围刺加电针治疗带状疱疹的临床随机对照研究
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摘要
目的：采用多中心随机对照临床试验,观察围刺加电针疗法治疗带状疱疹(AHZ)的临床疗效。
方法：采用多中心、随机对照试验的研究方法,共62例患者纳入并完成研究,随机分为治疗组(32例)和对照组(30例)。其中剔除病例4例,58例病人完成整个研究过程并纳入分析。治疗组采用围刺加电针治疗,对照组采用西药治疗。每天观察一次疗效,记录带状疱疹综合疗效评分、疱疹情况、疼痛情况,治疗结束后进行疗效评价。
结果：(1)两组的基线状况良好,分组均衡,可比性较强(P＞0.05)。(2)治疗组的总有效率为96.67%。治疗组的疗效,总有效率与对照组相比,差异无统计学意义(P＞0.05)。(3)治疗组疼痛VAS评分的自身前后对照,治疗后组间对照,治疗组较对照组有显著性差异(P<0.05)。(4)治疗组局部疼痛评分自身前后对照,治疗后组间对照,治疗组较对照组有显著性差异(P<0.05)。(5)治疗组第30天随访后遗神经痛发生率较对照组有显著性差异(P<0.05)。
结论：(1)围刺加电针疗法对带状疱疹具有良好的疗效,在改善患者VAS评分、疼痛持续时间、局部疼痛和控制30天后遗神经痛方面优于西药疗法。(2)针刺疗法不良反应少,安全性好。(3)针刺疗法操作简单,成本低廉,疗效好,适宜临床运用推广。
Object:This study was based on multi-center randomized controlled traial,to examine the effect of surrounding acupuncture plus electro-acupuncture for treating acute herpes zoster (AHZ).
Method:With a multi-center randomized, single-blind and controlled trial, a total of 62 patients included in this study were randomly divided into experimental group (32 cases) and controlled group (30 cases), which four were rejected, leaving 58 finished the whole study and been accounted into the final analysis. Experimental group was given surrounding acupuncture plus electro-acupuncture during observation while its counterpart was prescribed by western medicines. The effect of either group was checked daily. Scores of general effect assessment on AHZ, herpes syndrome as well as pain were recorded, and the effects of both groups were assessed upon completion of the treatment.
Result:(1). the baseline condition in either group was fine and balanced with reasonable compatibility (P>0.05); (2). the total effective rate in experimental group was 96.67%, and the total effective rate in both groups has no statistically significant difference (P>0.05); (3), the after-treatment score of the pain VAS assessment in experimental group has statistical significance comparing with that of before-treatment, and post treatment pain VAS scores between groups showed better result with statistical significance in the experimental group than that of the controlled group (P<0.05); (4), the local pain score of experimental group after treatment was with statistical significance compared with that of before treatment, and post-treatment local pain scores between groups showed statistical significance with better result in the experimental group (P<0.05); and (5), recurrence rate of postherpetic neuralgia (PHN) in the experimental group was statistically significant in contrast with that of the controlled group on the 30th day follow-up observation (P<0.05).
Conclusion:First, the combination of surrounding acupuncture with electro-acupuncture shows better effect for treating AHZ and is better over western medicine in terms of improving VAS scores for patients, shorting pain duration, relieving local pain as well as restraining postherpetic neuralgia after 30 days. Second, acupuncture demonstrates fewer adverse events and better safety. Third, simple manipulation, cheap cost and good effectiveness of acupuncture makes it suitable to popularize and practice in clinics.
方法：采用多中心、随机对照试验的研究方法,共62例患者纳入并完成研究,随机分为治疗组(32例)和对照组(30例)。其中剔除病例4例,58例病人完成整个研究过程并纳入分析。治疗组采用围刺加电针治疗,对照组采用西药治疗。每天观察一次疗效,记录带状疱疹综合疗效评分、疱疹情况、疼痛情况,治疗结束后进行疗效评价。
结果：(1)两组的基线状况良好,分组均衡,可比性较强(P＞0.05)。(2)治疗组的总有效率为96.67%。治疗组的疗效,总有效率与对照组相比,差异无统计学意义(P＞0.05)。(3)治疗组疼痛VAS评分的自身前后对照,治疗后组间对照,治疗组较对照组有显著性差异(P<0.05)。(4)治疗组局部疼痛评分自身前后对照,治疗后组间对照,治疗组较对照组有显著性差异(P<0.05)。(5)治疗组第30天随访后遗神经痛发生率较对照组有显著性差异(P<0.05)。
结论：(1)围刺加电针疗法对带状疱疹具有良好的疗效,在改善患者VAS评分、疼痛持续时间、局部疼痛和控制30天后遗神经痛方面优于西药疗法。(2)针刺疗法不良反应少,安全性好。(3)针刺疗法操作简单,成本低廉,疗效好,适宜临床运用推广。
Object:This study was based on multi-center randomized controlled traial,to examine the effect of surrounding acupuncture plus electro-acupuncture for treating acute herpes zoster (AHZ).
