泻热逐瘀法刺络放血治疗带状疱疹后遗神经痛的临床研究

发布时间：2018-06-20 17:22

本文选题：泻热逐瘀 + 刺络放血　；参考：《云南中医学院》2017年硕士论文

【摘要】：目的:观察“泻热逐瘀刺络放血疗法”(以取病灶局部阿是穴,大椎穴、委中穴进行刺络放血)与“口服普瑞巴林胶囊、甲钴胺片”对瘀血阻络型带状疱疹后遗神经痛的临床疗效对照观察。充分验证泻热逐瘀刺络放血疗法对治疗瘀血阻络型带状疱疹后遗神经痛是一种高治愈率、安全、优效的方法。方法:将60例患者用随机数字表法分为治疗组、对照组,每组30例。治疗组:采用“泻热逐瘀刺络放血疗法”,取病灶局部阿是穴,大椎穴、委中穴进行刺络放血,(周一、周三、周五选择病灶局部刺络放血,则周二、周四选择大椎、委中刺络放血)。每周为一疗程,治疗五天,周末休息两天。共治疗2个疗程;对照组采用口服药物:“普瑞巴林胶囊和甲钴胺片”同时服用。普瑞巴林胶囊,口服剂量为:150m bid;甲钴胺片,口服剂量为:0.5mg Tid。维持剂量,服用连续服药14天。(1)两组均在治疗前、治疗中(既第一疗程结束后,第二疗程开始前)、治疗后(既总疗程治疗结束后第二天),分别用VAS进行疼痛程度测评评分,用McGill疼痛综合积分表进行疼痛综合症状积分测评,用QS进行睡眠质量评分。(2)两组均在总疗程治疗前,治疗结束时分别用副反应量表测评,分别作为两组副作用的观察。从总体疗效、起效速率,治愈率,有效率,副反应的有无来评价泻热逐瘀法刺络放血治疗瘀血阻络型带状疱疹后遗神经痛的效果。结果:1.疗效比较:两组治疗结束后疗比较,刺络放血组总有效率为100%,其中治愈率60%,显效率30%;药物组总有效率为83.33%,其中治愈率23%,显效率20%差异有统计学意义(p0.05)。刺络放血组总有效率、治愈率、显效率高于对照组。2.疼痛程度VAS评分比较:两组治疗中(一疗程结束后)比较,刺络放血组与药物组比较差异有统计学意义(P0.05)。两组治疗后(总疗程结束后)比较,刺络放血组与药物组比较差异有统计学意义(P0.05)。刺络放血组止痛疗效、止痛速率优于药物组,随着治疗时间增加优效性更加突出。3.QS睡眠质量评分比较:两组治疗中(一疗程结束后)比较,刺络放血组与药物组比较差异有统计学意义(P0.05)。两组治疗后(总疗程结束后)比较,刺络放血组与药物组比较差异有统计学意义(P0.05)。刺络放血组在改善患者疼痛引起的睡眠质量降低方面优于药物组,且改善速率优于药物组,随着治疗时间增加优效性更加突出。4.McGill疼痛综合积分比较:两组治疗中(一疗程结束后)比较,刺络放血组与药物组比较差异有统计学意义(P0.05)。两组治疗后(总疗程结束后)比较,刺络放血组与药物组比较差异有统计学意义(P0.05)。刺络放血组在改善患者疼痛综合症状方面优于药物组,且改善速率优于药物组,随着治疗时间增加优效性更加突出。5.副反应量表(TESS)比较:两组治疗结束后,刺络放血组与药物组比较。刺络放血组治疗后有1人出现轻微皮肤症状;药物组治疗后出现不同程度的不良反应,人数为10人,副反应率为33.33%,最明显副作用为头晕头昏症状。结论:1.泻热逐瘀刺络放血疗法对瘀血阻络型带状疱疹后遗神经痛治愈率、显效率、有效率明显优于口服药物治疗。2.泻热逐瘀刺络放血疗法在改善患者疼痛程度优于药物组,且止痛速率优于药物组,随着治疗时间的增加优效性更加突出。3.泻热逐瘀刺络放血疗法在改善患者睡眠情况方面优于药物组,且改善速率优于药物组,随着治疗时间增加优效性更加突出。4.泻热逐瘀刺络放血疗法在改善患者疼痛综合症状方面优于药物组,且改善速率优于药物组,随着治疗时间增加优效性更加突出。5.泻热逐瘀刺络放血疗法治疗组治疗后副反应不明显,药物组治疗后出现头晕头昏、口干、嗜睡、消化系统主观症状以及血、尿、便及肝、肾功能等客观体征的异常。6.泻热逐瘀刺络放血疗法以病灶局部阿是穴、大椎、委中、为主穴以刺络放血治疗瘀血阻络型带状疱疹后遗神经痛起效快、疗效好、治愈速度快、随着治疗时间的增加优效性更加突出,是一种简便、安全、优效、高治愈率的方法。
[Abstract]:Objective: To observe the effect of "Purging Heat stasis bloodletting therapy" (for lesion Ashi point, Dazhui, Weizhong of bloodletting) and oral administration of Pregabalin Capsules, Mecobalamin Tablets observed "clinical curative effect on treating blood stasis type of postherpetic neuralgia. Fully verify the purging heat stasis pricking blood therapy for the treatment of blood stasis Type of postherpetic neuralgia is a high cure rate, safe, effective method. Methods: 60 cases were randomly divided into treatment group, patients in the control group, 30 cases in each group. The treatment group: the use of "Purging Heat stasis bloodletting therapy, taking local lesions point, Dazhui acupoint Weizhong of bloodletting, (Monday, Wednesday, Friday The lesion of bloodletting, Tuesday, Thursday Commission in blood pricking Dazhui). A week for a course of treatment is five days, weekend rest for two days. A total of 2 courses of treatment; the control group with oral administration of drugs: "Pregabalin Capsules and Mecobalamin Tablets" at the same time taking. Pregabalin Capsules, oral dose: 150m bid; Mecobalamin Tablets the oral dose was 0. .5mg Tid. dose, taking medication for 14 days. (1) in two groups before treatment, treatment (the first after the end of treatment, second courses before the start of treatment (second days), the total course of treatment after the end of both), with VAS degree of pain assessment score, pain symptom score comprehensive evaluation McGill pain table with QS The sleep quality score. (2) the two groups in the total course of treatment before the end of the treatment respectively, side effects scale, were observed as side effects of the two groups. The overall curative effect, the onset rate, cure rate, efficiency, side effects are to evaluate purging heat, removing blood stasis bloodletting the treatment of blood stasis type of postherpetic neuralgia. Results: 1. efficacy comparison: the treatment group after treatment, the end of the two, bloodletting group total effective rate was 100%, the cure rate is 60%, effective rate was 