火针治疗带状疱疹急性期临床观察及IL-6数据的研究
摘要
目的：
通过研究火针对带状疱疹急性期的疗效,探讨火针“火郁发之”法对急性期带状疱疹患者免疫功能及后遗神经痛的影响,为中医“火郁发之”理论临床应用提供高质量的循证医学依据。
方法：
本研究采用前瞻性随机对照方法,收集60例符合诊断、纳入标准者,采用简单随机法,分为治疗组及对照组各30例,设立I组为治疗组,接受火针治疗；II组为对照组,只接受口服抗病毒药及B族维生素的西医治疗。I组患者取卧位,在已选阿是穴上用活力碘消毒,点燃酒精灯,左手持酒精灯,右手持中粗火针在酒精灯的外焰加热针体,直至将针尖烧至红白后,迅速准确地刺入疱疹中央约0.2-0.3cm,根据疱疹数量的多少,先刺早发的疱疹,每次选择3-5个,每个疱疹针刺2次,术毕挤出疱液,按压约30秒钟。同时在央脊穴、支沟穴、后溪穴上涂上一层薄薄的万花油,用细火针轻刺约0.1cm。每日1次,10次为1个疗程,共计1个疗程。II组患者口服盐酸伐昔洛韦(丽珠威)：300mg/次,2次/日；维生素B1：10mg/次3次/日。10天1个疗程,共计1个疗程。1个疗程后观察患者的疗效指标、疼痛评价指标、发生后遗神经痛情况及炎症因子等,分析两组的治疗效果。
结果：
1.治疗组和对照组在治疗前后的疱疹评分比较中,治疗后两组的统计学比较,t=0.3294,p<0.05,有统计学意义,治疗组的效果明显优于对照组。
2.在治疗后的疗效的比较中,在治疗组的30例患者中,治愈20例,好转10例,无效0例,总有效率为100%。在对照组的30例患者中,治愈7例,好转22例,无效1例,总有效率为96.7%。两组经秩和检验的统计学分析,p<0.05,有统计学意义,治疗组在疗效方面优于对照组。
3.治疗组和对照组在治疗带状疱疹中镇痛方面的比较,p<0.05,有统计学意义,治疗组对带状疱疹的镇痛作用优于对照组。
4.治疗组和对照组在治疗带状疱疹后发生后遗神经痛的比较,31天、60天和90天时p<0.05,有统计学意义,治疗组对减少后遗神经痛的发生优于对照组。
5.治疗组和对照组对治疗带状疱疹后的白介素6(工L-6)数据影响的比较,p<0.05,有统计学意义,治疗组对降低带状疱疹的炎症因子明显优于对照组。
结论：
对两种方法治疗带状疱疹急性期的观察中,治疗组对疱疹的消退、临床症状的减轻、疼痛的缓解等综合评价上优于对照组,治疗组在镇痛方面明显优于对照组,在降低带状疱疹的IL-6方面,治疗组更有优势,在减少带状疱疹后遗神经痛的发生率上治疗组优于对照组。两组在患者的依从性和安全性方面均较好,无脱落病例和不良反应的发生。
Objeetive
To study the effect of treating acue Herpes Zoster with Fire Needle. The researeh is to study the immunity of the treating acue Herpes Zoster with Fire Needle and the postherpeti eneuralgia(PHN), and to provide clinical evidence for its Fire Needle.
Method
The ProPective randomized controlled study chose60cases were in accordance with the diagnostic and indrawing standards. The Patients were randomly divided into2groups, with30cases in the treatment group and30cases in the control group. The treatment group was given Fire Needle. The control group was given valaciclovir hydrochloride and Vitamin B for oral use.The treatment group:Heat the fire needle on the spirit lamp until burn red for degree, and prick into the center of ashi Points with the depth of0.2to0.3cm after the skin sterilization. The praecox herpes should be pricked first. Three to five herpes were pricked every times. Extrude the herpes liquid after fast insertion, and apply Wanhua oil on the herpes. The fire needle was burnt red and prick into the center of Jia-ji points, Houxi points and Zhigou points. The treatment above should be arranged once a day,10days as a course of treatment. The control group was given valaciclovir hydrochloride (Livzon Granville) oral,300mg/times,2times/day, vitamin Bl oral, lOmg/times,3times/day. A course of10days, for a total of one course of treatment. Evaluating criterions:blister evaluating criterions, neuralgia evaluating criterions, the incidence of PHN as well as the immunity.
