针刺结合壮医药线治疗带状疱疹后遗神经痛的临床研究
发布时间：2019-03-21 13:23
【摘要】：目的:本研究利用随机对照,进行临床观察试验,比较针刺结合壮医药线与常规西药治疗带状疱疹后遗神经痛(postherpetic neuralgia,PHN)的临床疗效,为评价针刺结合壮医药线治疗PHN临床疗效提供有效的依据。方法:本试验研究将符合诊断标准、纳入标准的60例PHN患者作为研究对象。将受试者随机分为治疗组和对照组,每组各30例。治疗组采用针刺结合壮医药线点灸治疗,对照组采用常规西药治疗:加巴喷丁胶囊、布洛芬缓释胶囊、甲钴胺片。两组均为10天一个疗程,连续治疗三个疗程。治疗前、治疗结束时分别进行评价,疼痛评分采用视觉模拟评分法(VAS),睡眠质量采用匹兹堡睡眠指数(PSQI),情绪状态采用汉密尔顿抑郁量表(HAMD)进行评价。并在结束1月后进行电话随访,记录两组VAS评分。结果:治疗过程中,治疗组有1例脱落病例,有效29例;对照组有1例脱落病例,有效29例。治疗前两组的性别、年龄构成、病程长短、VAS评分、PSQI指数以及HAMD量表的比较,均无统计学意义(P0.05),表明两组具有可比性。(1)治疗组治疗前后VAS比较,对照组组治疗前后VAS比较,均有P0.01,表明两种治疗方案均能镇痛。治疗后两组VAS的比较,P0.01,表明两种治疗方案镇痛效果不同,治疗组镇痛效果更好。治疗结束后1月进行随访,记录VAS,两组比较可得P0.01,治疗组的远期镇痛效果优于对照组。(2)治疗组治疗前后PSQI比较,对照组组治疗前后PSQI比较,均有P0.01,表明两种治疗方案均能改善睡眠。治疗后两组PSQI的比较,P0.05,表明两种治疗方案改善睡眠效的果不同,治疗组改善睡眠的效果更好。(3)治疗组治疗前后HAMD比较,对照组治疗前后HAMD比较,均有P0.01,表明两种治疗方案均能改善情绪状态。治疗后两组HAMD的比较,P0.01,表明两种治疗方案改善情绪状态效果不同,治疗组效果更好。(4)临床疗效比较。治疗组:痊愈16例,显效8例,有效3例,无效2例,总有效率93.10%;对照组:痊愈6例,显效11例,有效7例,无效5例,总有效率82.76%。两组疗效比较,P0.01,说明治疗组疗效优于对照组。结论:治疗组治疗PHN的疗效优于对照组。对PHN患者的疼痛、睡眠质量以及情绪状态的改善均优于对照组。远期镇痛效果也优于对照组。可知针刺结合壮医药线点灸治疗PHN,疗效确切,值得临床推广应用。
[Abstract]:Objective: to compare the clinical efficacy of acupuncture combined with Zhuang medicine line and conventional western medicine in the treatment of post-herpetic neuralgia (postherpetic neuralgia,PHN) with randomized controlled trials, and to compare the clinical efficacy of acupuncture combined with Zhuang medicine line in treating herpes zoster neuralgia (postherpetic neuralgia,PHN). To evaluate the clinical efficacy of acupuncture combined with Zhuang medicament thread in the treatment of PHN. Methods: 60 patients with PHN who met the diagnostic criteria were selected as subjects in this study. The subjects were randomly divided into treatment group (n = 30) and control group (n = 30). The treatment group was treated with acupuncture combined with Zhuang medicine thread moxibustion, while the control group was treated with conventional western medicine: gabapentin capsule, ibuprofen sustained-release capsule and mecobalamin tablet. Two groups are 10 days a course of treatment, continuous treatment of three courses. Before treatment, the patients were evaluated at the end of the treatment. The (VAS), sleep quality was evaluated by visual analogue scale (VAS), the Pittsburgh sleep index (PSQI),) was used to evaluate the emotional state, and the Hamilton depression scale (HAMD) was used to evaluate the emotional state. One month after the end of the telephone follow-up, the two groups of VAS scores were recorded. Results: in the course of treatment, there were 1 case of shedding and 29 cases of effective in the treatment group, and 1 case of shedding and 29 cases of effective in the control group. Before treatment, there was no significant difference in sex, age composition, duration of disease, VAS score, PSQI index and HAMD scale between the two groups (P0.05), which indicated that the two groups were comparable. (1) VAS in the treatment group was compared before and after treatment, and there was no significant difference between the two groups before and after treatment (P0.05). The comparison of VAS before and after treatment in the control group showed P 0.01, indicating that both of the two treatment schemes were able to relieve pain. The comparison of VAS between the two groups after treatment, P 0.01, showed that the analgesic effect of the two treatment schemes was different, and the analgesic effect of the treatment group was better than that of the control group. The long-term analgesic effect of the treatment group was better than that of the control group. (2) the comparison of PSQI before and after treatment in the treatment group and the PSQI comparison before and after treatment in the control group showed that there was P 0.01 in both the VAS, group and the control group. These results suggest that both treatments can improve sleep. The comparison of PSQI, P0.05 between the two groups after treatment showed that the effects of the two treatment schemes on improving sleep were different, and that the effect of improving sleep in the treatment group was better than that in the treatment group. (3) the comparison of HAMD before and after treatment in the treatment group and the HAMD comparison before and after treatment in the control group showed that both of them had P0.01, The results showed that both treatments could improve emotional state. The comparison of HAMD, P0.01 between the two groups after treatment showed that the two therapeutic schemes had different effects on improving emotional state, and the effect of the treatment group was better. (4) the clinical curative effect was compared. In the treatment group, 16 cases were cured, 8 cases were markedly effective, 3 cases were effective, 2 cases were ineffective, and the total effective rate was 93.10%, while in the control group, 6 cases were cured, 11 cases were markedly effective, 7 cases were effective, 5 cases were ineffective, and the total effective rate was 82.76%. Comparison of two groups, P 0.01, showed that the therapeutic effect of the treatment group was better than that of the control group. Conclusion: the therapeutic effect of PHN in the treatment group is better than that in the control group. The improvement of pain, sleep quality and emotional state of PHN patients was better than that of control group. The long-term analgesic effect was better than that of the control group. It is known that acupuncture combined with Zhuang medicine thread moxibustion is effective in the treatment of PHN, and it is worthy of clinical popularization and application.
