穴位注射联合药物治疗急性带状疱疹临床观察  

Clinical Observation on Acupuncture Point Injection plus Medication for Acute Herpes Zoster

作　　者：李浪平[1] 沈亮[1] 周进[1] 陆志俊[1] LI Lang-ping;SHEN Liang;ZHOU Jin;LU Zhi-jun(Shanghai Jiaotong University Medical School Ruijin Hospital Luwan Branch,Shanghai 200020,China)

机构地区：[1]上海交通大学医学院附属瑞金医院卢湾分院,上海200020

出　　处：《上海针灸杂志》2020年第9期1166-1171,共6页Shanghai Journal of Acupuncture and Moxibustion

基　　金：上海市卫生和计划生育委员会中医药科研专项课题(2016LP008)。

摘　　要：目的观察丹参注射液夹脊穴注射联合口服药物预防老年急性带状疱疹后遗神经痛(PHN)的临床疗效。方法带状疱疹患者100例,随机分为治疗组和对照组,每组50例。对照组给予口服盐酸伐昔洛韦片、加巴喷丁治疗,治疗组在对照组治疗的基础上给予丹参注射液夹脊穴注射治疗。两组患者必要时给予口服曲马多缓释片。观察两组治疗前和治疗后1周、3周、6周、12周和24周视觉模拟量表(VAS)评分及每周口服药物总量。记录治疗后12周、24周PHN发生情况。采用SF-36健康量表(SF-36)分别记录治疗前后12周和24周SF-36评分。观察头晕、嗜睡、恶心不良反应发生情况。结果治疗后1周、3周、6周、12周和24周,两组VAS评分明显低于治疗前(P<0.01),治疗组VAS评分明显低于对照组(P<0.01)。治疗后3、6、12和24周治疗组每周口服加巴喷丁剂量和曲马多缓释片剂量明显低于对照组(P<0.05)。治疗组治疗后12周和24周PHN发生率明显低于对照组(P<0.05)。治疗后12周和24周,治疗组SF-36中RF、RP、BP、VT和MH评分明显高于对照组(P<0.05)。治疗组头晕、嗜睡、恶心发生率明显低于对照组(P<0.05)。结论丹参注射液夹脊穴注射联合口服药物能有效降低急性带状疱疹相关性疼痛,可能是预防PHN的一种可行性方法。Objective To investigate the clinical preventing effect of Huatuojiaji point injection of Salvia Miltiorrhiza Injectio plus oral medication on postherpetic neuralgia(PHN)in old patients.Methods One hundred patients with herpes zoster were randomized to treatment and control groups,with 50 cases in each group.The control group received oral administration of Valaciclovir Hydrochloride and Gabapentin and the treatment group,Huatuojiaji point injection of Salvia Miltiorrhiza Injectio in addition.The two groups of patients received oral administration of Tramadol sustained-release tablets when necessary.The Visual Analogue Scale(VAS)score and weekly oral dosage were recorded in the two groups before treatment and after 1,3,6,12 and 24 weeks of treatment.PHN was observed after 12 and 14 weeks of treatment.The 36-Item Short Form Health Survey(SF-36)score was recorded before treatment and after 12 and 24 weeks of treatment.Adverse reactions such as dizziness,somnolence and nausea were observed.Result After 1,3,6,12 and 24 weeks of treatment,the VAS score decreased significantly in the two groups compared with before(P<0.01)and was significantly lower in the treatment group than in the control group(P<0.01).After 3,6,12 and 24 weeks of treatment,weekly oral Gabapentin and Tramadol dosages were significantly lower in the treatment group than in the control group(P<0.05).After 12 and 24 weeks of treatment,the PHN incidence was significantly lower in the treatment group than in the control group(P<0.05).After 12 and 24 weeks of treatment,the SF-36 RF,RP,BP,VT and MH subscores were significantly higher in the treatment group than in the control group(P<0.05).The incidences of dizziness,somnolence and nausea were significantly lower in the treatment group than in the control group(P<0.05).Conclusion Huatuojiaji point injection of Salvia Miltiorrhiza Injectio plus oral medication can effectively reduce the pain related to acute herpes zoster.It may be a practicable method to prevent PHN.

关 键 词：水针 针药并用 穴 夹脊 神经痛 带状疱疹 视觉模拟量表 

分 类 号：R246.6[医药卫生—针灸推拿学]