铺棉灸结合电针治疗带状疱疹的临床RCT研究
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摘要
目的:本研究采用随机对照试验的方法,对铺棉灸结合电针治疗带状疱疹与常规西药疗法进行疗效比较研究。
     方法:采用中央随机方法,选取自2008年1月4日至2008年12月31日的71例病例,其中剔除2例。治疗组采用铺棉灸结合电针的方法(n=36),对照采用常规西药疗法(n=33)。采用综合疗效评分、疱疹指标、疼痛指标、单项症候评分、安全性指标和耐受性指标等对两组进行疗效评价,以综合评定铺棉灸结合电针的疗法对于带状疱疹的临床治疗应用。
     结果:1.基线情况比较:两组基线状况良好,分组均衡,具有可比性(P>0.05)。2.综合疗效比较:治疗组治疗带状疱疹疗效显著,总有效率为97.3%,与对照组比较,差别无统计学意义(P>0.05)。在症候总积分方面,虽有显著改善,但与对照组相比,差别无统计学意义(P>0.05)。3.疱疹指标比较:治疗组可以缩短结痂时间,与对照组比较,差别有统计学意义(P<0.05);止疱时间及脱痂时间比较,差别无统计学意义(P>0.05)。4.疼痛指标比较:①治疗组在疼痛强度、疼痛持续时间与疼痛缓解程度方面,治疗组优于对照组,且比较差别有统计学意义(P<0.05);疼痛缓解时间比较,差别无统计学意义(P>0.05)。②带状疱疹后遗神经痛发生率比较,第30天治疗组优于对照组(P<0.05)。5.单项症候评分比较:两组均可对皮损面积、局部痒和促使水疱增多有所改善,但组间比较,差别无统计学意义(P>0.05)。6.安全性指标比较:两组的安全性均较好,差别无统计学意义(P>0.05)。7.耐受性指标比较:两组耐受性比较,差别无统计学意义(P>0.05)。
     结论:1.铺棉灸结合电针治疗带状疱疹疗效确切,不亚于常规西药疗法。2.在促使疱疹结痂、降低疼痛强度、减少疼痛持续时间、降低带状疱疹后遗神经痛的发生方面,明显优于常规西药疗法。3.铺棉灸结合电针在治疗带状疱疹过程中,操作性好、副作用少、安全性高、成本低廉、易于接受,适宜于临床推广。
Objective:To compare the clinical effect for HZ between the thin membrane cotton moxibustion (TMCM) combined with electropuncture (EA) method and western medicine treatment according to the RCT method。
     Methods:There were 71 cases randomly divided into the treatment group and control group, all the cases were the HZ patients from January 4,2008 to December 31,2008, and tow of them were knockout。We treated the treatment group with TMCM combined with EA (n=36), and the control group with western medicine (n=33)。We evaluated the clinical effectiveness between two groups by the total effective scale, the index of HZ and pain, single symptom scale, the safety index, as well as the tolerance index。Therefore, to evaluate the clinical application of TMCM combined with EA for the HZ。
     Result:1.To compare the base line conditions:The base line conditions of two groups were satisfactory with good proportionality, could observe comparable (P>0.05)。2. To compare the total therapeutic effect:The therapeutic effect of treatment group was special, total effective rate was high as 97.3%, but there was no comparability and statistical significance of the total symptom scores between two groups (P>0.05), although the symptoms of treatment group were improved markedly。