青龙摆尾法治疗带状疱疹后遗神经痛的临床研究
发布时间：2018-08-07 19:32
【摘要】：目的:本课题旨在通过观察青龙摆尾法治疗带状疱疹后遗神经痛(PHN)的临床疗效及患者治疗前后外周血血清白细胞介素6(IL-6)和肿瘤坏死因子α(TNF-α)水平变化,为青龙摆尾法治疗PHN提供一定的临床治疗依据。方法:课题研究病例均来自武汉市第一医院针灸科和皮肤科门诊、住院部诊断为PHN的患者。将筛选符合纳入标准的患者随机分为治疗组(青龙摆尾法针刺组)和对照组(普通毫针针刺组),两组各33例,共66例。治疗组和对照组分别有1例因特殊情况不坚持治疗,除去,所以最终治疗组和对照组各32例。观察青龙摆尾法治疗PHN的临床疗效,并对两组患者治疗前后的综合疗效、VAS评分、镇痛效果、HAMD评分及血清IL-6和TNF-α的浓度变化进行统计学分析。结果:(1)两组疗效比较,治疗组痊愈12例(占37.50%)、显效14例(占43.75%)、有效2例(占6.25%)、无效4例(占12.5%),总有效率87.5%;治疗组痊愈6例(占18.75%),显效8例(占25.00%),有效5例(占15.63%)、无效13例(占40.63%),总有效率59.37%。经统计分析,治疗组愈显率和总有效率均优于对照组,差异具有统计学意义(P0.05)。(2)两组在首次治疗前VAS评分,无明显差异,无统计学意义(P0.05);两组VAS疼痛评分,组内治疗前后比较,治疗后均优于治疗前,差异具有统计学意义(P0.05);治疗后组间比较,治疗组优于对照组,差异具有统计学意义(P0.05)。(3)两组镇痛疗效比较,治疗组镇痛效果明显优于对照组,差异具有统计学意义(P0.05)。(4)两组HAMD评分治疗前组间比较,无明显差异,无统计学意义(P0.05);两组治疗后组内比较,HAMD评分治疗后均低于治疗前,差异具有统计学意义(P0.05);两组治疗后进行组间比较,治疗组HAMD评分低于对照组,差异具有统计学意义(P0.05)。(5)两组血清IL-6水平,治疗前组间比较,无明显差异,无统计学意义(P0.05);两组治疗后组内比较,治疗后血清IL-6水平均低于治疗前,有统计学意义(P0.05);两组治疗后进行组间比较,治疗组血清IL-6水平明显低于对照组,差异具有统计学意义(P0.05)。(6)两组血清TNF-α水平,治疗前组间比较,差异无统计学意义(P0.05);两组治疗后组内比较,治疗后血清TNF-α水平均低于治疗前,差异具有统计学意义(P0.05);两组治疗后进行组间比较,治疗组血清TNF-α水平明显低于对照组,差异具有统计学意义(P0.05)。(7)安全性评价,两组患者在治疗过程中均未出现较为明显的感染、全身反应等副作用表现,表明青龙摆尾法治疗PHN临床较为安全。结论:针对PHN的治疗,青龙摆尾法优于常规毫针疗法,能明显降低血清IL-6和TNF-α浓度,减轻PHN的神经痛症状,具有比较好的镇痛疗效,改善患者焦虑抑郁的精神状态。此为古法今用,疗效确切,无副作用,是一种安全有效的治疗方法,值得在临床上推广和运用。
[Abstract]:Objective: the purpose of this study is to observe the clinical effect of the treatment of herpes zoster neuralgia (PHN) by Tsing dragon's tail tail method and the changes of serum interleukin 6 (IL-6) and tumor necrosis factor alpha (TNF- alpha) in peripheral blood serum before and after treatment. The patients who were diagnosed as PHN in the Department of acupuncture and moxibustion and Department of dermatology in Wuhan No.1 Hospital were randomly divided into the treatment group (Qinglong swing tail acupuncture group) and the control group (ordinary needle acupuncture group). The two groups were 33 cases each, with 66 cases. The treatment group and the control group were 1 cases who were not treated with special conditions and removed, respectively. With 32 cases in the final treatment group and the control group, the clinical effect of PHN was observed by the Tsing dragon's tail method, and the comprehensive curative effect, the VAS score, the analgesic effect, the HAMD score and the concentration of serum IL-6 and TNF- alpha in the two groups were statistically analyzed. Results: (1) the curative effect of the two groups was compared, 12 cases (37.50%) were cured and 14 cases were markedly effective (accounting for 14 cases). 43.75%) effective 2 cases (6.25%), invalid 4 cases (12.5%), the total effective rate was 87.5%, the treatment group cured 6 cases (18.75%), 8 cases (25%), effective 5 (occupy 15.63%), invalid 13 cases (occupy 40.63%), the total effective rate of 59.37%. was statistically analyzed, the healing rate and total effective rate of the treatment group were better than the control group, the difference was statistically significant (P0.05). VAS score before the first treatment, no significant difference, no statistical significance (P0.05); two groups of VAS pain score, before and after treatment in the group, after treatment were better than before the treatment, the difference was statistically significant (P0.05); after treatment group comparison, the treatment group was better than the control group, the difference was statistically significant (P0.05). (3) the two groups of analgesic effect comparison, treatment group The analgesic effect was significantly better than that of the control group (P0.05). (4) there was no significant difference between the two groups before treatment, no significant difference (P0.05); the two groups after treatment group comparison, HAMD score after treatment were lower than before the treatment, the difference was statistically significant (P0.05); two groups after treatment group comparison, treatment group HAM The score of D was lower than that of the control group (P0.05). (5) the level of serum IL-6 in the two groups, there was no significant difference between the groups before treatment (P0.05); the two groups after treatment, after treatment, the serum IL-6 water was lower than before the treatment, and there were statistical significance (P0.05); the two groups after treatment group comparison, the treatment group serum IL-6 The difference was significantly lower than that of the control group (P0.05). (6) the level of serum TNF- alpha in the two groups was not statistically significant (P0.05) before treatment (P0.05); the serum TNF- alpha water in the two groups after treatment was lower than before the treatment, the difference was statistically significant (P0.05); the two groups were compared after the treatment group, the treatment group was compared. The level of serum TNF- alpha was significantly lower than that of the control group (P0.05). (7) the safety evaluation, the two groups of patients had no obvious infection in the treatment process, and the general reaction and other side effects showed that the treatment of PHN was safer by the Tsing dragon method for the treatment of PHN. Conclusion: the Tsing dragon's tail method is superior to the conventional needle therapy for the treatment of PHN. Treatment, can obviously reduce the concentration of serum IL-6 and TNF- alpha, reduce the symptoms of neuralgia of PHN, have good analgesic effect and improve the mental state of anxiety and depression of the patients. This is a kind of safe and effective treatment method, which is a safe and effective treatment method, which is worthy to be popularized and used in clinical practice.
