刺血拔罐法联合清热利湿解毒法治疗对湿热内蕴证带状疱疹后神经痛患者疼痛介质水平的影响  

The Effect of Pricking Blood and Cupping Combined with Clearing Heat,Diuresis,and Detoxification Methods on the Level of Pain Mediators in Patients with Postherpetic Neuralgia Caused by Damp Heat Accumulation Syndrome

作　　者：于男 万康敏 陶阳[1] YU Nan;WAN Kangmin;TAO Yang(Nanchang Hongdu Traditional Chinese Medicine Hospital,Nanchang Jiangxi 330000,China)

机构地区：[1]南昌市洪都中医院,江西南昌330000

出　　处：《药品评价》2024年第8期983-987,共5页Drug Evaluation

基　　金：江西省中医药管理局科技计划(2023A0075)。

摘　　要：目的探讨刺血拔罐法联合清热利湿解毒法治疗对湿热内蕴证带状疱疹后神经痛(PHN)患者疼痛介质水平的影响。方法选取南昌市洪都中医院2023年1月至12月所收治湿热内蕴证PHN患者90例,分为对照组、拔罐组和联合组,每组各30例。对照组口服普瑞巴林胶囊,拔罐组在对照组基础上加用刺血拔罐法,联合组在拔罐组基础上服用除湿胃苓汤,三组疗程均为1个月。比较三组治疗3 d、7 d、14 d、治疗后的视觉模拟疼痛评分(VAS)及中医证候积分;于治疗前后比较三组P物质(SP)、前列腺素E2(PGE2)、β内啡肽(β-EP)、5-羟色胺(5-HT)、神经生长因子(NGF)、神经肽(NPY)水平,比较三组临床疗效及不良反应发生情况。结果三组治疗前VAS评分、中医证候积分、SP、PGE2、β-EP、5-HT、NGF、NPY水平差异无统计学意义(P>0.05)。治疗3 d、7 d、14 d及治疗后三组VAS评分、中医证候积分均降低,且联合组低于另外两组(均P<0.05)。治疗后,三组SP、PGE2、NGF、NPY、5-HT水平均降低,且联合组低于另外两组;三组β-EP均升高,且联合组高于另外两组(均P<0.05)。联合组临床总有效率高于另外两组(P<0.05),三组不良反应总发生率差异无统计学意义(P>0.05)。结论刺血拔罐法联合清热利湿解毒法对湿热内蕴证PHN患者效果良好,可改善患者疼痛介质水平。Objective To explore the effect of the combination of pricking blood and cupping therapy with clearing heat,diuresis,and detoxification methods on the level of pain mediators in patients with postherpetic neuralgia(PHN)caused by damp heat accumulation syndrome.Methods Ninety PHN patients with damp heat accumulation syndrome admitted to Nanchang Hongdu Traditional Chinese Medicine Hospital from January to December 2023 were selected and divided into a control group,a cupping group,and a combined group,with 30 cases in each group.The control group received oral administration of pregabalin capsules,while the cupping group received additional pricking blood and cupping therapy on the basis of the control group,the combined group received chushi weiling decoction on the basis of cupping group.The treatment course for all three groups of patients was one month.Compare the visual analogue pain score(VAS)and traditional Chinese medicine syndrome score of three groups of patients after treatment for 3 days,7 days,and 14 days,and after treatment;compare the levels of substance P(SP)and prostaglandin E2(PGE2),βEndorphin(β-EP),5-hydroxytryptamine(5-HT),nerve growth factor(NGF),and neuropeptide(NPY)levels were recorded and compared in clinical efficacy and incidence of adverse reactions among the three groups of patients.Results There was no statistically significant difference in VAS score,traditional Chinese Medicine syndrome score,SP,PGE2,β-EP,5-HT,NGF,and NPY levels among the three groups before treatment(P>0.05).The VAS score and traditional Chinese medicine syndrome score of the three groups of patients decreased after treatment for 3 days,7 days,14 days,and after treatment,and the combined group was lower than the other two groups(all P<0.05).After treatment,the levels of SP,PGE2,NGF,NPY,and 5-HT in all three groups of patients decreased,and the combined group was lower than the other two groups.Theβ-EP increased in three groups,and the combined group was higher than the other two groups(P<0.05).The total clinical

关 键 词：刺血拔罐法 清热利湿解毒法 湿热内蕴证 带状疱疹后神经痛 疼痛介质 

分 类 号：R275.9[医药卫生—中西医结合]