3. To compare the index of HZ:The scab time of treatment group was shorter than the control group, there were significant differences between two groups (P<0.05); But there was no obvious difference in the removing herpes and turning eschar time of two groups (P>0.05)。4. To compare the index of pain:①The treatment group was superior to the control group in the pain intensity(PI), pain duration(PD), and pain reduction (PAR), it was significantly different(P>0.05); on the contrary, the comparison of alleviating pain time has no significant difference (P>0.05)。②The recurrence rate of postherpetic neuralgia (PHN) on the thirtieth days, the treatment group was lower than the control group (P<0.05)。5. The comparison of single symptom scale:Both groups could improve the symptoms, such as the lesion size, local itching, as well as the blisters, but there was no statistic difference between two groups (P>0.05)。6. To compare the safety index:Both groups were safe, no statistic difference (P>0.05)。7. To compare the duration:There was no statistic difference (P>0.05)。
     Conclusion:1. The treatment of TMCM combined with EA showed significant effect on the HZ, as effective as the western medicine。2. The treatment group was superior to the control group on the effects of promoting the escharing, reducing the pain, shortening the time of pain, and decreasing the occurrence of PHN。3. The method of TMCM combined with EA has so many advantages, such as easy operation, less side effect, safe, low cost, easy to be accepted, therefore, this method is proper for the clinical application and further development。
引文
[1]林霖霖等.150例住院带状疱疹分析[J].临床皮肤科杂志,1995,24(4):228
    [2]Valacyclovir in the Treatment of Herpes Simplex, Herpes Zoster, and Other Viral Infections, Jashin J. Wu, Mathijs H. Brentjens, Gisela Torres,etc.J Cutan Med Surg,2003,372-381
    [3]周程.阿昔洛韦治疗带状疱疹64例[J].皮肤病与性病,2004,26(1):25-25
    [4]郑晓红等.不同剂量阿昔洛韦口服治疗带状疱疹疗效观察及安全性评价[J].中国医药导报,2008,5(25):64-66
    [5]泛昔洛韦治疗带状疱疹临床观察组.泛昔洛韦与阿昔洛韦治疗带状疱疹的多中央随机双盲对照研究[J].中华皮肤科杂志,2000,33(5):370-371
