火针赞刺法治疗急性期带状疱疹疗效观察及对血清Th17、Treg细胞水平的影响  

Clinical study on efficacy of observation shallow fire needle in treatment of acute herpes zoster and influence of serum Th17 and Treg cell levels

作　　者：许纪超 曾婧纯[2] 李铨江 刘子君 王鑫栋 林诗雨 刘琨[1] 林国华[2,3] XU Ji-chao;ZENG Jing-chun;LI Quan-jiang;LIU Zi-jun;WANG Xin-dong;LIN Shi-yu;LIU Kun;LIN Guo-hua(Guangzhou University of Traditional Chinese Medicine,Guangzhou 510405,China;The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine,Guangzhou 510405,China;Shenzhen Nanshan District Hospital of Traditional Chinese Medicine,Shenzhen 518052,China)

机构地区：[1]广州中医药大学,广州510405 [2]广州中医药大学第一附属医院,广州510405 [3]深圳市南山区中医院,深圳518052

出　　处：《中华中医药杂志》2022年第12期7508-7511,共4页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金面上项目(No.81574061);广东省科技计划项目(No.2017A020213019)。

摘　　要：目的:观察火针联合拔罐治疗急性期带状疱疹的临床疗效及对血清Th17、Treg细胞水平影响。方法:将60例急性期带状疱疹患者按随机数表法分为治疗组和对照组,每组30例。治疗组采用火针针刺疱疹区及夹脊穴配合拔罐治疗,对照组采用口服盐酸伐昔洛韦片、维生素B1片治疗。经治疗10d后,评定两组疗效,并比较两组患者的疼痛改善情况、后遗神经痛发生率及血清Th17、Treg细胞水平。结果:治疗组和对照组均能缓解急性期带状疱疹疼痛,视觉模拟量表(VAS)评分、疼痛缓解时间、疼痛持续时间较治疗前显著降低(P<0.05),且治疗组上述临床疗效均优于对照组(P<0.05)。治疗组后遗神经痛发生率为23.3%(7/30),显著低于对照组[50%(15/30)](P<0.05)。治疗组和对照组治疗后Th17、Treg细胞及Th17/Treg水平均显著低于治疗前(P<0.05)。后遗神经痛组Th17/Treg细胞水平显著高于无后遗神经痛组(P<0.05),且后遗神经痛的发生与Th17/Treg细胞水平呈正相关(P<0.01)。结论:火针赞刺法是治疗急性期带状疱疹的有效方法,可及时缓解疼痛并减少后遗神经痛的发生。Objective: To observe the clinical effect of fire needle combined with cupping therapy in the treatment of acute herpes zoster and influence of serum Th17 and Treg cells. Methods: A total of 60 patients with acute herpes zoster were randomly divided into treatment and control groups by random number table method with 30 patients in each group. Treatment group used shallow fire needle stimulation and cupping on herpes area and Jiaji points, and control group was treated with oral vaciclovir hydrochloride and vitamin B1. After 10 days of treatment, the efficacy of the two groups was assessed, and the pain improvement, the incidence of posterior neuralgia and serum Th17 and Treg cell levels were compared between the two groups.Results: Both the treatment group and the control group were able to relieve herpes zoster pain in the acute phase, VAS, pain relief time and pain duration were significantly relieved compared with those before treatment(P<0.05), and the effects of the treatment group was better than that of the control group(P<0.05). The incidence of sequela neuralgia in the treatment group was 23.3%(7/30),which was significantly lower than that in the control group [50%(15/30)](P<0.05). The levels of Th17, Treg cells and Th17/Treg cells in the treatment group and the control group after treatment were significantly lower than those before treatment(P<0.05).The level of Th17/Treg cells in the sequela neuralgia group was significantly higher than that in the non sequela neuralgia group(P<0.05), and the level of Th17/Treg cells was positively correlated with the occurrence of sequela neuralgia(P<0.01).Conclusion: Shallow fire acupuncture method is an effective treatment of acute herpes zoster, which can timely relieve pain and reduce the occurrence of posterior neuralgia.

关 键 词：火针赞刺法 急性期带状疱疹 带状疱疹急性期疼痛 TH17细胞 TREG细胞 

分 类 号：R246.7[医药卫生—针灸推拿学]