活络方内服联合丁香膏外用治疗带状疱疹后遗神经痛临床研究  

The Clinical Research of Huoluo Decoction Taken Orally Combined with Dingxiang Ointment in the Treatment of Postherpetic Neuralgia

作　　者：淮丁华[1] 黑春潮[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24期287-291,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:探讨活络方内服及丁香膏外用治疗带状疱疹后遗神经痛(PHN)的疗效及作用机制。方法:110例PHN患者随机按数字法分为对照组和观察组各55例。两组均采用针灸治疗,疗程10 d。对照组口服维生素B1片,20 mg/次,3次/d,甲钴胺片,0.5 mg/次,3次/d,双氯芬酸钠双释放肠溶胶囊,75 mg/次,1次/d。必要时口服氨酚曲马多片。疗程8周。观察组采用活络方内服,及丁香膏外用,疗程8周。采用(VAS)法评价患者疼痛情况,并计算疼痛下降指数;记录治疗前后生存质量(QOL)评分;记录治疗期间氨酚曲马多用量;检测治疗前后T细胞亚群和血清白细胞介素-6(IL-6)、白细胞介素-2(IL-2)水平。结果:观察组疼痛下降指数总有效率为95.54%,优于对照组的78.18%(P<0.05);两组(VAS)评分均较治疗前明显下降,观察组在第2、4、8周(VAS)评分均低于对照组(P<0.05或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);治疗后两组血清IL-6水平均下降(P<0.01),观察组低于对照组(P<0.01);两组血清IL-2水平上升,观察高于对照组(P<0.01);观察组QOL评分高于对照组(P<0.01);治疗期间观察组氨酚曲马多用量少于对照组(P<0.01)。结论:采用活络方内服联合丁香膏外用能快速减轻(PHN)疼痛症状,减少氨酚曲马多用量,提高患者生活质量,其作用机制可能与调节免疫功能,减轻炎症损伤,促进神经功能的恢复有关。Objective： To investigate the clinical effect of orally taken Huoluo decoction with external using Dingxiang ointment in the treatment of postherpetic neuralgia （PHN） and its mechanism of action. Method： One hundred-ten patients were randomly divided into observation group （n=55） and control group（n=55）. Both groups were given acupuncture treatment,the course of treatment was 10 days. The control group was given Vitamin B1 tablet orally, 50 mg/time,3 times/day, methylcobalamin, 0.5 mg/time, 3 times/day, diclofenac sodium dual release enteric-coated capsules, 75 mg/time,1 times/day. Taking paracetamol and tramadol hydrochloride tablets orally when it is necessary. The course of treatment was 8 weeks. The observation group was given oral Huoluo decoction,and external using Dingxiang ointment,treatment course 8 weeks. Pain relief degree by VAS, and calculate the pain decline index;record of quality of life （QOL） score before and after the treatment.Record the dosage in group of acetaminophen tramadol during the treatment.Test the level of T cell subsets and serum interleukin 6 （IL-6） and interleukin 2 （IL-2） before and after treatment. Result： The total effective rate of observation group on pain reduction index （95.54%） were lower than the control group （78.18%） （P〈 0.05）;the both groups using the VAS score were significantly decreased.The VAS scores of observation group were lower than the control group at the second,fourth and eighth week after treatment（P〈0.05 or P〈0.01）;the level of CD3,CD4 and CD4/CD8 in observation group of was superior to the control group, the level of CD8was lower than the control group（P〈0.05 or P〈0.01）; the level of IL-6 in the two groups were reduced（P〈0.01）, while the observation group was lower than control group （P〈0.01）;The level of IL-2 in the two groups were rising（P〈0.01）; while the observation group was higher than control group （P〈0.01）;the QOL scores of observation group was superior to the con

关 键 词：带状疱疹后遗神经痛 活络方 丁香膏 T细胞亚群 白细胞介素-6 白细胞介素-2 

分 类 号：R282[医药卫生—中药学]