【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 compare the clinical efficacy of acupuncture combined with Zhuang medicine line and conventional western medicine in the treatment of post-herpetic neuralgia (postherpetic neuralgia,PHN) with randomized controlled trials, and to compare the clinical efficacy of acupuncture combined with Zhuang medicine line in treating herpes zoster neuralgia (postherpetic neuralgia,PHN). To evaluate the clinical efficacy of acupuncture combined with Zhuang medicament thread in the treatment of PHN. Methods: 60 patients with PHN who met the diagnostic criteria were selected as subjects in this study. The subjects were randomly divided into treatment group (n = 30) and control group (n = 30). The treatment group was treated with acupuncture combined with Zhuang medicine thread moxibustion, while the control group was treated with conventional western medicine: gabapentin capsule, ibuprofen sustained-release capsule and mecobalamin tablet. Two groups are 10 days a course of treatment, continuous treatment of three courses. Before treatment, the patients were evaluated at the end of the treatment. The (VAS), sleep quality was evaluated by visual analogue scale (VAS), the Pittsburgh sleep index (PSQI),) was used to evaluate the emotional state, and the Hamilton depression scale (HAMD) was used to evaluate the emotional state. One month after the end of the telephone follow-up, the two groups of VAS scores were recorded. Results: in the course of treatment, there were 1 case of shedding and 29 cases of effective in the treatment group, and 1 case of shedding and 29 cases of effective in the control group. Before treatment, there was no significant difference in sex, age composition, duration of disease, VAS score, PSQI index and HAMD scale between the two groups (P0.05), which indicated that the two groups were comparable. (1) VAS in the treatment group was compared before and after treatment, and there was no significant difference between the two groups before and after treatment (P0.05). The comparison of VAS before and after treatment in the control group showed P 0.01, indicating that both of the two treatment schemes were able to relieve pain. The comparison of VAS between the two groups after treatment, P 0.01, showed that the analgesic effect of the two treatment schemes was different, and the analgesic effect of the treatment group was better than that of the control group. The long-term analgesic effect of the treatment group was better than that of the control group. (2) the comparison of PSQI before and after treatment in the treatment group and the PSQI comparison before and after treatment in the control group showed that there was P 0.01 in both the VAS, group and the control group. These results suggest that both treatments can improve sleep. The comparison of PSQI, P0.05 between the two groups after treatment showed that the effects of the two treatment schemes on improving sleep were different, and that the effect of improving sleep in the treatment group was better than that in the treatment group. (3) the comparison of HAMD before and after treatment in the treatment group and the HAMD comparison before and after treatment in the control group showed that both of them had P0.01, The results showed that both treatments could improve emotional state. The comparison of HAMD, P0.01 between the two groups after treatment showed that the two therapeutic schemes had different effects on improving emotional state, and the effect of the treatment group was better. (4) the clinical curative effect was compared. In the treatment group, 16 cases were cured, 8 cases were markedly effective, 3 cases were effective, 2 cases were ineffective, and the total effective rate was 93.10%, while in the control group, 6 cases were cured, 11 cases were markedly effective, 7 cases were effective, 5 cases were ineffective, and the total effective rate was 82.76%. Comparison of two groups, P 0.01, showed that the therapeutic effect of the treatment group was better than that of the control group. Conclusion: the therapeutic effect of PHN in the treatment group is better than that in the control group. The improvement of pain, sleep quality and emotional state of PHN patients was better than that of control group. The long-term analgesic effect was better than that of the control group. It is known that acupuncture combined with Zhuang medicine thread moxibustion is effective in the treatment of PHN, and it is worthy of clinical popularization and application.
【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
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相关期刊论文 前10条
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