抗毒消痛方内服加丁香膏外用配合针灸治疗带状疱疹急性期的疗效及对后遗神经痛的影响  

Kangdu Xiaotong Decoction Cooperate Clove Ointment With the Effect of Acupuncture in the Treatment of Acute Herpes Zoster and Influence on Herpetic Neuralgia

作　　者：黑春潮[1] 淮丁华[1] 杜志超[1] 

机构地区：[1]河北工程大学医学院中医系,河北邯郸056001

出　　处：《中国实验方剂学杂志》2013年第23期286-290,共5页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：邯郸市科技计划项目(1223108089-5)

摘　　要：目的： 观察中医综合疗法治疗带状疱疹（HZ）急性期的疗效及对后遗神经痛的影响。 方法： 将120例患者随机按数字法分为对照组和观察组各60例。对照组采用西医常规治疗：泛昔洛韦片，0.25 g/次，3次/d，口服;维生素B1片，10 mg/次，3次/d，口服;甲钴胺片，0.5 mg/次，3次/d，口服，阿昔洛韦软膏，外涂，2~3次/d。观察组采用中医综合疗法：抗毒消痛方，1剂/d，丁香膏外敷，2~3次/d，针灸围针刺，1次/d，两组疗程均为14 d。记录疱疹止疱时间、结痂和脱痂时间;采用视觉模拟（VAS）法评价患者疼痛情况，记录皮损评分，检测治疗前后T细胞亚群和血清肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）、白细胞介素-10（IL-10）水平，随访3个月记录后遗神经痛（PHN）发生例数。 结果： 观察组总有效率95.0%，优于对照组的83.3%（P〈0.05）;观察组止疱时间、结痴时间（结痴面积超过50%）及脱痂时间均低于对照组（P〈0.01）;治疗后第7，14天，观察组VAS评分及皮损评分均低于对照组（P〈0.01）;治疗后观察组CD3、CD4及CD4/CD8水平高于对照组，CD8低于对照组（P〈0.05或P〈0.01）;治疗后观察组外周血TNF-α，IL-6，IL-10水平低于对照组（P〈0.01）;进行3个月的随访，对照组有37例（61.7%）出现PHN，观察组有23例（38.3%），观察组PHN发生率低于对照组（P〈0.05）。 结论： 中医综合疗法能减轻HZ患者疼痛，快速减轻皮损症状，促进疱疹愈合，减少PHN的发生率，临床疗效显著;中医综合疗法能调节T淋巴细胞亚群功能，提高免疫力，还能降低外周血TNF-α，IL-6，IL-10水平，减轻炎性损伤。Objective： To observe the therapeutic effects of comprehensive treatment of TCM on herpes zoster （HZ）in acute stage and the influence on postherpetic neuralgia. Method： One hundred and twenty patients were randomly divided into observation group （n=60） and control group （n=60）. Patients in the two groups were both treated with conventional Western therapy：Famciclovir tablets,0.25 g/time,3times/d,orally;vitamin B1 tablets,10 mg/time,3 times/d,orally;Mecobalamine tablets,0.5 mg/time,3 times/d,orally,Aciclovir ointment Lowe ointment,coated,2 to 3 times/d. Patients in observation group were treated with Chinese medicine therapy：Kangdu Xiaotong Decoction,one dose/d,Cloves Cream,2 to 3 times/d,acupuncture around method,1 times/d,14 days as one cycle. Record herpes blisters stop time,crusting and scab off time;evaluate pain in patients using the Visual Analogue Scale（VAS） method,recording the levels of T cell subsets and serum tumor necrosis factor-α （TNF-α）,interleukin-6 （IL-6）,interleukin-10 （IL-10） before and after treatment,recording the cases of postherpetic neuralgia （PHN） in the followed three months. Result： The total efficacy of the observation group （95.0% ） was significantly better than the control group （83.3% ）（P〈0.05）. crusting and scab off time of the observation group were lower than the control group（P〈0.01）. VAS scores and lesions of the observed group scores were lower than the control group in 7 and 14 day （P〈0.01）. Levels of CD3,CD4 and CD4/CD8 were higher than the control group,level of CD8 was lower than the control group（P〈0.05 or P〈0.01.After treatment,blood TNF-α,IL-6,IL-10 levels of the observed group were significantly lower than the control group than the control group （P〈0.01）;In the following three months,37 cases occurred PHN in the control group （61.7% ）,the observation group was 23 cases （38.3% ）,the incidence of PHN of observation group was lower than the control group （P〈0.05）. Conclusion�

关 键 词：带状疱疹 抗毒消痛方 丁香膏 T细胞亚群 炎症因子 

分 类 号：R287[医药卫生—中药学]