温针灸夹脊穴配合穴位注射治疗气虚血瘀型带状疱疹后遗神经痛的临床研究
发布时间：2018-11-20 04:00
【摘要】：目的:本课题以传统温针灸与现代穴位注射技术相结合,通过观察气虚血瘀型带状疱疹后遗神经痛患者治疗前后临床症状的改善情况,并以视觉模拟量表(Visual Analog Scale,VAS)、现有疼痛强度评定分级(Present Pain Intensity,PPI)、中医证候分级量化表等为观察指标,客观评价温针灸夹脊穴配合穴位注射疗法治疗气虚血瘀型带状疱疹后遗神经痛的临床疗效及安全性,为针灸疗法治疗本病提供疗效确切、操作安全的诊疗技术。方法:选取符合纳入标准的气虚血瘀型带状疱疹后遗神经痛患者70例为研究对象,采用随机数字表法,按1:1比例随机分为治疗组、对照组各35例。治疗组采用温针灸夹脊穴配合丹参穴位注射疗法治疗,取穴:夹脊、阿是穴、足三里。对照组予口服吲哚美辛肠溶片,开始时每次服25mg,每日3次,饭时或饭后立即服,若未见不良反应,可逐渐增至每日125~150mg;甲钴胺片0.5mg/次,每日3次。治疗期间不得饮用咖啡或酒等刺激性饮料,禁止服用与研究药物效用相近的中西药品或采用推拿、烫疗等其他治疗方法,患处避免接触冷水。针灸组治疗5次为1疗程,每个疗程结束后休息2天;西药组连续服用7日为1疗程;两组均共治疗3个疗程后评定疗效。分别于治疗前、治疗后、治疗结束后1个月随访用VAS、PPI、中医证候分级量化表等为观察指标进行评价疗效,并随时记录研究过程中的不良事件。采用统计软件SPSS 17.0对所收集的数据进行统计分析。结果:1.治疗前,治疗组与对照组的性别、年龄、发病部位、病程等一般情况相比较无差异(P0.05),具有可比性。2.治疗前,两组的VAS、PPI、中医证候评分比较,差异无显著性意义(P0.05),两组具有可比性。3.同组治疗前后比较:疗程结束后,两组的VAS、PPI、中医证候评分与同组治疗前比较,差异均有统计学意义(P0.05),提示两种疗法都具有良好的临床疗效。4.两组间治疗后比较:疗程结束后,治疗组的VAS、PPI、中医证候评分与对照组比较,差异有显著性意义(P0.01),提示治疗组近期疗效优于对照组。5.两组间随访时比较:疗程结束后1个月,治疗组的VAS、PPI、中医证候评分与对照组比较,有显著性差异(P0.01),提示治疗组远期疗效优于对照组。6.治疗后以及随访时,治疗组的愈显率、总有效率均优于对照组(P0.01)。结论:1.两种治疗方法均可改善带状疱疹后遗神经痛患者的疼痛症状;2.温针灸夹脊穴配合穴位注射疗法在近期及远期疗效上均优于西药治疗,且疗效稳定,复发率低,为治疗气虚血瘀型带状疱疹后遗神经痛的有效方法之一。
[Abstract]:Objective: to observe the improvement of clinical symptoms of patients with herpes zoster neuralgia of deficiency of qi and blood stasis before and after treatment with traditional warm acupuncture and modern point injection technique, and to use visual analogue scale (Visual Analog Scale,VAS). The existing pain intensity rating scale (Present Pain Intensity,PPI) and TCM syndrome classification and quantification table are the observation indexes. Objective to evaluate the clinical efficacy and safety of warming acupuncture and moxibustion Jiaji point combined with acupoint injection therapy in treating postherpetic neuralgia of herpes zoster with deficiency of qi and blood stasis. Methods: seventy patients with herpes zoster neuralgia with deficiency of qi and blood stasis were selected and randomly divided into treatment group (n = 35) and control group (n = 35). The treatment group was treated with warm-moxibustion and Jiaji points combined with salvia miltiorrhiza injection therapy. Points: Jiaji, Ashi, Zusanli. The control group was treated with indolomethacin enteric-coated tablets, 25mg at the beginning, 3 times a day, at the time of meal or immediately after meals. If no adverse reaction was observed, it could be gradually increased to 125 mg / d and 3 times per day (0.5mg/). During treatment, you are not allowed to drink stimulating drinks such as coffee or wine, or to take Chinese and Western medicines similar to the research drug or other treatments such as massage and scalding therapy. Avoid cold water in the affected areas. The acupuncture and moxibustion group was treated for 5 times as a course of treatment, each course was rested for 2 days after the end of each course; the western medicine group was taken continuously for 7 days as a course of treatment; the two groups were all treated for 3 courses and evaluated the curative effect. The curative effect was evaluated by VAS,PPI, TCM syndrome classification and quantification table before treatment, after treatment and 1 month after treatment, and the adverse events in the course of study were recorded at any time. Statistical software SPSS 17.0 was used to analyze the collected data. The result is 1: 1. Before treatment, there was no difference between the treatment group and the control group in sex, age, location of disease, course of disease and other general conditions (P0.05), which was comparable. Before treatment, there was no significant difference in VAS,PPI, syndrome score between the two groups (P0.05), the two groups were comparable. 3. Comparison before and after treatment in the same group: after the course of treatment, the VAS,PPI, syndrome score of the two groups compared with the same group before treatment, the difference was statistically significant (P0.05), indicating that the two treatments have good clinical efficacy. 4. Comparison after treatment between the two groups: after the course of treatment, the VAS,PPI, syndrome score of the treatment group was significantly different from that of the control group (P0.01), indicating that the short-term curative effect of the treatment group was better than that of the control group. 5. Comparison between the two groups at the follow-up time: 1 month after the end of the course of treatment, the VAS,PPI, syndrome score of the treatment group was significantly different from that of the control group (P0.01), indicating that the long-term curative effect of the treatment group was better than that of the control group. After treatment and follow-up, the curative effect rate and total effective rate of the treatment group were better than those of the control group (P0.01). Conclusion: 1. Both methods can improve the pain symptoms of patients with postherpetic neuralgia; 2. Warming acupuncture and acupuncture Jiaji point combined with acupoint injection therapy are better than western medicine in the short and long term curative effect, and the curative effect is stable, the recurrence rate is low, it is one of the effective methods to treat the postherpetic neuralgia after herpes zoster of qi deficiency and blood stasis type.
