麦粒灸联合微针治疗带状疱疹的临床随机对照观察  

Grain-moxibustion Combined with Microacupuncture for Treatment of Herpes Zoster: a Clinical Randomized Controlled Study

作　　者：任圣 鲍春龄[1] 李申[1] 杨滢瑶 王亚平 郑巧平 REN Sheng;BAO Chun-ling;LI Shen;YANG Ying-yao;WANG Ya-ping;ZHENG Qiao-ping(Department of Acupuncture and Moxibustion,Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai (200437);Department of Dermatology,Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai (200437);Department of Traditional Chinese Medicine,Shanghai Fourth People's Hospital,Shanghai (200081))

机构地区：[1]上海中医药大学附属岳阳中西医结合医院针灸科,上海200437 [2]上海中医药大学附属岳阳中西医结合医院皮肤科,上海200437 [3]上海市第四人民医院中医科,上海200081

出　　处：《中国中西医结合杂志》2019年第10期1204-1208,共5页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：上海市虹口区“国医强优”三年行动计划中医药科研基金项目(No.HGY-KY-2018-12)

摘　　要：目的观察麦粒灸联合头皮针、麦粒灸联合腕踝针与药物治疗带状疱疹的临床疗效。方法采用随机、对照的研究方法,将符合纳入标准的81例初发带状疱疹患者随机分为3组:对照组(CG)、试验组(EG)即麦粒灸+头皮针组(EG1)和麦粒灸+腕踝针组(EG2)。对照组采用抗病毒药物治疗;试验组在此基础上分别采用麦粒灸联合头皮针或腕踝针治疗。治疗5天,随访30天,比较治疗前后整体疗效。采用疼痛程度的数字等级评分法(NRS),观察疼痛开始缓解时间,疼痛缓解程度,后遗神经痛发生率;检验血清白介素(IL)-1β、IL-2R、IL-6、IL-8、IL-10和肿瘤坏死因子α(TNF-α)。结果 EG1和EG2的合并疗效评价优于CG(χ^2=8.816, P=0.012)。3组治疗前后NRS评分、疼痛开始缓解时间比较,差异均有统计学意义(P<0.01)。治疗后3组间IL-6和IL-8比较,差异有统计学意义(P<0.05),EG2的IL-6和IL-8比EG1降低明显(P<0.05)。EG2的带状疱疹后遗神经痛发生率低于CG(P<0.05)。结论在应用伐昔洛韦抗病毒的前提下,麦粒灸联合头皮针、麦粒灸联合腕踝针可以更好更快的治愈带状疱疹,预防后遗神经痛的发生。Objective To observe the difference of clinical efficacy between grain-moxibustion(GM) combined with scalp acupuncture(SA), GM combined with wrist-ankle acupuncture(WAA) and drug treatment for herpes zoster. Methods A randomized, controlled study was conducted. Totally 81 primary herpes zoster patients met the inclusion criteria were randomly assigned to the control group(CG), experimental group 1(EG1; GM+SA), and experimental group 2(EG2; GM+WAA). Patients in the CG group received anti-viral drug treatment, while those in the other two groups additionally received GM+SA or GM+WAA. The treatment course was 5 days and the follow-up day was day 30 after admission. The overall efficacy was compared before and after treatment. Numerical rating scale(NRS) was used to observe pain relief time, pain relief degree, incidence of postherpetic neuralgia(PHN). Cytokine indicators such as serum IL-1β, IL-2 R, IL-6, IL-8, IL-10, and tumor necrosis factor alpha(TNF-α) were detected. Results The curative effects of EG1 and EG2 were higher than that of CG(χ~2=8.816, P=0.012). There were significant differences in NRS score and pain relief starting time in the three groups before and after treatment(P<0.01). Statistical difference existed in IL-6 and IL-8 levers among the three group(P<0.05). IL-6 and IL-8 after treatment decreased more obviously in EG2 than in EG1(P<0.05). The incidence of PHN in EG2 was lower than that in CG(P<0.05). Conclusion Under the premise of anti-virus valaciclovir, GM+SA and GM+WAA cured herpes zoster better and faster and prevented the incidence of PHN.

关 键 词：带状疱疹 麦粒灸 腕踝针 头皮针 

分 类 号：R246.7[医药卫生—针灸推拿学]