龙胆泻肝汤加减联合局部围刺治疗肝经郁热型带状疱疹疗效观察
发布时间：2018-09-19 18:00
【摘要】：目的:带状疱疹是临床上常见皮肤病之一,其典型的皮损及神经痛常对患者正常的生活、工作和学习造成影响。本次研究以龙胆泻肝汤加减联合局部围刺作为治疗方法来观察其对于肝经郁热型带状疱疹的临床疗效,并对其疗效作出客观评价,为带状疱疹的防治提供参考依据。材料与方法:病例均选自2015.3-2016.3期间就诊于辽宁中医药大学附属第一医院皮肤科病房的肝经郁热型带状疱疹患者,发病部位均为躯干部,共计96例,通过随机化分组的方法将患者分为治疗组与对照组,每组48例。治疗组予盐酸伐昔洛韦片联合维生素B1、B12口服,龙胆泻肝汤(龙胆草20g、大青叶15g、板蓝根15g、栀子15g、黄芩15g、泽泻10g、车前子10g、柴胡10g、生地10g、当归10g、木通10g、甘草10g)联合局部针灸围刺,对照组予盐酸伐昔洛韦片联合生素B1、B12口服,局部针灸围刺,共治疗15天,并于治疗5天、10天、15天时对患者病情状态进行观察并记录评分,治疗结束1个月后对完成试验的患者进行随访,观察两组患者后遗神经痛发病情况并进行比较。结果:1.治疗组在治疗至第5天、第10天、第15天时分别与治疗前相比较在皮损相关指标方面其评分差异均具有统计学意义(P0.05),对照组在治疗第5天、第10天、第15天时分别与治疗前比较在皮损相关指标方面其差异具有统计学意义(P0.05);在治疗第5天、10天、15天时治疗组与对照组相比,在皮损相关指标方面其差异具有统计学意义(P0.05),由此表明治疗组在对皮损的治疗方面优于对照组。2.治疗组在治疗第5天、10天、15天时与治疗前相比较在疼痛评分方面其差异均具有统计学意义(P0.05),对照组在治疗第5天、第10天、第15天时与治疗前比较在疼痛评分方面其差异具有统计学意义(P0.05);在治疗第5天、10天、15天时治疗组与对照组相比,在疼痛评分方面其差异具有统计学意义(P0.05),由此表明治疗组在对疼痛的治疗方面优于对照组。3.治疗结束后,治疗组、对照组总有效率分别为91.11%、72.72%,治疗组优于对照组。4.治疗结束1个月后随访,治疗组后遗神经痛发病率为11.11%,对照组后遗神经痛发病率为34.15%,表明治疗组能够有效的预防后遗神经痛的发病。结论:1.龙胆泻肝汤联合局部针灸围刺对于肝经郁热型带状疱疹的皮损及疼痛具有显著的治疗作用。2.龙胆泻肝汤联合局部针灸围刺对于带状疱疹后遗神经痛有着显著的防治作用。
[Abstract]:Objective: herpes zoster is one of the common skin diseases in clinic. Its typical skin lesions and neuralgia often affect the normal life, work and study of patients. In this study, Gentian Xiegan decoction combined with local circumference was used to observe the clinical effect of Ganyan Xiegan decoction for the treatment of herpes zoster with stagnation of the liver meridian, and to make an objective evaluation of its curative effect, and to provide a reference for the prevention and treatment of herpes zoster. Materials and methods: all the patients were selected from the Department of Dermatology of the first affiliated Hospital of Liaoning University of traditional Chinese Medicine during the period of 2015.3-2016.3. Patients were randomly divided into treatment group and control group with 48 cases in each group. In the treatment group, valaciclovir hydrochloride combined with vitamin B1 B12 was given orally, and Longdan Xiegan decoction (Gentiangrass 20g, Daqingye 15g, Isatidis lanceolata 15g, Gardenia jasminoides 15g, Radix Scutellariae 15g, Radix Alismatis 10g, Plantago 10g, Radix Bupleurum 10g, Shengdi 10g, Angelica sinensis 10g, Akebia chinensis 10g) combined with local acupuncture and moxibustion. The control group was treated with valciclovir hydrochloride combined with B1B12 orally, and local acupuncture and moxibustion were used to treat the patients for a total of 15 days. The patients' state of illness was observed and scored at 5 days, 10 days and 15 days, respectively. One month after treatment, the patients who completed the trial were followed up to observe and compare the incidence of sequelae neuralgia between the two groups. The result is 1: 1. There were statistically significant differences in the scores of skin lesions between the treatment group and the pre-treatment group on the 5th, 10th and 15th day (P0.05), and the control group on the 5th, 10th, 10th day after treatment. On the 15th day, there were significant differences in the relative indexes of skin lesions between the treatment group and the control group (P0.05); on the 5th day, 10 days and 15 days after treatment, the treatment group was compared with the control group. There was significant difference in the related indexes of skin lesions (P0.05), which indicated that the treatment group was better than the control group in the treatment of skin lesions. 2. There were significant differences in pain scores between the treatment group and the control group on the 5th day and the 10th day after treatment (P0.05), and the control group on the 5th day, the 10th day, the control group on the 5th day, the 10th day after treatment, and the control group on the 5th and 10th day after treatment. There was significant difference in pain score between the 15th day and the pre-treatment day (P0.05); the treatment group was compared with the control group on the 5th day and the 10th day and the 15th day after the treatment, the pain score of the treatment group was significantly higher than that of the control group. The difference in pain score was statistically significant (P0.05), which indicated that the treatment group was better than the control group in the treatment of pain. 3. After the treatment, the total effective rates of the treatment group and the control group were 91.11 and 72.72, respectively, and the treatment group was superior to the control group. The incidence of sequelae neuralgia was 11.11 in the treatment group and 34.15 in the control group, which indicated that the treatment group could effectively prevent the incidence of sequelae neuralgia. Conclusion 1. Longdan Xiegan decoction combined with local acupuncture and moxibustion has a significant therapeutic effect on the skin lesions and pain of liver meridian heat zoster. Longdan Xiegan decoction combined with local acupuncture has a significant preventive and therapeutic effect on postherpetic neuralgia.
