桃红四物汤加味联合穴位贴敷治疗带状疱疹后遗神经痛患者的临床疗效及作用机制  

Clinical Efficacy and Mechanism of Modified Taohong Siwu Decoction Combined with Acupoint Application in the Treatment of Postherpetic Neuralgia

作　　者：朱芳[1] 漆涛[1] 吴丹 ZHU Fang;QI Tao;WU Dan(Pain Department,Hospital of Chengdu University of TCM,Chengdu Sichuan 610072)

机构地区：[1]成都中医药大学附属医院疼痛科,四川成都610072

出　　处：《世界中西医结合杂志》2024年第8期1634-1640,1646,共8页World Journal of Integrated Traditional and Western Medicine

基　　金：四川省中医医院成都中医药大学附属医院科研项目(21HL21);四川省中医药管理局2021年度中医药科研专项课题(第299)。

摘　　要：目的探讨桃红四物汤加味联合穴位贴敷治疗带状疱疹后遗神经痛(Postherpetic nerualgia,PHN)患者的临床疗效及作用机制。方法选取2021年2月—2023年2月期间成都中医药大学附属医院疼痛科收治的93例PHN患者,按入院顺序分为对照组46例和观察组47例。其中对照组脱落3例,观察组脱落2例,最终88例完成试验,每组各44例。对照组采用常规西药治疗,观察组在对照组基础上加用桃红四物汤加味和穴位贴敷治疗。治疗4周后,观察比较两组患者治疗前后疼痛情况[视觉模拟评分(Visual analogue scales,VAS)、疼痛持续时间积分、疼痛间隔时间积分]、炎症因子[环氧化酶-2(Cyclooxygenase-2,COX-2)、肿瘤坏死因子-α(Tumor necrosis factor,TNF-α)、白细胞介素-6(Interleukin-6,IL-6)、白细胞介素-1β(Interleukin-1β,IL-1β)、白细胞介素-10(Interleukin-10,IL-10)]、疼痛介质[P物质(Substance P,SP)、神经肽Y(Neuropeptide Y,NPY)、β-内啡肽(β-endorphin,β-EP)]、T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))变化情况,评估临床疗效及安全性。结果治疗后两组患者VAS、疼痛持续时间积分、疼痛间隔时间积分均较治疗前降低,差异有统计学意义(P<0.05);且观察组各疼痛积分明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者COX-2、TNF-α、IL-6、IL-1β水平均较治疗前降低,IL-10水平均较治疗前升高,差异有统计学意义(P<0.05);且观察组COX-2、TNF-α、IL-6、IL-1β水平均明显低于对照组,IL-10水平明显高于对照组,差异有统计学意义(P<0.05)。治疗后两组患者血清SP、NPY水平均较治疗前降低,β-EP水平均较治疗前升高,差异有统计学意义(P<0.05);且观察组血清SP、NPY水平均明显低于对照组,β-EP水平明显高于对照组,差异有统计学意义(P<0.05)。治疗后两组患者CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)均较治疗前升高,CD8^(+)均较治疗前降低,差异有统计学意义(P<0.05);且Objective To investigate the clinical efficacy and mechanism of modified Taohong Siwu decoction combined with acupoint application in the treatment of patients with postherpetic neuralgia(PHN).Methods 93 PHN patients treated in the Pain Department of the Hospital of Chengdu University of TCM from February 2021 to February 2023 were selected.They were divided into a control group(46 cases)and an observation group(47 cases)according to the order of admission.In the control group,3 cases dropped out;in the observation group,2 cases dropped out,resulting in 88 patients completing the trial,with 44 cases in each group.The control group received conventional Western medicine treatment,while the observation group received modified Taohong Siwu decoction combined with acupoint application in addition to the treatment given to the control group.After 4 weeks of treatment,the pain levels[visual analog scales(VAS),pain duration score,pain interval score],inflammation factors[cyclooxygenase 2(COX-2),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),Interleukin-1β(IL-1β),Interleukin-10(IL-10)],pain mediators[substance P(SP),neuropeptide Y(NPY),β-endorphin(β-EP)],and T lymphocyte subsets(CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+))were observed and compared before and after treatment to assess clinical efficacy and safety.Results After treatment,VAS,pain duration scores,and pain interval scores were significantly lower in both groups compared to before treatment,with statistically significant differences(P<0.05);the pain scores in the observation group were significantly lower than those in the control group,with a statistically significant difference(P<0.05).After treatment,COX-2,TNF-α,IL-6,and IL-1βlevels were significantly reduced,while IL-10 levels were significantly increased in both groups compared to before treatment,with statistically significant differences(P<0.05);the levels of COX-2,TNF-α,IL-6,and IL-1βin the observation group were significantly lower,and IL-10 levels were significantly higher compared to the

关 键 词：桃红四物汤加味 穴位贴敷 带状疱疹后遗神经痛 疼痛 气虚血瘀 

分 类 号：R752.12[医药卫生—皮肤病学与性病学]