双重围刺法联合叩刺拔罐治疗老年带状疱疹后遗神经痛临床研究
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摘要
目的观察双重围刺法联合叩刺拔罐治疗老年带状疱疹后遗神经痛(PHN)的临床疗效。方法将72例老年PHN患者按照随机数字表法分为2组。对照组36例予加巴喷丁胶囊口服治疗,共治疗22 d;治疗组36例予双重围刺法联合叩刺拔罐治疗,10 d为1个疗程,疗程间隔2 d,共治疗2个疗程。比较2组治疗前后疼痛视觉模拟评分(VAS)变化情况,比较2组疗效,并比较治疗组中不同疼痛发生部位疗效。结果治疗组总有效率94.44%,对照组总有效率75.00%,治疗组疗效优于对照组(P<0.05)。治疗后2组疼痛VAS评分均降低(P<0.01),且治疗组低于对照组(P<0.05)。治疗组中疼痛部位在胸腹部及腰背部者疗效优于在四肢部者,但比较差异无统计学意义(P>0.05)。结论双重围刺法联合叩刺拔罐治疗老年PHN疗效确切,能明显改善疼痛症状,值得临床推广应用。
Objective To observe the clinical efficacy of double surround needling combined with pricking-cupping bloodletting in the treatment of senile postherpetic neuralgia(PHN). Methods 72 elderly patients with PHN were divided into two groups according to random number table method. 36 cases in control group were treated by gabapentin capsule orally for 22 day. 36 cases in treatment group were treated by double surround needling combined with pricking-cupping bloodletting, the treatment lasted for 10 days as a course of treatment, with an interval of 2 days, and a total of 2 courses of treatment, the changes of pain visual analogue scale(VAS) before and after treatment were compared between the two groups,the curative effects of the two groups were compared, and the effects of different pain sites in the treatment group were compared. Results The total effective rate was 94.44 % in treatment group and 75.00% control group. The clinical curative effect of the treatment group was better than that of the control group(P<0.05). After treatment, the VAS pain scores of the two groups were lower than those in the group before treatment(P<0.01), and the treatment group was lower than the control group(P<0.05). In the treatment group, the curative effect of pain location in the back and chest was better than that in the limbs, but there was no significant difference(P>0.05). Conclusion Double surround needling combined with pricking-cupping bloodletting is effective and safe in the treatment of elderly PHN, which is worthy of clinical application.
Objective To observe the clinical efficacy of double surround needling combined with pricking-cupping bloodletting in the treatment of senile postherpetic neuralgia(PHN). Methods 72 elderly patients with PHN were divided into two groups according to random number table method. 36 cases in control group were treated by gabapentin capsule orally for 22 day. 36 cases in treatment group were treated by double surround needling combined with pricking-cupping bloodletting, the treatment lasted for 10 days as a course of treatment, with an interval of 2 days, and a total of 2 courses of treatment, the changes of pain visual analogue scale(VAS) before and after treatment were compared between the two groups,the curative effects of the two groups were compared, and the effects of different pain sites in the treatment group were compared. Results The total effective rate was 94.44 % in treatment group and 75.00% control group. The clinical curative effect of the treatment group was better than that of the control group(P<0.05). After treatment, the VAS pain scores of the two groups were lower than those in the group before treatment(P<0.01), and the treatment group was lower than the control group(P<0.05). In the treatment group, the curative effect of pain location in the back and chest was better than that in the limbs, but there was no significant difference(P>0.05). Conclusion Double surround needling combined with pricking-cupping bloodletting is effective and safe in the treatment of elderly PHN, which is worthy of clinical application.
引文
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[9] 王存斌,耿立成.中西医结合治疗带状疱疹后遗神经痛的进展[J].内蒙古中医药,2017,36(15):117-118.
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[13] 张秋凤.中药内服外敷治疗带状疱疹后遗神经痛的临床疗效观察[J].中国实用医药,2018,13(19):98-100.
[14] 赵学军,傅志俭.抗抑郁药对带状疱疹后神经痛疗效影响的随机对照研究[J].中国疼痛医学杂志,2012,18(2):81-83.
[15] 方丽,吴贤杰.带状疱疹及其后遗神经痛治疗与预防[J].国际皮肤性病学杂志,2009,35(3):173-175.
