通络止痛方联合叩刺拔罐法治疗老年带状疱疹后遗神经痛60例  

Tongluo Zhitong Decoction Combined with Tapping and Cupping Treatment in 60 Cases of Senile Postherpetic Neuralgia

作　　者：王晓丽 张跃营 邱曙光 刘学伟[2] 

机构地区：[1]郑州市中医院,郑州450007 [2]河南省中医院,郑州450002

出　　处：《中国实验方剂学杂志》2014年第7期212-215,共4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:观察通络止痛方内服联合叩刺拔罐法治疗老年带状疱疹后遗神经痛(PHN)的临床疗效及对患者血清白细胞介素-2(IL-2)和肿瘤坏死因子-α(TNF-α)的影响。方法:将120例老年PHN患者随机分为对照组和观察组各60例。对照组采用盐酸阿米替林片,25 mg/次,每晚1次,口服;甲钴胺片,0.5 mg/次,3次/d,口服;氨酚曲马多片,1片/次,必要时服用;双氯芬酸钠乳膏,适量外涂患处。观察组内服通络止痛方,1剂/d,采用叩刺拔罐,隔日1次,连续治疗10次;必要时可服用氨酚曲马多片。两组疗程均为4周。记录疼痛程度、疼痛减轻时间、进行睡眠质量评定及氨酚曲马多片的使用量;检测治疗前后血清IL-2和TNF-α水平。结果:观察组治疗总有效率95.0%优于对照组的81.67%(P<0.05);治疗后1周两组疼痛程度均较治疗前减轻(P<0.01),第2,3,4周,观察组疼痛程度评分均低于对照组(P<0.01);治疗后1周两组睡眠质量评分均较治疗前下降(P<0.01);观察组疼痛减轻时间少于对照组(P<0.01),氨酚曲马多片的使用量少于对照组(P<0.01);治疗后观察组血清IL-2高于对照组,TNF-α水平低于对照组(P<0.01)。结论:络病理论指导下的叩刺拔罐法和通络止痛方内服快速减轻老年PHN患者疼痛,改善患者睡眠质量,临床疗效显著,其作用机制可能与升高IL-2、降低TNF-α水平,调节免疫功能,减轻炎症对神经功能的损伤有关。Objective： The purpose is to discuss the clinical effects of Tongluo Zhitong decoction united tapping and cupping methods to treat agedness ostherpetic neuralgia （PHN） and observe the influence of it on serum interleukin-2 （IL-2）and tumor necrosis factor-α（TNF-α）. Method： One hundred and twenty elder patients with PHN were randomly divided into control group （60 cases） and observation group （60 cases）.in control group, Control group amitriptyline hydrochloride tablets,25 mg/time,only 1 time at night,taken orally;mecobalamin tablets,0.5 mg/time,3 times/day,taken orally,paracetamol and tramadol hydrochloride tablets,1 piece/time, taken when necessary,diclofenac sodium cream,coated infected part appropriately.For patients in observation group, they took tapping acupuncture cupping, every other day,continuing using ten times;Tongluo Zhitong decoction,1 does/day,taken orally.When necessary, patients can take acetaminophen tramadol tablets.Both groups were treated for 4 weeks.Record pain degree,time of pain relief,evaluate sleep quality,and application amount of paracetamol and tramadol hydrochloride tablets. Detect the level of serum IL-2 and TNF-α before and after treatment. Result： The total treatment efficacy of the observation group was 95.0% superior to 81.67% of the control group（P〈0.05）. After one week of the treatment,the pain degree of the two groups were both lower than that before the treatment,at 2,3,4 weeks,the pain degree score of the observation group was lower than that of the control group（P〈0.01）. After one week of the treatment, the sleep quality score of the two groups were lower than that before the treatment（P〈0.01）,the alleviative time of pain of the observation group was less than that of the control group（P〈0.01）, besides,the dosage of paracetamol and tramadol hydrochloride tablets were less than that of the control group（P〈0.01）. Conclusion： Guided by the collateral disease theory can relief the pain of elderly PHN patients,and impr

关 键 词：带状疱疹后遗神经痛 络病 叩刺拔罐 通络止痛方 白细胞介素-2 肿瘤坏死因子-α 

分 类 号：R287[医药卫生—中药学]