Results
1.The comprehensive effect score of the treatment group was better than the control group. There was a significant difference(p<0.05).2. The total effective rate of the treatment group better than the control group. There was a significant difference(p<0.05).3. VAS score of the treatment group after treatment compared with the control group there was a significant difference (p<0.05).4. The treatment group was better than the control group, in the incidence of PHN between the two groups。It Prove that the fire Needle treating has the predominance in reducing the incidence of PHN.5. The treatment group better than the control group with Reducing the values of the IL6. There was a significant difference(p<0.05).
Conclus ion
The Fire Needle therapy has superior curative effect in treating acute herpes zoster, especially in reducing the VAS score and IL6. The reducing the incidence of PHN was statistic difference. Two groups had good complying and securing.
通过研究火针对带状疱疹急性期的疗效,探讨火针“火郁发之”法对急性期带状疱疹患者免疫功能及后遗神经痛的影响,为中医“火郁发之”理论临床应用提供高质量的循证医学依据。
方法：
本研究采用前瞻性随机对照方法,收集60例符合诊断、纳入标准者,采用简单随机法,分为治疗组及对照组各30例,设立I组为治疗组,接受火针治疗；II组为对照组,只接受口服抗病毒药及B族维生素的西医治疗。I组患者取卧位,在已选阿是穴上用活力碘消毒,点燃酒精灯,左手持酒精灯,右手持中粗火针在酒精灯的外焰加热针体,直至将针尖烧至红白后,迅速准确地刺入疱疹中央约0.2-0.3cm,根据疱疹数量的多少,先刺早发的疱疹,每次选择3-5个,每个疱疹针刺2次,术毕挤出疱液,按压约30秒钟。同时在央脊穴、支沟穴、后溪穴上涂上一层薄薄的万花油,用细火针轻刺约0.1cm。每日1次,10次为1个疗程,共计1个疗程。II组患者口服盐酸伐昔洛韦(丽珠威)：300mg/次,2次/日；维生素B1：10mg/次3次/日。10天1个疗程,共计1个疗程。1个疗程后观察患者的疗效指标、疼痛评价指标、发生后遗神经痛情况及炎症因子等,分析两组的治疗效果。
结果：
1.治疗组和对照组在治疗前后的疱疹评分比较中,治疗后两组的统计学比较,t=0.3294,p<0.05,有统计学意义,治疗组的效果明显优于对照组。
2.在治疗后的疗效的比较中,在治疗组的30例患者中,治愈20例,好转10例,无效0例,总有效率为100%。在对照组的30例患者中,治愈7例,好转22例,无效1例,总有效率为96.7%。两组经秩和检验的统计学分析,p<0.05,有统计学意义,治疗组在疗效方面优于对照组。
3.治疗组和对照组在治疗带状疱疹中镇痛方面的比较,p<0.05,有统计学意义,治疗组对带状疱疹的镇痛作用优于对照组。
4.治疗组和对照组在治疗带状疱疹后发生后遗神经痛的比较,31天、60天和90天时p<0.05,有统计学意义,治疗组对减少后遗神经痛的发生优于对照组。
5.治疗组和对照组对治疗带状疱疹后的白介素6(工L-6)数据影响的比较,p<0.05,有统计学意义,治疗组对降低带状疱疹的炎症因子明显优于对照组。
结论：
对两种方法治疗带状疱疹急性期的观察中,治疗组对疱疹的消退、临床症状的减轻、疼痛的缓解等综合评价上优于对照组,治疗组在镇痛方面明显优于对照组,在降低带状疱疹的IL-6方面,治疗组更有优势,在减少带状疱疹后遗神经痛的发生率上治疗组优于对照组。两组在患者的依从性和安全性方面均较好,无脱落病例和不良反应的发生。
Objeetive
To study the effect of treating acue Herpes Zoster with Fire Needle. The researeh is to study the immunity of the treating acue Herpes Zoster with Fire Needle and the postherpeti eneuralgia(PHN), and to provide clinical evidence for its Fire Needle.
Method
The ProPective randomized controlled study chose60cases were in accordance with the diagnostic and indrawing standards. The Patients were randomly divided into2groups, with30cases in the treatment group and30cases in the control group. The treatment group was given Fire Needle. The control group was given valaciclovir hydrochloride and Vitamin B for oral use.The treatment group:Heat the fire needle on the spirit lamp until burn red for degree, and prick into the center of ashi Points with the depth of0.2to0.3cm after the skin sterilization. The praecox herpes should be pricked first. Three to five herpes were pricked every times. Extrude the herpes liquid after fast insertion, and apply Wanhua oil on the herpes. The fire needle was burnt red and prick into the center of Jia-ji points, Houxi points and Zhigou points. The treatment above should be arranged once a day,10days as a course of treatment. The control group was given valaciclovir hydrochloride (Livzon Granville) oral,300mg/times,2times/day, vitamin Bl oral, lOmg/times,3times/day. A course of10days, for a total of one course of treatment. Evaluating criterions:blister evaluating criterions, neuralgia evaluating criterions, the incidence of PHN as well as the immunity.