    [6]徐慧珍等.泛昔洛韦和阿昔洛韦治疗带状疱疹疗效对比研究[J].临床皮肤科杂志,2000,29(5):288-289
    [7]Sandy MC. Herpeszoster. medical and nursing management[J]. Clin J Oncol Nurs, 2005,9 (4):443-446
    [8]张冬萍等.带状疱疹后神经痛的危险因素和预防措施[J].中国临床康复,2005,37(9):118-119
    [9]KARL R, BEUTNER, DAVID J. FRIEDMAN, CHRISTINE FORSZPANIAK,PAUL L. ANDERSEN, AND MARTIN J. WOOD. Valaciclovir Compared with Acyclovir for Improved Therapy for Herpes Zoster in Immunocompetent Adults [J]. ANTIMICROBIAL AGENTS AND. CHEMOTHERAPY,1995,7: 1546-1553
    [10]刁灿阳等等.贴棉灸治疗神经性皮炎60例[J].陕西中医,2007,28(4):473-474
    [11]Goldman,Bennet(美国),王贤才主译Cecil Textbook of Medicine·第10分册·肌和结缔组织疾病[M].10版,西安:世界图书出版公司西安公司,2004:363-363
    [12]吴志华.皮肤性病学[M].5版,广州:广东科技出版社,2006:78-78
    [13]Jashin J. Wu, Mathijs H. Brent jens, Gisela Torres, etc. Valacyclovir in the Treat-ment of Herpes Simplex, Herpes Zoster, and Other Viral Infections[J]. J Cutan Med Surg,2003:372-381
    [14]王家良.临床流行病学[M].2版,北京:人民卫生出版社,2004:45-45
    [15]张冬萍等.带状疱疹后神经痛的危险因素和预防措施[J].中国临床康复,2005,37(9):118-119
    [16]任勇等.带状疱疹的病因及发病机制[J].中国临床区生,2003,31(5):4-5
    [17]熊德等.辨证分型治疗蛇串疮[J].江西中医药,2004年,35(254):29
    [18]王孝飞.内服龙胆泻肝汤外敷三黄软膏治疗带状疱疹64例[J].陕西中医,2007,28(6):689-690
    [19]何天佑等.蛇床子散化裁治疗病毒性疱疹87例疗效观察[J].云南中医中药杂志.2004,25(5):18
    [20]李尧庭等.五倍珍珠散外搽治疗疮疡临床观察[J].中国民间疗法.2003,11(12):29-30
    [21]向莉等.针刺治疗带状疱疹160例临床疗效观察[J].针灸临床杂志,1997,14(3):28
    [22]杨润莲等.皮肤针叩刺配合治疗带状疱疹的疗效观察[J].护理研究,2005,19(5):902
    [23]樊秋玲.针灸围刺治疗带状疱疹56例[J].浙江中医杂志,2004,10,449
    [24]廖治中等.加味二味拔毒散外敷治疗带状疱疹40例[J].中国中医急症,2004,13(4):235-235
    [25]李军体等等.雄黄外敷治疗带状疱疹200例观察[J].中华实用中西医杂志,2003,16(4):505-505
    [26]向莉等.针刺治疗带状疱疹160例临床疗效观察[J].针灸临床杂志,1997,14(3):28
    [27]杨润莲等.皮肤针叩刺配合治疗带状疱疹的疗效观察[J].护理研究,2005,19(5):902
    [28]樊秋玲.针灸围刺治疗带状疱疹56例[J].浙江中医杂志,2004,10,449
    [29]黄雪梅等等.火针结合电针治疗急性期带状疱疹40例疗效观察[J].湖南中医药导报,2003,9(8):36-37
    [30]胥林波等.铺棉灸法治疗带状疱疹疗效观察[J].四川中医,2003,21(8):82
    [31]竺炯等.麦粒灸治疗急性期带状疱疹40例疗效观察[J].上海针灸杂志,2003,22(4):10
    [32]张红.夹脊穴穴位注射治疗带状疱疹神经痛[J].辽宁中医杂志,1999,26(3):125
    [33]郑琼美等.梅花针刺血拔罐治疗带状疱疹50例疗效观察[J].河北中医,2004,26(5):368
    [34]吴昊.体针结合回旋灸治疗带状疱疹临床观察[J].针灸临床杂志,2003,19(3):55-56
    [35]丁晓丹.针刺配合TDP治疗带状疱疹59例临床观察[J].中医药导报,2006,12(3):44