【学位授予单位】：辽宁中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R275.9
本文编号：2250906
[Abstract]:Objective: herpes zoster is one of the common skin diseases in clinic. Its typical skin lesions and neuralgia often affect the normal life, work and study of patients. In this study, Gentian Xiegan decoction combined with local circumference was used to observe the clinical effect of Ganyan Xiegan decoction for the treatment of herpes zoster with stagnation of the liver meridian, and to make an objective evaluation of its curative effect, and to provide a reference for the prevention and treatment of herpes zoster. Materials and methods: all the patients were selected from the Department of Dermatology of the first affiliated Hospital of Liaoning University of traditional Chinese Medicine during the period of 2015.3-2016.3. Patients were randomly divided into treatment group and control group with 48 cases in each group. In the treatment group, valaciclovir hydrochloride combined with vitamin B1 B12 was given orally, and Longdan Xiegan decoction (Gentiangrass 20g, Daqingye 15g, Isatidis lanceolata 15g, Gardenia jasminoides 15g, Radix Scutellariae 15g, Radix Alismatis 10g, Plantago 10g, Radix Bupleurum 10g, Shengdi 10g, Angelica sinensis 10g, Akebia chinensis 10g) combined with local acupuncture and moxibustion. The control group was treated with valciclovir hydrochloride combined with B1B12 orally, and local acupuncture and moxibustion were used to treat the patients for a total of 15 days. The patients' state of illness was observed and scored at 5 days, 10 days and 15 days, respectively. One month after treatment, the patients who completed the trial were followed up to observe and compare the incidence of sequelae neuralgia between the two groups. The result is 1: 1. There were statistically significant differences in the scores of skin lesions between the treatment group and the pre-treatment group on the 5th, 10th and 15th day (P0.05), and the control group on the 5th, 10th, 10th day after treatment. On the 15th day, there were significant differences in the relative indexes of skin lesions between the treatment group and the control group (P0.05); on the 5th day, 10 days and 15 days after treatment, the treatment group was compared with the control group. There was significant difference in the related indexes of skin lesions (P0.05), which indicated that the treatment group was better than the control group in the treatment of skin lesions. 2. There were significant differences in pain scores between the treatment group and the control group on the 5th day and the 10th day after treatment (P0.05), and the control group on the 5th day, the 10th day, the control group on the 5th day, the 10th day after treatment, and the control group on the 5th and 10th day after treatment. There was significant difference in pain score between the 15th day and the pre-treatment day (P0.05); the treatment group was compared with the control group on the 5th day and the 10th day and the 15th day after the treatment, the pain score of the treatment group was significantly higher than that of the control group. The difference in pain score was statistically significant (P0.05), which indicated that the treatment group was better than the control group in the treatment of pain. 3. After the treatment, the total effective rates of the treatment group and the control group were 91.11 and 72.72, respectively, and the treatment group was superior to the control group. The incidence of sequelae neuralgia was 11.11 in the treatment group and 34.15 in the control group, which indicated that the treatment group could effectively prevent the incidence of sequelae neuralgia. Conclusion 1. Longdan Xiegan decoction combined with local acupuncture and moxibustion has a significant therapeutic effect on the skin lesions and pain of liver meridian heat zoster. Longdan Xiegan decoction combined with local acupuncture has a significant preventive and therapeutic effect on postherpetic neuralgia.
【学位授予单位】：辽宁中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R275.9
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