状疱疹神经后遗痛的临床观察

目的观察深刺夹脊穴结合等电势电针围刺法与普通针刺加TDP治疗仪照射法治疗带状疱疹神经后遗痛的疗效。方法以深刺夹脊穴结合等电势电针围刺法方法治疗带状疱疹后遗神经痛25例的3个疗程的疗效与普通针刺加TDP治疗仪照射方式治疗25例3个疗程的疗效进行随机对比研究。结果深刺夹脊穴结合等电势电针围刺组愈显率96.00%高于普通针刺加TDP治疗仪照射组愈显率72.00%,差异有统计学意义(P<0.05)。深刺夹脊穴结合等电势电针围刺组各疗程的VAS评分均优于普通针刺加TDP治疗仪照射组,差异具有统计学意义(P<0.05)。结论深刺夹脊穴结合等电势电针围刺法对带状疱疹神经后遗痛临床疗效优于普通针刺加TDP治疗仪照射方法。

干扰素α-2b联合注射用倍他米松磷酸钠局部封闭治疗带状疱疹神经后遗痛31例疗效观察

目的:探讨干扰素α-2b注射剂联合注射用倍他米松磷酸钠注射剂局部封闭治疗带状疱疹神经后遗痛的临床疗效。方法:31例患者均口服药物维生素B120mg/次,3次/日;谷维素片20mg,3次/日;每周行干扰素α-2b注射剂(300万U)联合注射用倍他米松磷酸钠注射剂(5.26mg)、利多卡因(3ml)、局部封闭治疗,共3次。治疗结束后,评价临床疗效。结果:31例带状疱疹神经后遗痛患者疼痛的缓解率均达85%左右。结论:干扰素α-2b联合注射用倍他米松磷酸钠局部封闭治疗带状疱疹神经后遗痛取得良好效果。

火针扬刺法治疗带状疱疹血瘀型神经痛的效果

目的:观察采用火针扬刺法治疗带状疱疹血瘀型神经痛的临床效果。方法:选取带状疱疹血瘀型神经痛的患者80例,采用随机数字表法将患者分为对照组和观察组各40例,对照组采用毫针针刺进行治疗,观察组采用火针扬刺法进行治疗,对比两组患者的临床治疗效果。结果:观察组治疗总有效率为92.5%,高于对照组的82.5%,差异有统计学意义(P<0.05);观察组的疼痛视觉模拟(VAS)评分、睡眠质量评分、止痛即刻起效时间明显优于对照组(P<0.05)。结论:采用火针扬刺法治疗带状疱疹血瘀型神经痛的效果优于毫针针刺治疗,可有效缓解患者的疼痛。

神经病理性疼痛治疗靶点和药物（节选）

神经病理性疼痛常由外周神经或脊髓损伤、疾病所引起，并往往持续到原发损伤愈合后数月甚至数年，与组织损伤所引起的伤害性疼痛和炎性疼痛不同，普通镇痛药物往往效果欠佳，而治疗神经病理性疼痛的效应又与疾病的病因学有关，某些药物对三叉神经后遗痛有一定治疗效果，但幻肢痛却无效，到目前为止尚未发现单一药物所有类型神经性疾病疾病都有效，

内服外用中药治疗带状疱疹

带状疱疹中医称“缠腰火丹”、“蛇串疮”。西医治疗多用抗病毒药，如阿昔洛韦、泛昔洛韦等。中医传统辨证多谓“肝胆湿热”，倡用龙胆泻肝汤治之。笔者遵循中医教科书，从俗首先使用龙胆泻肝汤，但几无疗效，有时反而使病情加重，苦恼不已。后偶读当代已故中医名家刘绍奇著《临证发微》，里面有两则治疗带状疱疹病案，作者用“瓜蒌散”加味治之，效出意外。笔者又参阅其他医家外治之治，自拟六一冰朱散外涂，内服瓜蒌散、犀角（水牛角代之）地黄汤、一贯煎化裁合方，效果较好。一般不留神经后遗痛。

虎甘散治疗带状疱疹46例

带状疱疹是由水痘-带状疱疹病毒引起的皮肤病,沿一侧周围神经分布,簇集性疱疹排列成带状,伴剧烈烧灼样刺痛,好发于头面部、胸背部、腰部,中医学称为＂缠腰火丹＂、＂蛇串疮＂,常留下神经后遗痛。笔者自拟虎甘散治疗46例取得了满意疗效,现报告如下：

Observation on the effect of fire needle combined with Linggui Bafa for post-herpetic neuralgia

Objective To observe the clinical effect of fire needle combined with Linggui Bafa for post-herpetic neuralgia （PHN）. Methods One hundred and twenty patients were randomly divided into an observation group and a control group with 60 cases each. For observation group, fire needle was applied to prick Zusanli （足三里 ST 36）, Yanglingquan （阳陵泉 GB 34）, Taichong （太冲 LR 3）, Sanyinjiao （三阴交 SP 6） and partial Ashi points around the lesion, and Linggui Bafa was combined to perform acupuncture therapy, once every other day, 10 times as a course of treatment; for the control group, only fire needle was applied. After 2 courses of treatment, the comparison of the value of visual analogue scale （VAS） and the total effective rate for the two groups were carried out. Results The VAS value of the observation group after treatment was obviously lower than that before treatment （2.28±2.08 vs 6.12±1.96） and that of the control group （2.28±2.08 vs 3.62±2.90）, there were significant differences （all P〈0.01）. The total effective rate of the observation group was obviously higher than that of the control group [93.3% （56/60） vs 76.7% （46/60）], the difference between the two groups was statistically significant （P〈0.05）. Conclusion The effect of fire needle combined with Linggui Ba.fa for PHN is obviously superior to that of single fire needle therapy.