    [36]田艳玲等.干扰电综合治疗带状疱疹29例疗效观察[J].宁夏医学杂志,2004,26(8):487
    [37]张永玲.针灸合用超激光疼痛仪治疗带状疱疹疗效的临床观察[J].华西医学,2005,20(1):128
    [38]马少群等.马氏温灸法[R].北京科学技术出版社.1994,4,1
    [39]娄必丹等.棉花灸结合针刺治疗带状疱疹65例临床观察[J].中国医师杂志.2002,4(6):661-662
    [40]曹晓滨.围刺电针艾条灸治疗带状疱疹的临床观察[J].中国医药研究,2005,3(1):18
    [41]袁鹤庭等.围针刺治疗带状疱疹后遗神经痛[J].针灸临床杂志,2007,23(12):16
    [42]潘太哲等.电针加紫外线照射治疗带状疱疹30例[J].中国临床医药实用杂志,2004,21:56
    [43]徐秋明等.电针围刺治疗带状疱疹后遗神经痛57例效果观察[J].交通医学,2008,22(5):495-496
    [44]王升旭等.电针夹脊穴对佐剂关节炎大鼠脊髓C-FOS基因表达的影响[J].中国中医药科技.1999,6(6):353
    [45]王升旭等.电针夹脊穴对佐剂关节炎大鼠脊髓p物质影响的免疫组化研究[J].中国中医药科技.2000,7(3):131
    [46]王升旭等.电针夹脊穴对佐剂关节炎大鼠外周血单胺类物质含量的影响[J].中国中医药科技.2000,7(5):273-274
    [47]王升旭等.电针夹脊穴对佐剂关节炎大鼠脊髓单胺类递质含量的影响[J].中国中医药科技.2001,8(1):1-2
    [48]刘成华等.电针夹脊与中药外敷治疗带状疱疹后遗神经痛72例[J].中医外治杂志,2007,16(1):26
    [49]沈素绒.后溪穴的临床应用[J].针灸临床杂志,2008,24(3):20-21
    [50]赵琪等.独取后溪穴治疗痛证[J].中国民间疗法,2008,16(1):7
    [1]李克卉等.带状疱疹的针刺疗法[J].中华当代医学,2005,3(7):87-87
    [2]王立群.,针刺治疗带状疱疹78例[J].中医研究,2008,21(5):45-46
    [3]白华.针灸治疗带状疱疹54例临床观察[J].湖南中医药导报,2004,10(6):63-64
    [4]王敏等.针灸治疗带状疱疹疗效观察[J].针灸临床杂志,1995,11(4):24
    [5]张倩等.针刺治疗带状疱疹32例[J],针灸临床杂志,2004,20(11):7-7
    [6]夏兆新.围针法治疗带状疱疹81例[J],南京中医药大学学报(自然科学版),2001,17(2):117-117
    [7]冯跃华.毫针围刺配合药物治疗带状疱疹30例临床观察[J],中华现代内科学杂志,2009,6(1):57
    [8]黄杰等.围刺法梅花针及火罐联合应用治疗急性带状疱疹疗效观察[J].辽宁中医药大学学报,2008,10(6):168-169
    [9]刘明.剌络拔罐治疗带状疱疹30例[J].陕西中医,2006,27(11):1417-1417
    [10]王岫岩等.刺络拔罐治疗带状疱疹42例临床观察[J].针灸临床杂志,2002,18(9):29-29
    [11]邹秋英.刺络拔罐治疗带状疱疹68例[J].河北中医,2002,24(2):106-106
    [12]姚星宇等.梅花针治疗带状疱疹的疗效观察[J].包头医学院学报,2008,24(2):193-194
    [13]王乐荣等.刺络拔罐放血为主治疗带状疱疹50例[J].中医研究,2009,22(11):55-56
    [14]周仔贵.火针配合围刺治疗带伏疱疹60例[J].湖北中医杂志,2009,31(12):68
    [15]徐世芳.火针点刺治疗带状疱疹10例[J].新疆中医院,2008,26(2):35
    [16]岳进等.多头火针治疗带状疱疹35例[J].福建中医药,2008,39(1):32-33
    [17]刘芳.火针治疗带状疱疹55例[J].内蒙古中医药,2007,26(1):21-21
    [18]李民兰等.火针为主综合疗法治疗带状疱疹141例[J].中华现代中医学杂志,2006,2(4):354-355
    [19]朱俊平.电针加穴位注射治疗带状疱疹50例[J].陕西中医,2009,30(6):717-718
    [20]刘银妮等.电针夹脊穴配合刺络拔罐治疗治疗带状疱疹疗效观察[J].上海针灸杂志,2009,28(9):523-525
    [21]陈敏.电针围刺加穴位注射治疗带状疱疹在阿尔及利亚的应用[J].中国康复,2009,24(4):227
    [22]陈守龙.电围针为主治疗带状疱疹152例[J].中国针灸,2000,11:650-650
    [23]付景兰等.电针艾灸治疗带状疱疹36例[J].中国针灸,2002,22(5):314-314