30%; the medicine group total effective rate was 83.33%, the cure rate was 23%, statistically significant difference (P0.05) was 20%. The total efficiency of bloodletting group and the cure rate, the effective rate was higher than the control group.2. pain rating VAS Comparison: two groups of treatment (one after the end of treatment), there was significant difference between the bloodletting group and drug group (P0.05). The two groups after treatment (total after treatment), there was significant difference between the bloodletting group and drug group (P0.05). Pricking blood group on analgesic effect, analgesic rate is better than the drug group, with treatment time Increase efficiency more prominent sleep quality.3.QS scores were compared between the two treatment (after a period of treatment), there was significant difference between the bloodletting group and drug group (P0.05). The two groups after treatment (total after treatment), bloodletting group and drug group was statistically significant compared the difference (P0.05). Pricking blood group in improving patients Pain caused by sleep quality is better than the drug group decreased, and the improvement rate is better than the drug group, with treatment time increase efficiency more prominent.4.McGill pain score comparison: two groups of treatment (one after the end of treatment), there was significant difference between the bloodletting group and drug group (P0.05 group) two. After treatment (total therapy After the end of the process), there was significant difference between the bloodletting group and drug group (P0.05). Bloodletting group in improving patients' pain symptoms than the drug group, and the improvement rate is better than the drug group, with treatment time increase efficiency more prominent.5. side effects scale (TESS): end the two groups after treatment, pricking blood group Compared with the drug group. Bloodletting group after treatment 1 showed mild skin symptoms; different degrees of adverse reactions occurred in drug group after treatment, the number is 10, the rate of side reaction was 33.33%, the most obvious side effects were dizziness symptoms. Conclusion: 1. purging heat, blood stasis bloodletting therapy to cure rate blood stasis type of postherpetic neuralgia, The significant efficiency, efficiency is obviously superior to oral therapy.2. Purging Heat stasis pricking blood therapy in improving the pain degree of patients better than the drug group, and the analgesic rate is better than the drug group, with the increase of treatment time superiority is more prominent.3. Purging Heat stasis pricking blood therapy in improving the patients sleep better than drug group and improve the speed. The rate is better than the drug group, with treatment time increase efficiency more prominent.4. Purging Heat stasis pricking blood therapy in improving the patients pain symptoms than the drug group, and the improvement rate is better than the drug group, with treatment time increase efficiency more prominent.5. Purging Heat stasis bloodletting therapy without obvious adverse reactions in the treatment after the treatment group, Dizziness, drug group after treatment, dry mouth, digestive system symptoms and subjective sleepiness, blood, urine, liver and renal function, abnormal.6. Purging Heat and other objective signs of blood stasis bloodletting therapy to the lesion point, Dazhui, commission, the main points with pricking blood therapy on blood stasis blocking collateral type ribbon postherpetic neuralgia rapid onset, good curative effect, treatment The speed, with the increase of treatment time superiority is more prominent, is a simple, safe, effective, high cure rate.
【学位授予单位】：云南中医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.7

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