Method:With a multi-center randomized, single-blind and controlled trial, a total of 62 patients included in this study were randomly divided into experimental group (32 cases) and controlled group (30 cases), which four were rejected, leaving 58 finished the whole study and been accounted into the final analysis. Experimental group was given surrounding acupuncture plus electro-acupuncture during observation while its counterpart was prescribed by western medicines. The effect of either group was checked daily. Scores of general effect assessment on AHZ, herpes syndrome as well as pain were recorded, and the effects of both groups were assessed upon completion of the treatment.
Result:(1). the baseline condition in either group was fine and balanced with reasonable compatibility (P>0.05); (2). the total effective rate in experimental group was 96.67%, and the total effective rate in both groups has no statistically significant difference (P>0.05); (3), the after-treatment score of the pain VAS assessment in experimental group has statistical significance comparing with that of before-treatment, and post treatment pain VAS scores between groups showed better result with statistical significance in the experimental group than that of the controlled group (P<0.05); (4), the local pain score of experimental group after treatment was with statistical significance compared with that of before treatment, and post-treatment local pain scores between groups showed statistical significance with better result in the experimental group (P<0.05); and (5), recurrence rate of postherpetic neuralgia (PHN) in the experimental group was statistically significant in contrast with that of the controlled group on the 30th day follow-up observation (P<0.05).
Conclusion:First, the combination of surrounding acupuncture with electro-acupuncture shows better effect for treating AHZ and is better over western medicine in terms of improving VAS scores for patients, shorting pain duration, relieving local pain as well as restraining postherpetic neuralgia after 30 days. Second, acupuncture demonstrates fewer adverse events and better safety. Third, simple manipulation, cheap cost and good effectiveness of acupuncture makes it suitable to popularize and practice in clinics.
引文
1.陈扬,郑茂荣.疱疹后遗神经痛发病机理与治疗的研究进展[J].国外医学皮肤性病学分册,2002,28(1)：49-51.
2.吴志华.皮肤性病学[M].第3版.广州：广东科技出版社,1997.79-80
3.李朝红,齐华光,李萍,等.带状疱疹患者疼痛与肋间神经传导功能相关性的研究[J].中华物理医学与康复杂志,2007,29(12)：828-829
4.张金帅,戴飞.带状疱疹致贝尔面瘫一例[J].实用心脑肺血管病杂志,2008,16(12)：3-3
5.谢英,王丽娜.眼部带状疱疹并发角膜炎继发青光眼3例分析[J].山西医药杂志,2008,37(7)：593-593
6.林霖霖,沈奇范.150例住院带状疱疹分析[J].临床皮肤科杂志,1995,24(4)：228-228
7.任勇,路麒.带状疱疹的病因及发病机制[J].中国临床区生,2003,31(5)：4-5
8.张冬萍,何俐.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.谭开明,刘矗,李伟权.带状疱疹患病现状的调查与分析[J].中国基层医药,2006,13(1)：52-53
11.刘太华,张忠奎,许泽娟,等.带状疱疹临床流行病学分析[J].西南军医,2005,7(6)：28-30
12.张慰民.夹脊穴定位的研究[J].上海针灸杂志,1987,6(4)：23.
13.魏玲,苑贵毕.穴位注射夹脊穴加针刺治疗老年带状疱疹后遗神经痛疗效观察[J].中国针灸,2001,21(6)：333-334.
14.付景兰,董文毅.电针艾灸治疗带状疱疹36例[J].中国针灸,2002,22(5)：314.
1. 彭建民.针刺治疗带状疱疹神经痛的临床研究[J].福建中医药.2009,40(3)：6--8.
2. 向莉,杜家忠.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.
3. 王敏,林海峰,装志萍.针灸治疗带状疮疹疗效观察[J].针灸临床杂志,1995,11(4)：16.
4. 许纲,戴广珠.围针治疗带状疱疹疗效观察[J].浙江中西医结合杂志,2001,11(10)：650-651.
5. 王立群.针刺治疗带状疱疹78例[J].中医研究.2008,21(5)：45-46.
6. 苏静,程进.针刺治疗带状疱疹82例[J].山东中医杂志.2007,26(7)：468.
7. 刘银妮,张红星,黄国付,等.电针夹脊穴配合刺络拔罐治疗带状疱疹疗效观察[J].上海针灸杂志.2009,28(9)：523-525
8. 石吉娣.针刺配合梅花针叩刺治疗带状疱疹疗效观察[J].上海针灸杂志.2009,28(6)：354.
9. 巫华俊.梅花针刺络拔罐治疗带状疱疹疗效观察[J].西南军医.2009,11(5)：826-827.
10. 范红军.针刺拔罐放血治疗带状疱疹60例[J].中外健康文摘：医药月刊.2006,3(11)：173-174.
11. 周仔贵.火针配合围刺治疗带状疱疹60例[J].湖北中医杂志.2009,31(12)：68.