    [24]贺芳玲.电针火罐疗法治疗带状疱疹40例[J].江西中医药,2002,33(3):39-39
    [25]王元林等.穴位注射疗法治疗带状疱疹[J].中国实用医药,2009,4(10):144-145
    [26]魏玲.穴位注射治疗季胁部带状疱疹临床观察[J].贵阳中医学院学报,2003,21(1):41-43
    [27]秦晓真等.阿是穴药物注射治疗带状疱疹神经痛疗效观察[J].华夏医学,2006,19(6):1169-1171
    [28]刘娜等,刺络拔罐、耳针综合治疗6例带状疱疹中华综合医学杂志[J].2001,2(9):835-835
    [29]李灼华.针灸耳埋结合龙胆泻肝汤治疗带状疱疹[J].浙江中西医结合杂志,1998,8(5):315
    [30]沈继平.耳针为主治疗头面部带状疙疹40例[J].新中医.2000,32(7):30-30
    [31]刘佳等.杨运宽教授铺棉灸治疗皮肤病经验举隅[J].中国针灸,2008,28(11):852-853
    [32]沈晓聪等.杨远宽教授针灸治疗带状疱疹临床经验撷要[J].针灸临床杂志,2009,25,(1):33-34
    [33]孙福政等.薄棉灸为主的综合疗法治疗带状疱疹106例临床观察[J].中华临床医学杂志,2008,9(7):44-46
    [34]李慧.棉花灸为主治疗带状疱疹30例[J].中国民族医药杂志,2006,5:32
    [35]余畅等.贴棉灸治疗带状疱疹153例分析[J].中国民族民间医药杂志,2006,83:339-340
    [36]许卫国.针刺配棉花灸治疗带状疱疹58例[J].辽宁中医药大学学报,2008,10(8):132-132
    [37]尹士军.贴棉灸治疗带状疱疹[J].中国民间疗法,2009,17(9):66
    [38]竺炯等.麦粒灸治疗急性期带状疱疹40例疗效观察[J].上海针灸杂志,2003,22(4):10
    [39]莫晓枫等.麦粒灸治疗带状疱疹临床报道[J].针灸临床杂志.2004,20(2):43-44
    [40]刘忠云.灯火灸治疗带状疱疹60例[J].中国民间疗法.2009,17(1):7
    [41]张永树.灯芯灸治疗带状疱疹54例[J],中国针灸,1999,(8):456
    [42]彭崇信.壮医药线点灸配合熊胆溶液外涂治疗面部带状疱疹疗效观察[J],广西中医药,2009,32(6):20-21
    [43]徐晓燕.综合疗法治疗带状疱疹60例疗效观察[J],浙江中西医结合杂志,2009,19(10):628-629
    [44]罗胜平等.针灸配合阿昔洛韦治疗带状疱疹40例临床观察[J].云南中医中药杂志,2008,29(6):35-31
    [45]刘志群等.龙胆泻肝汤配合针灸治疗带状疱疹46例[J].辽宁中医药大学学报,2008,10(6):104-104
    [46]王贵全等.针刺加中药治疗带状疱疹37例临床观察[J].中外健康文摘:医药月刊,2007,4(12):73-74
    [47]刘笑丽.针灸综合疗法治疗带状疱疹32例临床观察[J].中国现代医生,2007,45(11Z):60-60
    [48]谢惠素.应用蜘蛛穴治疗带状疱疹[J].北京中医药,2009,28(7):55560-60
    [49]周莉.龙眼穴治疗带状疱疹30例[J].中国中医药现代远程教育,2008,6(6):524-524
    [50]李宏大等.蛇眼穴点刺对带状疱疹的早期诊断[J].针灸临床杂志,2007(10):11-11
    [51]王慧敏等.截刺拔毒法治疗带状疱疹的临床研究[J].河北医学,2008,14(4):404-405
    [52]李巧云,浮针泻法加穴位注射治疗带状疱疹48例[J].陕西中医,2008,29(4):485-486
    [53]袁洪明.针灸治疗带状疱疹305例疗效分析[J].中国现代临床医学,2004,3(1):60-60
    [54]李季珍等.针灸配合蒙药治疗带状疱疹的临床观察[J].中国民族医药杂志,2004,1:12-12
    [1]孙福政等.薄棉灸为主的综合疗法治疗带状疱疹106例临床观察[J].中华临床医学杂志,2008,9(7):44-46
    [2]刘艳平等.针刺结合棉花灸治疗带状疱疹30例[J].甘肃中医,2009,22(3):49-50
    [3]潘慧芬等.棉花灸治疗带状疱疹33例临床观察[J].中医药导报,2009,15(7):58-59
    [4]罗湘筠等.棉花灸配合耳穴压丸治疗带状疱疹疗效观察[J].中医药临床杂志,2009,21(3):223-224
    [5]李慧.棉花灸为主治疗带状疱疹30例[J].中国民族医药杂志,2006,5:32-32
    [6]余畅等.贴棉灸治疗带状疱疹153例分析[J].中国民族民间医药杂志,2006,83:339-340
    [7]许卫国.针刺配棉花灸治疗带状疱疹58例[J].辽宁中医药大学学报,2008,10(8):132-132