[16] 段彩茹.针灸为主治疗带状疱疹后遗神经痛的临床观察[J].光明中医,2018,33(5):681-683.
[17] 王敏华,池凤好,王蕾.中医综合疗法治疗带状疱疹后遗神经痛的疗效观察[J].岭南皮肤性病科杂志,2007,14(4):264,269.
[18] 孙远征,王啸平,李磊.针刺郄穴配合电针围刺治疗枕神经痛疗效观察[J].上海针灸杂志,2017,36(1):45-47.
[19] 丁吉林,陈诚,资昌艳,等.近15年针灸疗法治疗带状疱疹后遗神经痛研究进展[J].亚太传统医药,2017,13(2):71-73.
[20] 姜建芳.夹脊穴斜刺配合局部围刺治疗带状疱疹后遗神经痛36例临床观察[J].甘肃中医药大学学报,2017,34(4):67-70.
[21] 刘会霞,袁秀丽,吕雪莲,等.围刺针法在临床中的应用现状研究[J].亚太传统医药,2017,13(17):72-75.
[22] 罗春艳,蒋著椿,刘振威.围刺配合拔血罐治疗艾滋病合并带状疱疹后遗神经痛22例[J].光明中医,2017,26(4):9-10.
[23] 李莉莉.局部围刺法联合桃红四物汤加减治疗面部黄褐斑患者的临床观察[J].中国民间疗法,2019,27(1):51-53.
[24] 殷建波,王敏.梅花针加罐配合药物治疗颈部以下带状疱疹[J].光明中医,2018,33(4):537-539.
[25] 曾玲,付勇,黄河,等.热敏灸配合皮肤针叩刺治疗气滞血瘀型带状疱疹后遗神经痛23例[J].江西中医药,2013,44(4):51-53.
[26] 刘军.皮肤针叩刺加拔罐治疗带状疱疹后遗神经痛50例[J].中国民间疗法,2012,20(12):25-26.
[27] 傅佳.试探刺血疗法治病机理及临床应用[J].光明中医,2018,33(1):94-96.
[28] 李丹丹,孟向文,刘华朋,等.拔罐疗法作用机理研究概述[J].辽宁中医杂志,2014,41(11):2506-2508.
[29] 林华胜,黄贵华,李雪梅,等.壮医针灸技术机理研究之壮医莲花针拔罐逐瘀疗法[J].时珍国医国药,2016,27(8):1927-1928.
[30] 高国胜,康国辉,袁军,等.背部特定腧穴拔罐治疗小儿肺气亏虚型咳嗽的临床观察[J].河北中医,2017,39(5):659-662.
[31] 何舟,赵朝庭.刺血拔罐配合电针治疗带状疱疹后遗神经痛的临床疗效观察[J].广西医科大学学报,2018,35(2):271-272.
[32] 李灯彤,耿立东.放血拔罐配合中药治疗带状疱疹后遗神经痛25例[J].实用中医药杂志,2017,33(9):1034-1035.
[33] 田浩,田永静,王兵,等.刺血拔罐对带状疱疹后遗神经痛患者血清P物质的影响[J].中国针灸,2013,33(8):678-681.
[2] 潘朝霞,邓海清.围刺法加TDP照射治疗带状疱疹后遗神经痛99例[J].中医研究,2009,22(12):47-48.
[3] Ma SM,Ni JX,Li XY,et al.High-frequency repetitive transcranial magnetic stimulation reduces pain in postherpetic neuralgia[J].Pain Med,2015,16(11):2162-2170.
[4] 黄玮,戴若以,顾小红.带状疱疹后遗神经痛患者生命质量研究[J].华西医学,2017,32(8):1203-1207.
[5] 倪家骧,樊碧发,薛富善.临床疼痛治疗技术[M].北京:科学技术文献出版社,2005:126.
[6] 国家中医药管理局.中医病证诊断疗效标准[M].南京:南京大学出版社,1994:144.
[7] 赵英.疼痛的测量和评估方法[J].中国临床康复,2002,6(16):2347-2349,2352.
[8] 周世荣.带状疱疹后遗神经痛的发病机制及治疗进展[J].皮肤病与性病,2011,33(4):204-206.
