“自拟活血止痛方”治疗初期带状疱疹（肝经郁热型）的疗效观察及对预防后遗神经痛的临床探索

发布时间：2018-02-05 21:23

本文关键词： 带状疱疹后遗神经痛肝经郁热型临床观察　出处：《成都中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的：本课题基于中医“治未病”之“既病防变”理论及“辨证与辨病相结合”治疗特色,评价“自拟活血止痛方”治疗初期带状疱疹(肝经郁热型)的临床疗效及安全性,以及探索早期运用活血化瘀通络法对预防后遗神经痛的疗效,为临床提供新思路。方法：将90名肝经郁热型带状疱疹患者随机分为两组,对照组予西药常规治疗,试验组在对照组用药基础上加用自拟活血止痛方干预治疗。连续治疗2周。于治疗前及治疗第3、7、10、14天以及治疗后随访1月、2月、3月,通过病证评定指标及VAS评分比较两组间带状疱疹体征、疼痛程度以及后遗神经痛发生率的差异,作出疗效判定。结果：(1)综合疗效治疗组有效率为79.55%,对照组有效率为72.09%,治疗组与对照组疗效相当(P0.05)；改善疼痛疗效治疗组有效率84.09%,对照组65.12%；在改善疼痛疗效方面,治疗组均优于对照组(P0.05)；(2)两组在VAS评分方面,治疗组优于对照组(P0.05),即在改善疼痛方面,治疗组优于对照组；(3)两组在改善皮损及疼痛程度方面,治疗前后均有改善(P0.05)； (4)两组在疼痛缓解50%、结痂面积达50%所需时间方面,治疗组低于对照组(P0.05)；(5)在改善全身症状(中医次症)方面,治疗组优于对照组(P0.05)；(6)治疗结束后1、2、3月随访,治疗组发生后遗神经痛的频率低于对照组,差异有显著性(P0.05)。结论：(1)“自拟活血止痛方”针对肝经郁热型带状疱疹疗效明显,对疼痛程度的改善尤为明显。(2)对于肝经郁热型带状疱疹,早期运用“自拟活血止痛方”预防后遗神经痛的发生,疗效确切、安全,具有临床推广性；(3)早期运用活血化瘀通络法治疗肝经郁热型带状疱疹,对预防后遗神经痛的发生起一定作用。
[Abstract]:Objective: this subject is based on the "disease prevention" theory and the treatment characteristics of "syndrome differentiation and disease differentiation". Objective: to evaluate the clinical efficacy and safety of "Huoxue Zhitong recipe" in the treatment of early herpes zoster (liver meridian stagnation and heat type), and to explore the effect of early application of Huoxue Huayu Tongluo method on the prevention of posthumous neuralgia. Methods: 90 patients with herpes zoster due to stagnation of liver meridian were randomly divided into two groups, the control group was treated with routine western medicine. The experimental group was treated with self-made Huoxue Zhitong prescription on the basis of the control group. The treatment lasted for 2 weeks, followed up on January, February, March before and after treatment. The difference of herpes zoster sign, pain degree and the incidence rate of sequelae neuralgia were compared between the two groups by the evaluation index of disease syndrome and VAS score. Results the effective rate of the comprehensive treatment group was 79.55 and that of the control group was 72.09. The curative effect of the treatment group was equal to that of the control group (P 0.05). The effective rate was 84.09 in the treatment group and 65.12 in the control group. In improving the curative effect of pain, the treatment group was better than the control group (P 0.05). 2) the VAS score of the two groups was better than that of the control group (P 0.05), that is, the treatment group was superior to the control group in improving the pain. 3) both groups improved the degree of skin lesion and pain before and after treatment (P 0.05). (4) the time of pain relief and scabbing area of 50% in the two groups was lower than that in the control group (P 0.05). 5) the treatment group was superior to the control group in improving the systemic symptoms. The frequency of posthepatitic neuralgia in the treatment group was lower than that in the control group. The difference was significant (P 0.05). Conclusion the "Self-made prescription for promoting Blood Circulation and Zhitong" is effective in treating herpes zoster with stagnation and heat of liver meridian. For herpes zoster with stagnation and heat of liver meridian, early application of "self-made prescription for activating blood circulation and Zhitong" to prevent the occurrence of sequelae neuralgia is effective, safe and has clinical popularization. 3) early treatment of herpes zoster with stagnation of liver meridian by activating blood circulation and removing blood stasis and dredging collaterals plays a certain role in preventing the occurrence of sequelae neuralgia.
【学位授予单位】：成都中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R275.9

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