Clinical research on postherpetic neuralgia treated by floating-acupuncture combined with collateral-bloodletting puncture and cupping

Objective To observe the clinical efficacy of treating postherpetic neuralgia （PHN） by combining floating-acupuncture laser with cupping following collateral bloodletting, and to analyze its mechanism. Method One hundred and thirty cases of PHN were randomly divided into a floating-acupuncture laser with cupping following collateral bloodletting group （group A） and an electroacupuncture group （group B） based on the treatment sequence and according to the random number table, with 65 cases in each group. In the group B, G-6805 electroacupuncture apparatus was adopted after the arrival of qi through even reinforcing and reducing （even method） in such acupoints as Hegu （合俗 LI 4）, Taihong （太冲 LR 3）, Zhigou （支沟 TE 6）, Quchi （ 曲池 LI 11） and Zusanli （足三里 ST 36）; in the group A, the treatment combining floatingacupuncture laser with cupping following collateral bloodletting was adopted, and the score of VAS and clinical efficacy before and after treatment in the two groups were compared. Result The differences of VAS scores of the two groups between the time points of after one course of treatment, after the entire treatment, follow up visit three months after the treatment and before treatment were statistically significant （all P〈0.05）. The rate of significant efficiency and total effective rate in the group A were respectively 37.8% and 98.5% （64/65）, and 11.2% and 78.5% （52/65） in the group B. The difference between the two groups was statistically significant after Ridit analysis （P〈0.05）. Conclusion The efficacy of treating PHN by combining floating-acupuncture laser with cupping following collateral bloodletting was significant.

Thin cotton moxibustion combined with plum-blossom needle in treatment of herpes zoster:a controlled trial

Objective To compare the difference of clinical efficacy of thin cotton moxibustion combined with plum-blossom needle and western medication in treatment of herpes zoster.Method Eighty patients with herpes zoster were divided into thin cotton moxibustion group（group A,n=40） and western medication group（group B,n=40） according to the sequence of admission.Patients in group A received thin cotton moxibustion that the colton was used as thin as a cicada＇s wings,combined with plum-blossom needle,and patients in group B received intravenous infusion with 0.25 g of acyclovir once a day,and acyclovir ointment application on affected part for 3-5 times per day.Five days were considered as a course of treatment.Analgesic effect and the incidence of postherpetic neuralgia were observed after two consecutive courses.Result The total effective rate was 97.5%（39/40） in group A,and80.0%（32/40） in group B（P〈0.05）;it was shown from the comparison of course between two groups that the cure rate after one in group A was markedly higher than that in group B（P〈0.01,P〈0.05）;the differences in effectual time and analgesic time between group A and group B were statistically significant（P〈0.05）;after treatment,the incidence of postherpetic neuralgia in group A was markedly lower than that in group B（P〈0.05）.Conclusion Thin cotton moxibustion combined with plum-blossom needle in treatment of herpes zoster can obviously shorten the time of therapy,effectively control pain,and reduce the incidence of postherpetic neuralgia.

Observation on therapeutic effect of combined therapy mainly based on acupuncture for postherpetic neuralgia

Objective To compare the difference in therapeutic effect between the combined therapy mainly based on acupuncture and western medicine in treating postherpetic neuralgia. Methods Eighty patients were randomly divided into a treatment group and a control group by ballot, and 40 patients were included in each group. The patients in the treatment group were treated by using the combined therapy mainly based on acupuncture, in other words, electroacupuncture at Jiáj （夹脊 EX-B2） and acupoint injection, and He-Ne laser therapy was also carried out. The patients in the control group were orally administered with 10 mg oxycodone controlled release tablets, twice a day; 0.5 mg mecobalamin tablets, three times a day. Scores for pain, sleep disorders and anxiety degree of the patients were recorded respectively, and the therapeutic effect in the two groups was counted. Results The total effective rate in the treatment group was 100.0% （40/40）, which was higher than 87.5% （35/40） in the control group; the markedly effective rate in the treatment group was 85.0% （34/40）, which was better than 65.0% （26/40） in the control group （both P0.05）. The therapeutic effects in reliefing pain, sleep disorders and anxiety of the patients in the treatment group were better than that in the control group （all P0.01）. Conclusion The combined therapy mainly based on acupuncture can effectively treat postherpetic neuralgia and the therapeutic effect is better than that in the western medicine group