溫針灸夾脊穴配合穴位注射治療氣虛血瘀型帶狀皰疹后遺神經(jīng)痛的臨床研究
發(fā)布時(shí)間：2018-11-20 04:00
【摘要】：目的:本課題以傳統(tǒng)溫針灸與現(xiàn)代穴位注射技術(shù)相結(jié)合,通過觀察氣虛血瘀型帶狀皰疹后遺神經(jīng)痛患者治療前后臨床癥狀的改善情況,并以視覺模擬量表(Visual Analog Scale,VAS)、現(xiàn)有疼痛強(qiáng)度評定分級(Present Pain Intensity,PPI)、中醫(yī)證候分級量化表等為觀察指標(biāo),客觀評價(jià)溫針灸夾脊穴配合穴位注射療法治療氣虛血瘀型帶狀皰疹后遺神經(jīng)痛的臨床療效及安全性,為針灸療法治療本病提供療效確切、操作安全的診療技術(shù)。方法:選取符合納入標(biāo)準(zhǔn)的氣虛血瘀型帶狀皰疹后遺神經(jīng)痛患者70例為研究對象,采用隨機(jī)數(shù)字表法,按1:1比例隨機(jī)分為治療組、對照組各35例。治療組采用溫針灸夾脊穴配合丹參穴位注射療法治療,取穴:夾脊、阿是穴、足三里。對照組予口服吲哚美辛腸溶片,開始時(shí)每次服25mg,每日3次,飯時(shí)或飯后立即服,若未見不良反應(yīng),可逐漸增至每日125~150mg;甲鈷胺片0.5mg/次,每日3次。治療期間不得飲用咖啡或酒等刺激性飲料,禁止服用與研究藥物效用相近的中西藥品或采用推拿、燙療等其他治療方法,患處避免接觸冷水。針灸組治療5次為1療程,每個(gè)療程結(jié)束后休息2天;西藥組連續(xù)服用7日為1療程;兩組均共治療3個(gè)療程后評定療效。分別于治療前、治療后、治療結(jié)束后1個(gè)月隨訪用VAS、PPI、中醫(yī)證候分級量化表等為觀察指標(biāo)進(jìn)行評價(jià)療效,并隨時(shí)記錄研究過程中的不良事件。采用統(tǒng)計(jì)軟件SPSS 17.0對所收集的數(shù)據(jù)進(jìn)行統(tǒng)計(jì)分析。結(jié)果:1.治療前,治療組與對照組的性別、年齡、發(fā)病部位、病程等一般情況相比較無差異(P0.05),具有可比性。2.治療前,兩組的VAS、PPI、中醫(yī)證候評分比較,差異無顯著性意義(P0.05),兩組具有可比性。3.同組治療前后比較:療程結(jié)束后,兩組的VAS、PPI、中醫(yī)證候評分與同組治療前比較,差異均有統(tǒng)計(jì)學(xué)意義(P0.05),提示兩種療法都具有良好的臨床療效。4.兩組間治療后比較:療程結(jié)束后,治療組的VAS、PPI、中醫(yī)證候評分與對照組比較,差異有顯著性意義(P0.01),提示治療組近期療效優(yōu)于對照組。5.兩組間隨訪時(shí)比較:療程結(jié)束后1個(gè)月,治療組的VAS、PPI、中醫(yī)證候評分與對照組比較,有顯著性差異(P0.01),提示治療組遠(yuǎn)期療效優(yōu)于對照組。6.治療后以及隨訪時(shí),治療組的愈顯率、總有效率均優(yōu)于對照組(P0.01)。結(jié)論:1.兩種治療方法均可改善帶狀皰疹后遺神經(jīng)痛患者的疼痛癥狀;2.溫針灸夾脊穴配合穴位注射療法在近期及遠(yuǎn)期療效上均優(yōu)于西藥治療,且療效穩(wěn)定,復(fù)發(fā)率低,為治療氣虛血瘀型帶狀皰疹后遺神經(jīng)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.
【學(xué)位授予單位】：廣西中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：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.
【學(xué)位授予單位】：廣西中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R246.7
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