12. 吴昊.针刺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.
13. 张宏荣.针刺配合棉花灸治疗带状疱疹32例疗效观察[J].新中医,2004,36(1)：50.
14. 刘艳平,张高峰,朱或,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.
15. 赵桂香.针刺放血加穴位注射治疗带状疱疹临床观察[J].山西中医.2008,24(4)：28.
16. 彭长林.针刺结合穴位注射治疗带状疱疹疗效观察[J].中医药临床杂志.2008,20(5)：493-494.
17. 韩慧兰.紫外线照射结合穴位注射和针刺治疗带状疱疹35例[J].内蒙古医学杂志.2009(5)：610-611.
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28. 王红艳,樊延红,王怀成.针刺拔罐治疗带状疱疹后遗神经痛68例临床观察[J].中国中西医结合皮肤性病学杂志.2008,7(1)：47.
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31. 胡立丹.针刺夹脊穴合围刺刺络拔罐治疗带状疱疹25例[J].浙江中医杂志.2009,44(1)：57.
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34. 李晓红.套管针阿是穴埋针配合微波治疗带状疱疹后遗神经痛42例[J].针灸临床杂志.2009,25(5)：11-12.
35. 鲁亦斌,程井军,孙国杰,等.针刺华佗夹脊穴合穴位注射治疗带状疱疹后遗神经痛的临床观察[J].湖北中医杂志.2006,28(5)：13-14.
2.吴志华.皮肤性病学[M].第3版.广州：广东科技出版社,1997.79-80
3.李朝红,齐华光,李萍,等.带状疱疹患者疼痛与肋间神经传导功能相关性的研究[J].中华物理医学与康复杂志,2007,29(12)：828-829
4.张金帅,戴飞.带状疱疹致贝尔面瘫一例[J].实用心脑肺血管病杂志,2008,16(12)：3-3
5.谢英,王丽娜.眼部带状疱疹并发角膜炎继发青光眼3例分析[J].山西医药杂志,2008,37(7)：593-593
6.林霖霖,沈奇范.150例住院带状疱疹分析[J].临床皮肤科杂志,1995,24(4)：228-228
7.任勇,路麒.带状疱疹的病因及发病机制[J].中国临床区生,2003,31(5)：4-5
8.张冬萍,何俐.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.谭开明,刘矗,李伟权.带状疱疹患病现状的调查与分析[J].中国基层医药,2006,13(1)：52-53
11.刘太华,张忠奎,许泽娟,等.带状疱疹临床流行病学分析[J].西南军医,2005,7(6)：28-30
12.张慰民.夹脊穴定位的研究[J].上海针灸杂志,1987,6(4)：23.
13.魏玲,苑贵毕.穴位注射夹脊穴加针刺治疗老年带状疱疹后遗神经痛疗效观察[J].中国针灸,2001,21(6)：333-334.
14.付景兰,董文毅.电针艾灸治疗带状疱疹36例[J].中国针灸,2002,22(5)：314.
1. 彭建民.针刺治疗带状疱疹神经痛的临床研究[J].福建中医药.2009,40(3)：6--8.
2. 向莉,杜家忠.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.
3. 王敏,林海峰,装志萍.针灸治疗带状疮疹疗效观察[J].针灸临床杂志,1995,11(4)：16.
4. 许纲,戴广珠.围针治疗带状疱疹疗效观察[J].浙江中西医结合杂志,2001,11(10)：650-651.
5. 王立群.针刺治疗带状疱疹78例[J].中医研究.2008,21(5)：45-46.
6. 苏静,程进.针刺治疗带状疱疹82例[J].山东中医杂志.2007,26(7)：468.
7. 刘银妮,张红星,黄国付,等.电针夹脊穴配合刺络拔罐治疗带状疱疹疗效观察[J].上海针灸杂志.2009,28(9)：523-525
8. 石吉娣.针刺配合梅花针叩刺治疗带状疱疹疗效观察[J].上海针灸杂志.2009,28(6)：354.
9. 巫华俊.梅花针刺络拔罐治疗带状疱疹疗效观察[J].西南军医.2009,11(5)：826-827.
10. 范红军.针刺拔罐放血治疗带状疱疹60例[J].中外健康文摘：医药月刊.2006,3(11)：173-174.
11. 周仔贵.火针配合围刺治疗带状疱疹60例[J].湖北中医杂志.2009,31(12)：68.
12. 吴昊.针刺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.
13. 张宏荣.针刺配合棉花灸治疗带状疱疹32例疗效观察[J].新中医,2004,36(1)：50.
14. 刘艳平,张高峰,朱或,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.
15. 赵桂香.针刺放血加穴位注射治疗带状疱疹临床观察[J].山西中医.2008,24(4)：28.
16. 彭长林.针刺结合穴位注射治疗带状疱疹疗效观察[J].中医药临床杂志.2008,20(5)：493-494.
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