【学位授予单位】：广西中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.7
[Abstract]:Objective: to observe the improvement of clinical symptoms of patients with herpes zoster neuralgia of deficiency of qi and blood stasis before and after treatment with traditional warm acupuncture and modern point injection technique, and to use visual analogue scale (Visual Analog Scale,VAS). The existing pain intensity rating scale (Present Pain Intensity,PPI) and TCM syndrome classification and quantification table are the observation indexes. Objective to evaluate the clinical efficacy and safety of warming acupuncture and moxibustion Jiaji point combined with acupoint injection therapy in treating postherpetic neuralgia of herpes zoster with deficiency of qi and blood stasis. Methods: seventy patients with herpes zoster neuralgia with deficiency of qi and blood stasis were selected and randomly divided into treatment group (n = 35) and control group (n = 35). The treatment group was treated with warm-moxibustion and Jiaji points combined with salvia miltiorrhiza injection therapy. Points: Jiaji, Ashi, Zusanli. The control group was treated with indolomethacin enteric-coated tablets, 25mg at the beginning, 3 times a day, at the time of meal or immediately after meals. If no adverse reaction was observed, it could be gradually increased to 125 mg / d and 3 times per day (0.5mg/). During treatment, you are not allowed to drink stimulating drinks such as coffee or wine, or to take Chinese and Western medicines similar to the research drug or other treatments such as massage and scalding therapy. Avoid cold water in the affected areas. The acupuncture and moxibustion group was treated for 5 times as a course of treatment, each course was rested for 2 days after the end of each course; the western medicine group was taken continuously for 7 days as a course of treatment; the two groups were all treated for 3 courses and evaluated the curative effect. The curative effect was evaluated by VAS,PPI, TCM syndrome classification and quantification table before treatment, after treatment and 1 month after treatment, and the adverse events in the course of study were recorded at any time. Statistical software SPSS 17.0 was used to analyze the collected data. The result is 1: 1. Before treatment, there was no difference between the treatment group and the control group in sex, age, location of disease, course of disease and other general conditions (P0.05), which was comparable. Before treatment, there was no significant difference in VAS,PPI, syndrome score between the two groups (P0.05), the two groups were comparable. 3. Comparison before and after treatment in the same group: after the course of treatment, the VAS,PPI, syndrome score of the two groups compared with the same group before treatment, the difference was statistically significant (P0.05), indicating that the two treatments have good clinical efficacy. 4. Comparison after treatment between the two groups: after the course of treatment, the VAS,PPI, syndrome score of the treatment group was significantly different from that of the control group (P0.01), indicating that the short-term curative effect of the treatment group was better than that of the control group. 5. Comparison between the two groups at the follow-up time: 1 month after the end of the course of treatment, the VAS,PPI, syndrome score of the treatment group was significantly different from that of the control group (P0.01), indicating that the long-term curative effect of the treatment group was better than that of the control group. After treatment and follow-up, the curative effect rate and total effective rate of the treatment group were better than those of the control group (P0.01). Conclusion: 1. Both methods can improve the pain symptoms of patients with postherpetic neuralgia; 2. Warming acupuncture and acupuncture Jiaji point combined with acupoint injection therapy are better than western medicine in the short and long term curative effect, and the curative effect is stable, the recurrence rate is low, it is one of the effective methods to treat the postherpetic neuralgia after herpes zoster of qi deficiency and blood stasis type.
【学位授予单位】：广西中医药大学
【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 杨海东;;按疼痛分型治疗带状疱疹后遗神经痛[J];中国中医药现代远程教育;2016年21期
2 杨恂;杨敏;王忠兰;陈涵;张大伟;;当归四逆汤合大乌头汤加减治疗带状疱疹后遗神经痛1例报告[J];中医临床研究;2016年30期
3 程宏斌;伍景平;王岷珉;;从中医古籍角度试论蛇串疮病因病机[J];四川中医;2016年10期
4 段宝学;梁虹;;血府逐瘀胶囊联合LED红光照射治疗带状疱疹后遗神经痛疗效观察[J];中国实用神经疾病杂志;2016年16期
5 朱志强;;刺络放血治疗带状疱疹后遗神经痛的疗效观察[J];中国实用神经疾病杂志;2016年13期
6 白露;陈攀;范小婷;林辰;;壮医药线点灸法治疗带状疱疹后遗神经痛临床研究[J];亚太传统医药;2016年12期
7 黄心熳;张赛赛;邓享强;韦日铺;杜艳;;温针灸配合壮医药线点灸治疗躯干部带状疱疹后遗神经痛的临床观察[J];大众科技;2016年06期
8 徐纬;张大同;吴金星;;腹针配合阿是穴着肤灸治疗带状疱疹后遗神经痛36例[J];浙江中西医结合杂志;2016年05期
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