青龍擺尾法治療帶狀皰疹后遺神經(jīng)痛的臨床研究
發(fā)布時(shí)間：2018-08-07 19:32
【摘要】：目的:本課題旨在通過觀察青龍擺尾法治療帶狀皰疹后遺神經(jīng)痛(PHN)的臨床療效及患者治療前后外周血血清白細(xì)胞介素6(IL-6)和腫瘤壞死因子α(TNF-α)水平變化,為青龍擺尾法治療PHN提供一定的臨床治療依據(jù)。方法:課題研究病例均來自武漢市第一醫(yī)院針灸科和皮膚科門診、住院部診斷為PHN的患者。將篩選符合納入標(biāo)準(zhǔn)的患者隨機(jī)分為治療組(青龍擺尾法針刺組)和對(duì)照組(普通毫針針刺組),兩組各33例,共66例。治療組和對(duì)照組分別有1例因特殊情況不堅(jiān)持治療,除去,所以最終治療組和對(duì)照組各32例。觀察青龍擺尾法治療PHN的臨床療效,并對(duì)兩組患者治療前后的綜合療效、VAS評(píng)分、鎮(zhèn)痛效果、HAMD評(píng)分及血清IL-6和TNF-α的濃度變化進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果:(1)兩組療效比較,治療組痊愈12例(占37.50%)、顯效14例(占43.75%)、有效2例(占6.25%)、無效4例(占12.5%),總有效率87.5%;治療組痊愈6例(占18.75%),顯效8例(占25.00%),有效5例(占15.63%)、無效13例(占40.63%),總有效率59.37%。經(jīng)統(tǒng)計(jì)分析,治療組愈顯率和總有效率均優(yōu)于對(duì)照組,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。(2)兩組在首次治療前VAS評(píng)分,無明顯差異,無統(tǒng)計(jì)學(xué)意義(P0.05);兩組VAS疼痛評(píng)分,組內(nèi)治療前后比較,治療后均優(yōu)于治療前,差異具有統(tǒng)計(jì)學(xué)意義(P0.05);治療后組間比較,治療組優(yōu)于對(duì)照組,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。(3)兩組鎮(zhèn)痛療效比較,治療組鎮(zhèn)痛效果明顯優(yōu)于對(duì)照組,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。(4)兩組HAMD評(píng)分治療前組間比較,無明顯差異,無統(tǒng)計(jì)學(xué)意義(P0.05);兩組治療后組內(nèi)比較,HAMD評(píng)分治療后均低于治療前,差異具有統(tǒng)計(jì)學(xué)意義(P0.05);兩組治療后進(jìn)行組間比較,治療組HAMD評(píng)分低于對(duì)照組,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。(5)兩組血清IL-6水平,治療前組間比較,無明顯差異,無統(tǒng)計(jì)學(xué)意義(P0.05);兩組治療后組內(nèi)比較,治療后血清IL-6水平均低于治療前,有統(tǒng)計(jì)學(xué)意義(P0.05);兩組治療后進(jìn)行組間比較,治療組血清IL-6水平明顯低于對(duì)照組,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。(6)兩組血清TNF-α水平,治療前組間比較,差異無統(tǒng)計(jì)學(xué)意義(P0.05);兩組治療后組內(nèi)比較,治療后血清TNF-α水平均低于治療前,差異具有統(tǒng)計(jì)學(xué)意義(P0.05);兩組治療后進(jìn)行組間比較,治療組血清TNF-α水平明顯低于對(duì)照組,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。(7)安全性評(píng)價(jià),兩組患者在治療過程中均未出現(xiàn)較為明顯的感染、全身反應(yīng)等副作用表現(xiàn),表明青龍擺尾法治療PHN臨床較為安全。結(jié)論:針對(duì)PHN的治療,青龍擺尾法優(yōu)于常規(guī)毫針療法,能明顯降低血清IL-6和TNF-α濃度,減輕PHN的神經(jīng)痛癥狀,具有比較好的鎮(zhèn)痛療效,改善患者焦慮抑郁的精神狀態(tài)。此為古法今用,療效確切,無副作用,是一種安全有效的治療方法,值得在臨床上推廣和運(yùn)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.
【學(xué)位授予單位】：湖北中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：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.
【學(xué)位授予單位】：湖北中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R246.7
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