调气法针刺联合加巴喷丁治疗带状疱疹后遗神经痛的疗效观察及对血清β-EP和NK-1水平的影响  

Observation of the therapeutic effect of qi-regulating acupuncture combined with gabapentin in the treatment of postherpetic neuralgia and its effect on serumb-EP and NK-1 levels

作　　者：张禹 孟晓敏 张猛 国海超 ZHANG Yu;MENG Xiaomin;ZHANG Meng;GUO Haichao(Baoding Hospital,Guang'anmen Hospital,China Academy of Chinese Medical Sciences(Baoding No.1 Hospital of Traditional Chinese Medicine of Hebei Province),Baoding 071000,China;Xingtai Hospital of Traditional Chinese Medicine of Hebei Province,Xingtai 054001,China)

机构地区：[1]中国中医科学院广安门医院保定医院(河北省保定市第一中医院),保定071000 [2]河北省邢台市中医院,邢台054001

出　　处：《上海针灸杂志》2024年第3期301-306,共6页Shanghai Journal of Acupuncture and Moxibustion

基　　金：河北省中医药管理局中医药类科研计划项目(2022306);保定市科技计划项目(2141ZF105)。

摘　　要：目的 观察调气法针刺联合加巴喷丁治疗带状疱疹后遗神经痛(postherpetic neuralgia, PHN)的临床疗效及对患者血清β-内啡肽(beta endorphin, β-EP)、神经激肽1-受体(neurokinin-1 receptor, NK-1)和P物质(substance P, SP)水平的影响。方法 将102例PHN患者随机分为对照组及治疗组,每组51例。对照组给予单纯加巴喷丁治疗,治疗组给予调气法针刺联合加巴喷丁治疗。观察两组治疗前后视觉模拟疼痛量表(visual analog scale, VAS)、睡眠状况自评量表(self-rating scale of sleep, SRSS)、汉密顿焦虑量表(Hamilton anxiety scale, HAMA)、世界卫生组织生存质量量表(World Health Organization quality of life assessment,WHOQOL)及血清β-EP、NK-1和SP水平,并比较两组临床疗效。结果 治疗后,两组VAS、SRSS及HAMA评分均低于治疗前(P<0.05),且治疗组VAS、SRSS及HAMA评分低于对照组(P<0.05)。治疗后,两组WHOQOL各维度评分均高于治疗前(P<0.05),且治疗组均高于对照组(P<0.05)。治疗后,两组血清β-EP水平升高(P<0.05),血清NK-1和SP水平降低(P<0.05),且治疗组优于对照组(P<0.05)。治疗组的总有效率为94.1%,高于对照组的82.4%(P<0.05)。结论 调气法针刺联合加巴喷丁治疗PHN疗效较好,可有效减轻患者不适症状,提高生活质量,有效降低血清NK-1、SP水平,升高血清β-EP水平。Objective To observe the clinical effect of qi-regulating acupuncture combined with gabapentin on postherpetic neuralgia(PHN)and its effect on serum β-endorphin(β-EP),neurokinin-1 receptor(NK-1),and substance P(SP)levels in patients.Method A total of 102 patients with PHN were randomly divided into a control group and a treatment group,with 51 cases in each group.The control group was treated with gabapentin alone,and the treatment group was treated with qi-regulating acupuncture combined with gabapentin.The visual analog scale(VAS),self-rating scale of sleep(SRSS)and Hamilton anxiety scale(HAMA),World Health Organization quality of life assessment(WHOQOL)and serum β-EP,NK-1 and SP levels were observed before and after treatment in the two groups,and the clinical efficacy of the two groups was compared.Result After treatment,the scores of VAS,SRSS and HAMA in the two groups were lower than those before treatment(P<0.05),and the scores of VAS,SRSS and HAMA in the treatment group were lower than those in the control group(P<0.05).After treatment,the scores of all dimensions of WHOQOL in the two groups were higher than those before treatment(P<0.05),and those in the treatment group were higher than those in the control group(P<0.05).After treatment,the serum β-EP levels were increased(P<0.05),and the serum NK-1 and SP levels were decreased in the two groups(P<0.05),and the treatment group was superior to the control group(P<0.05).The total effective rate of the treatment group was 94.1%,which was higher than 82.4% of the control group(P<0.05).Conclusion Qi-regulating acupuncture combined with gabapentin is effective in the treatment of PHN,which can effectively reduce the discomfort symptoms of patients,improve the quality of life of patients,effectively reduce the levels of serum NK-1 and SP,and increase the level of serum β-EP.

关 键 词：针药并用 神经痛 疱疹后 针刺疗法 调气法 Β-内啡肽 神经激肽1-受体 P物质 

分 类 号：R246.6[医药卫生—针灸推拿学]