[9] 王存斌,耿立成.中西医结合治疗带状疱疹后遗神经痛的进展[J].内蒙古中医药,2017,36(15):117-118.
[10] 杜元灏.现代针灸病谱[M].北京:人民卫生出版社,2009:97.
[11] 赵东利,张豫凤,李竹茜.带状疱疹后遗神经痛的治疗进展[J].中外医疗,2013,32(19):191-192.
[12] 伍小敏,于泳健,蔡放,等.带状疱疹后遗神经痛的发病相关因素分析[J].中华全科医学,2016,14(3):352-354.
[13] 张秋凤.中药内服外敷治疗带状疱疹后遗神经痛的临床疗效观察[J].中国实用医药,2018,13(19):98-100.
[14] 赵学军,傅志俭.抗抑郁药对带状疱疹后神经痛疗效影响的随机对照研究[J].中国疼痛医学杂志,2012,18(2):81-83.
[15] 方丽,吴贤杰.带状疱疹及其后遗神经痛治疗与预防[J].国际皮肤性病学杂志,2009,35(3):173-175.
[16] 段彩茹.针灸为主治疗带状疱疹后遗神经痛的临床观察[J].光明中医,2018,33(5):681-683.
[17] 王敏华,池凤好,王蕾.中医综合疗法治疗带状疱疹后遗神经痛的疗效观察[J].岭南皮肤性病科杂志,2007,14(4):264,269.
[18] 孙远征,王啸平,李磊.针刺郄穴配合电针围刺治疗枕神经痛疗效观察[J].上海针灸杂志,2017,36(1):45-47.
[19] 丁吉林,陈诚,资昌艳,等.近15年针灸疗法治疗带状疱疹后遗神经痛研究进展[J].亚太传统医药,2017,13(2):71-73.
[20] 姜建芳.夹脊穴斜刺配合局部围刺治疗带状疱疹后遗神经痛36例临床观察[J].甘肃中医药大学学报,2017,34(4):67-70.
[21] 刘会霞,袁秀丽,吕雪莲,等.围刺针法在临床中的应用现状研究[J].亚太传统医药,2017,13(17):72-75.
[22] 罗春艳,蒋著椿,刘振威.围刺配合拔血罐治疗艾滋病合并带状疱疹后遗神经痛22例[J].光明中医,2017,26(4):9-10.
[23] 李莉莉.局部围刺法联合桃红四物汤加减治疗面部黄褐斑患者的临床观察[J].中国民间疗法,2019,27(1):51-53.
[24] 殷建波,王敏.梅花针加罐配合药物治疗颈部以下带状疱疹[J].光明中医,2018,33(4):537-539.
[25] 曾玲,付勇,黄河,等.热敏灸配合皮肤针叩刺治疗气滞血瘀型带状疱疹后遗神经痛23例[J].江西中医药,2013,44(4):51-53.
[26] 刘军.皮肤针叩刺加拔罐治疗带状疱疹后遗神经痛50例[J].中国民间疗法,2012,20(12):25-26.
[27] 傅佳.试探刺血疗法治病机理及临床应用[J].光明中医,2018,33(1):94-96.
[28] 李丹丹,孟向文,刘华朋,等.拔罐疗法作用机理研究概述[J].辽宁中医杂志,2014,41(11):2506-2508.
[29] 林华胜,黄贵华,李雪梅,等.壮医针灸技术机理研究之壮医莲花针拔罐逐瘀疗法[J].时珍国医国药,2016,27(8):1927-1928.
[30] 高国胜,康国辉,袁军,等.背部特定腧穴拔罐治疗小儿肺气亏虚型咳嗽的临床观察[J].河北中医,2017,39(5):659-662.
[31] 何舟,赵朝庭.刺血拔罐配合电针治疗带状疱疹后遗神经痛的临床疗效观察[J].广西医科大学学报,2018,35(2):271-272.
[32] 李灯彤,耿立东.放血拔罐配合中药治疗带状疱疹后遗神经痛25例[J].实用中医药杂志,2017,33(9):1034-1035.
[33] 田浩,田永静,王兵,等.刺血拔罐对带状疱疹后遗神经痛患者血清P物质的影响[J].中国针灸,2013,33(8):678-681.