Results
1.The comprehensive effect score of the treatment group was better than the control group. There was a significant difference(p<0.05).2. The total effective rate of the treatment group better than the control group. There was a significant difference(p<0.05).3. VAS score of the treatment group after treatment compared with the control group there was a significant difference (p<0.05).4. The treatment group was better than the control group, in the incidence of PHN between the two groups。It Prove that the fire Needle treating has the predominance in reducing the incidence of PHN.5. The treatment group better than the control group with Reducing the values of the IL6. There was a significant difference(p<0.05).
Conclus ion
The Fire Needle therapy has superior curative effect in treating acute herpes zoster, especially in reducing the VAS score and IL6. The reducing the incidence of PHN was statistic difference. Two groups had good complying and securing.
引文
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[5]KARL R,BEUTNER,DAVID J.FRIEDMAN,CHRISTINE FORSZPANIAK,PAUL L.ANDERSEN,AND MARTIN J.WOOD.Valaciclovir Compared with Acyclovir for Improved Therepy for Herpes Zoster in Immunocompetent AduIts.ANTIMICROBIAL AGENTS AND CHEMOTHERAPY,1995,7:1546-1553.
[6]Henry JL. Future basic science directions into mechanisms of neuropathic pain[刀. J Orofac Pain,2004,18(4):306—310.
[7]童晓云,陈益丹等.针刺联合西药治疗带状疱疹的临床观察及其对血浆P物质的影响,中国中西医结合皮肤性病学杂志.2010,9(4)：225-228.
[8]元·朱丹溪.丹溪心法.北京：人民卫生出版社,2005：182
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[16]肖红艳,蔡亮.阿米替林联合He—Ne激光治疗带状疤疹神经痛100例[J].中国热带医学,2007；7(8)：1381,1425
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[2]Kost RG,Straus SE.Postherpetic neuralgia-pathogenesis,treatment,and prevention.N EngI J Med 1996; 335:32-42.
[3]张冬萍,何莉.带状疱疹后神经痛的危险因素和预防措施,中国临床康复.2005,37(9)：118-119
[4]吴志华.皮肤性病学[M].广州：广东科学技术出版社,1998：79.
[5]KARL R,BEUTNER,DAVID J.FRIEDMAN,CHRISTINE FORSZPANIAK,PAUL L.ANDERSEN,AND MARTIN J.WOOD.Valaciclovir Compared with Acyclovir for Improved Therepy for Herpes Zoster in Immunocompetent AduIts.ANTIMICROBIAL AGENTS AND CHEMOTHERAPY,1995,7:1546-1553.
[6]Henry JL. Future basic science directions into mechanisms of neuropathic pain[刀. J Orofac Pain,2004,18(4):306—310.
[7]童晓云,陈益丹等.针刺联合西药治疗带状疱疹的临床观察及其对血浆P物质的影响,中国中西医结合皮肤性病学杂志.2010,9(4)：225-228.
[8]元·朱丹溪.丹溪心法.北京：人民卫生出版社,2005：182
[9]明·孙一奎.医旨绪余.见：孙一奎医学全书.北京：中国中医药出版社,1999：668..
[10]陈曦,“火郁发之”探微,中国中医基础医学杂志.2008,14(2)：89.
[11]罗珍春.浅谈“火郁发之”,江西中医药.1997,28(2)：48.
[12]郑彩华,郭光业等.论“火郁发之”,河北中医.2008,30(2)：184-185
[13]袁红霞,曹丽霞.论“火郁发之”,辽宁中医杂志.2008,36(8)：1143
[14]蒋小敏,蒋晶晶.论“火郁发之”—从《伤寒论》探析火郁发之的机理,江西中医学院学报.2007,19(3)：16-18
[15]王丽,何柱裕.伐昔洛韦治疗带状疱疹52例临床观察[J].山东医药,2007；47(25)：51.
[16]肖红艳,蔡亮.阿米替林联合He—Ne激光治疗带状疤疹神经痛100例[J].中国热带医学,2007；7(8)：1381,1425
[17]简红艳,李智芹,郑慧.干扰素局部运用治疗带状疙疹.中华现代皮肤科学杂志2005；2(：3)
[18]张继成.火针治疗带状疱疹62例疗效观察.实用医院临床杂,2007,9(4)：64-65.
[19]旷秋和.火针治疗带状疱疹48例.中国民间疗法,2007,15(5)：13.
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