    [8]田海燕.薄棉灸治疗带状疱疹50例[J].江西中医药,2003,34(12):42-42
    [9]韩慧等.围刺加棉花灸治疗带状疱疹[J].中医药学刊,2006,24(3):544-545
    [10]胥林波等等.铺棉灸法治疗带状疱疹疗效观察[J].四川中医,2003,21(8):82-83
    [11]高俊峰等.脱脂棉燎灸合中药浸剂外搽治疗带状疱疹108例[J].钊灸临床杂志,2008,24(9):35-35
    [12]李万高.棉花灸治疗带状疱疹30例疗效观察[J].实用中医内科杂志,2007,21(4):97-97
    [13]李念.梅花针加铺棉灸治疗带状疱疹20例[J].针灸临床杂志,2005,21(9):40-40
    [14]郑晓莹等.棉花网直接灸治疗带状疱疹84例[J].中国民间疗法,2004,12(7):16-17
    [15]德力格尔等.棉花灸治疗带状疱疹10例[J].中国民族民间医药杂志,2003(5):283-284
    [16]王立新等.刺络拔罐并贴棉灸治疗带状疱疹65例[J].中国民间疗法,2003,11(6):36-36
    [17]李明等.棉花灸治疗带状疱疹[J].中国民间疗法,2003,11(5):17-18
    [18]娄必丹等.棉花灸结合针刺治疗带状疱疹65例临床观察[J].中国医师杂志,2002,4(6):661-662
    [19]李杰等.棉花灸治疗带状疱疹80例[J].中医研究,2001,14(3):57-58
    [20]杨雪利.棉绒灼灸法治疗带状疱疹100例[J].实用中医药杂志,2001,17(8):30-31
    [21]高润华.贴棉灸治疗带状疱疹32例[J].河北中医,1999,21(6):367-367
    [22]潘祥龙.中医薄棉片灸法治疗带状疱疹[J].辽宁中医学院学报,1999,1(1):37-37
    [23]陈剑波等.薄棉灸治疗带状疱疹106例临床观察[J].按摩与导引,1997(2):24-25
    [24]何幼民等.棉花灸配京万红膏治疗带状疱疹58例观察[J].实用中西医结合杂志,1996,9(2):122-123
    [25]武春喜等.药棉灸治疗带状疱疹顽周性神经痛[J].陕西中医杂志,2003,3:23-23
    [26]李杰.围刺加棉花灸治疗带状疱疹后遗神经痛38例[J].上海针灸杂志,2006,25(8):32-32
    [27]杨运宽等.“杨氏贴棉灸”治疗局限性神经性皮炎54例临床观察[J].四川中医,2006,24(9):92-93
    [28]刁灿阳等.贴棉灸治疗神经性皮炎60例[J].陕西中医,2007,28(4):473-474
    [29]杨运宽等.杨氏贴棉灸治疗神经性皮炎临床观察[J].辽宁中医杂志,2007,34(5):649-650
    [30]杨运宽等.杨氏贴棉灸治疗神经性皮炎143例临床观察[J].中医杂志,2007,48(11).1000-1001
    [31]田永萍等.龙文君教授治疗神经性皮炎琐谈[J].甘肃中医,2005,18(6):13-13
    [32]黄冬娥等.梅花针加贴棉灸治疗神经性皮炎[J].中医外治杂志,2002,11(4):34-35
    [33]王权.药棉灸配针刺治疗神经性皮炎80例[J].黑龙江中医药,1996(3):42-43
    [34]缪奇祥等Treatment of 32 Cases of Psoriasis by Cotton Moxibustion(针灸推拿医学:英文版)[M].2004,2(1):14-15
    [35]翟佳滨.铺棉灸治疗老年皮肤瘙痒病32例[J].中国中医急症,2008,17(2):256-257
    [36]刘学兰等.刺络拔罐加贴棉灸治疗顽固性面瘫疗效观察[J].湖北中医杂志,2007,29(4):46-47
    [37]缪希寿.药棉炎治疗颞下颌关节功能紊乱综合征临床观察[J].针刺研究,1992,17(4):232-233
    [38]缪希寿.药棉灸治疗第三腰椎横突综合征[J].福建中医药,1995,26(6):26-26
    [39]许健阳.杨介宾教授灸法集萃[J].上海针灸杂志,1999,18(6):1-2
    [40]刁锦蓉.铺棉灸在临床治疗皮肤病中的运用[J].针灸临床杂志,1999,15(7):57-59
    [41]水竹林等.杨介宾教授灸法举要[J].陕西中医函授,1993(4):1-3
    [42]刘佳等.杨运宽教授铺棉灸治疗皮肤病经验举隅[J].中国针灸,2008,28(11):852-853
    [43]沈晓聪等.杨远宽教授针灸治疗带状疱疹临床经验撷要[J].针灸临床杂志,2009,25(1):33-34

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