夹脊穴埋线联合围灸对带状疱疹后遗神经痛的镇痛效果及机制研究  

Analgesic Effect and Mechanism of Jiaji Catgut Embedding Combined with Peripheral Moxibustion in Treatment of PHN

作　　者：赵净 由丽娜[2] 周璇[1] ZHAO Jing;YOU Lina;ZHOU Xuan(The Fifth Affiliated Hospital of Xinjiang Medical University,Urumqi 830011,China;Affiliated Cancer Hospital of Xinjiang Medical University,Urumqi 830011,China)

机构地区：[1]新疆医科大学第五附属医院,新疆乌鲁木齐830011 [2]新疆医科大学附属肿瘤医院,新疆乌鲁木齐830011

出　　处：《针灸临床杂志》2025年第2期26-30,共5页Journal of Clinical Acupuncture and Moxibustion

基　　金：新疆维吾尔自治区自然科学基金,编号:2020D01C320。

摘　　要：目的:观察夹脊穴埋线联合围灸疗法对带状疱疹后遗神经痛(PHN)患者的临床疗效及可能的机制。方法:选取80例PHN患者,将其随机分为对照组和观察组,每组各40例。对照组给予常规西药治疗,观察组采用夹脊穴穴位埋线配合围灸疗法,疗程均为4周。治疗4周后比较两组患者临床疗效,比较治疗前后患者中医症候评分、疼痛视觉模拟评分(VAS)、皮肤病生活质量指数量表评分(DLQI)、抑郁自评量表(SDS)评分及睡眠质量评分(QS)的变化,检测两组患者外周血血清中P物质(SP)、脑源性神经营养因子(BDNF)和原肌球蛋白受体激酶B(TrkB)的表达水平。结果:对照组、观察组患者临床总有效率比较差异无统计学意义(P>0.05),观察组愈显率明显优于对照组(P<0.05);与治疗前比较,两组患者经治疗后中医症候评分、VAS、DLQI及SDS评分明显降低,QS评分明显提升,差异有统计学意义(P<0.05),患者血清中SP的水平明显下降,BDNF、TrkB的水平明显升高,差异有统计学意义(P<0.05);治疗后两组组间比较,观察组患者中医症候评分、VAS、DLQI、SDS评分及血清中SP的水平明显低于对照组,QS评分及血清BDNF、TrkB的水平明显高于对照组,差异有统计学意义(P<0.05)。结论:夹脊穴埋线联合围灸疗法用于PHN治疗疗效显著,可有效降低疼痛程度,改善负面情绪和睡眠质量,其作用机制可能与调节BDNF/TrkB信号通路分子水平相关。Objective:To observe the clinical effect and possible mechanism of catgut Jiaji catgut embedding combined with peripheral moxibustion in treatment of postherpetic neuralgiar(PHN).Methods:80 patients with PHN were randomly divided into the control group and the observation group,with 40 cases in each group.The control group was treated with conventional Western medication,and the observation group was treated with Jiaji catgut embedding.The treatment course was 4 weeks in both groups.Clinical efficacy was compared between the two groups.The scores of TCM symptoms,VAS,DLQI,SDS and QS were compared between before and after the treatment in the two groups.The serum levels of SP,BDNF and TrkB were detected in both groups.Results:There was no statistical difference in the total clinical effective rate between the two groups(P>0.05).The remarkable effective rate of the observation group was significantly higher than that of the control group(P<0.05).The scores of TCM symptoms,VAS,DLQI and SDS were significantly decreased,and the OS score was significant increased after the treatment compared with those before the treatment in the two groups(P<0.05).The serum level of SP was significantly reduced,whereas the serum levels of BDNF and TrkB were significantly increased after the treatment in the two groups(P<0.05).The scores of TCM symptoms,VAS,DLQI and SDS,as well as the serum level of SP were significantly lower in the observation group than those in the control group,whereas the QS score and the serum levels of BDNF and TrkB were significantly higher in the observation group than those in the control group(P<0.05).Conclusion:The combination of Jiaji catgut embedding and peripheral moxibustion has a significant therapeutic effect on PHN,which can effectively reduce the degree of pain,improve negative emotions and sleep quality.The mechanism of action may be related to the molecular level regulation of the BDNF/TrkB signaling pathway.

关 键 词：带状疱疹 后遗神经痛 夹脊穴埋线 围灸 

分 类 号：R246.6[医药卫生—针灸推拿学]