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.7
[Abstract]:Objective: the purpose of this study is to observe the clinical effect of the treatment of herpes zoster neuralgia (PHN) by Tsing dragon's tail tail method and the changes of serum interleukin 6 (IL-6) and tumor necrosis factor alpha (TNF- alpha) in peripheral blood serum before and after treatment. The patients who were diagnosed as PHN in the Department of acupuncture and moxibustion and Department of dermatology in Wuhan No.1 Hospital were randomly divided into the treatment group (Qinglong swing tail acupuncture group) and the control group (ordinary needle acupuncture group). The two groups were 33 cases each, with 66 cases. The treatment group and the control group were 1 cases who were not treated with special conditions and removed, respectively. With 32 cases in the final treatment group and the control group, the clinical effect of PHN was observed by the Tsing dragon's tail method, and the comprehensive curative effect, the VAS score, the analgesic effect, the HAMD score and the concentration of serum IL-6 and TNF- alpha in the two groups were statistically analyzed. Results: (1) the curative effect of the two groups was compared, 12 cases (37.50%) were cured and 14 cases were markedly effective (accounting for 14 cases). 43.75%) effective 2 cases (6.25%), invalid 4 cases (12.5%), the total effective rate was 87.5%, the treatment group cured 6 cases (18.75%), 8 cases (25%), effective 5 (occupy 15.63%), invalid 13 cases (occupy 40.63%), the total effective rate of 59.37%. was statistically analyzed, the healing rate and total effective rate of the treatment group were better than the control group, the difference was statistically significant (P0.05). VAS score before the first treatment, no significant difference, no statistical significance (P0.05); two groups of VAS pain score, before and after treatment in the group, after treatment were better than before the treatment, the difference was statistically significant (P0.05); after treatment group comparison, the treatment group was better than the control group, the difference was statistically significant (P0.05). (3) the two groups of analgesic effect comparison, treatment group The analgesic effect was significantly better than that of the control group (P0.05). (4) there was no significant difference between the two groups before treatment, no significant difference (P0.05); the two groups after treatment group comparison, HAMD score after treatment were lower than before the treatment, the difference was statistically significant (P0.05); two groups after treatment group comparison, treatment group HAM The score of D was lower than that of the control group (P0.05). (5) the level of serum IL-6 in the two groups, there was no significant difference between the groups before treatment (P0.05); the two groups after treatment, after treatment, the serum IL-6 water was lower than before the treatment, and there were statistical significance (P0.05); the two groups after treatment group comparison, the treatment group serum IL-6 The difference was significantly lower than that of the control group (P0.05). (6) the level of serum TNF- alpha in the two groups was not statistically significant (P0.05) before treatment (P0.05); the serum TNF- alpha water in the two groups after treatment was lower than before the treatment, the difference was statistically significant (P0.05); the two groups were compared after the treatment group, the treatment group was compared. The level of serum TNF- alpha was significantly lower than that of the control group (P0.05). (7) the safety evaluation, the two groups of patients had no obvious infection in the treatment process, and the general reaction and other side effects showed that the treatment of PHN was safer by the Tsing dragon method for the treatment of PHN. Conclusion: the Tsing dragon's tail method is superior to the conventional needle therapy for the treatment of PHN. Treatment, can obviously reduce the concentration of serum IL-6 and TNF- alpha, reduce the symptoms of neuralgia of PHN, have good analgesic effect and improve the mental state of anxiety and depression of the patients. This is a kind of safe and effective treatment method, which is a safe and effective treatment method, which is worthy to be popularized and used in clinical practice.
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.7
【参考文献】
相关期刊论文 前10条
1 申海燕;申文;袁燕;;CT引导下背根神经节阻滞治疗带状疱疹后神经痛的疗效观察及对IL-6的影响[J];中国疼痛医学杂志;2016年11期
2 董新秀;黄正正;石义容;胡慧;;艾灸联合穴位按摩对带状疱疹后遗神经痛的影响[J];全科护理;2016年23期
3 陈付强;常敏;王风华;于洋;杨文荣;王昕;付世欧;谢平;;老年带状疱疹后神经痛与白介素和TNF-α水平的相关研究[J];中国疼痛医学杂志;2016年08期
4 魏常学;;穴位埋线结合电针及中药治疗带状疱疹后遗神经痛的临床价值分析[J];临床医学研究与实践;2016年09期
5 闫s，
本文编号：2171124
本文链接：https://www.wllwen.com/zhongyixuelunwen/2171124.html
最近更新
教材专著
