针药并用对卒中后中枢性疼痛患者痛觉和感觉阈值的影响  

Effect of Combined Acupuncture and Medicine on Pain Sense and Sensory Threshold in Patients with Central Post-stroke Pain

作　　者：王翠[1] 张京兰[1] WANG Cui;ZHANG Jinglan(Wuhan Hospital of Traditional Chinese Medicine,Wuhan 430000,China)

机构地区：[1]武汉市中医医院,武汉430000

出　　处：《上海针灸杂志》2022年第10期964-969,共6页Shanghai Journal of Acupuncture and Moxibustion

基　　金：武汉市医学科研项目(WZ20C41)。

摘　　要：目的观察针刺联合普瑞巴林治疗卒中后中枢性疼痛的临床疗效及其对患者痛觉耐受阈值、感觉阈值和血清白介素-1β(IL-1β)和趋化因子CXC配体10(CXCL10)的影响。方法将70例卒中后中枢性疼痛患者随机分为对照组和观察组,每组35例。对照组予口服普瑞巴林,观察组予针刺联合口服普瑞巴林治疗。比较两组治疗前后疼痛视觉模拟量表(VAS)评分、匹兹堡睡眠质量指数(PSQI)评分、痛觉耐受阈值、感觉阈值及血清IL-1β和CXCL10水平,比较两组临床疗效。结果观察组总有效率高于对照组(P<0.05)。治疗后,两组VAS和PSQI评分均降低(P<0.05),且观察组上述评分均低于对照组(P<0.05)。对照组治疗后2000 Hz、250 Hz和5 Hz频率下的痛觉耐受阈值和感觉阈值无明显变化(P>0.05)。观察组治疗后各频率下的痛觉耐受阈值明显升高(P<0.05),感觉阈值明显降低(P<0.05);且均优于对照组(P<0.05)。对照组治疗后血清IL-1β和CXCL10水平无明显变化(P>0.05)。观察组治疗后血清IL-1β和CXCL10水平明显降低(P<0.05),且低于对照组(P<0.05)。结论针刺联合普瑞巴林治疗卒中后中枢性疼痛的临床疗效优于单纯普瑞巴林治疗,可控制疼痛症状,提高睡眠质量,改善痛觉耐受阈值和感觉阈值,可能与其降低患者血清IL-1β和CXCL10水平有关。Objective To observe the clinical efficacy of acupuncture plus Pregabalin for central post-stroke pain and its effect on pain tolerance threshold,sensory threshold,and serum interleukin-1β(IL-1β)and chemokine CXC motif ligand 10(CXCL10)in the patients.Method Seventy patients with central post-stroke pain were randomized to a control group and an observation group,with 35 cases in each group.The control group received oral administration of Pregabalin and the observation group received acupuncture in addition.The visual analog scale(VAS)scores,the Pittsburgh sleep quality index(PSQI)scores,pain tolerance threshold,sensory threshold,and serum IL-1βand CXCL10 levels were compared between the two groups before and after treatment.The clinical therapeutic effects were also compared between the two groups.Result The total efficacy rate was higher in the observation group than in the control group(P<0.05).After treatment,the VAS score and the PSQI score decreased in the two groups(P<0.05)and were lower in the observation group than in the control group(P<0.05).Pain tolerance threshold and sensory threshold at 2000 Hz,250 Hz and 5 Hz did not change significantly in the control group after treatment(P<0.05).After treatment,pain tolerance threshold increased significantly and sensory threshold decreased significantly at every frequency in the observation group(P<0.05)and they were better than in the control group(P<0.05).Serum IL-1βand CXCL10 levels did not change significantly in the control group after treatment(P>0.05).After treatment,serum IL-1βand CXCL10 levels decreased significantly in the observation group(P<0.05)and were lower than in the control group(P<0.05).Conclusion Acupuncture plus Pregabalin is clinically more effective than Pregabalin alone in treating central post-stroke pain.It can control pain symptoms,raise sleep quality and improve pain tolerance threshold and sensory threshold,which may be related to its reducing serum IL-1βand CXCL10 levels in the patients.

关 键 词：针刺疗法 针药并用 中风后遗症 疼痛 痛觉耐受阈值 白介素1Β 趋化因子CXC配体10 

分 类 号：R246.6[医药卫生—针灸推拿学]