腕踝针治疗带状疱疹后神经痛临床疗效观察及对血清炎症因子水平的影响

Clinical Observation on Wrist and Ankle Acupuncture in Treatment of Postherpetic Neuralgia and Its Influence to Inflammatory Factors

摘要:

目的:探讨腕踝针治疗带状疱疹后神经痛(postherpetic neuralgia, PHN)患者的临床疗效及对血清炎症因子水平的影响。方法:选取2023年5月至2024年3月就诊于我院的88例PHN患者,运用数字表模式随机分成观察组及对照组各44例,对照组给予普瑞巴林口服治疗,观察组接受腕踝针治疗,疗程均为4周。观察两组治疗前、治疗后7d,治疗后14d,治疗后28d 疼痛视觉模拟量表(visual analogue scale, VAS)评分以评估疼痛改善状况。比较两组治疗前、治疗结束后匹兹堡睡眠质量指数((Pittsburg sleep quality index, PSQI)、焦虑自评量表(self-rating anxiety scale, SAS)评分和抑郁自评量表((self-rating depression scale, SDS)评分及血清炎症因子水平变化情况。并对两组进行临床疗效评价；同时记录患者不良反应情况。结果:治疗组和对照组各脱落2例,两组各42例纳入分析。两组治疗后7d,治疗后14d,治疗后28d疼痛VAS评分均较治疗前显著降低(P<0.05),且观察组各时间点VAS评分均低于对照组(P<0.05),观察组VAS评分下降较对照组更快速(P<0.05)。与本组治疗前比较,两组治疗后均有效降低PSQI评分、SAS评分、SDS评分及抑制血清IL-6、TNF-α和CRP水平(P<0.05),且观察组较对照组降低幅度更加显著(P<0.05)。观察组临床总有效率为90.5%不亚于对照组的83.3%(P>0.05)。治疗期间观察组患者不良反应率为9.52%(4/42)显著低于对照组的28.57%(12/42)(P<0.05)。结论:腕踝针治疗PHN患者疗效显著,可有效降低VAS评分,改善睡眠质量及调节负性情绪,抑制炎性因子水平,总体临床疗效不劣于普瑞巴林组,且不良反应低于药物组,值得临床推广应用。

Abstract:

Objective:To investigate the clinical effect of wrist and ankle acupuncture in the treatment of PHN and its impact on serum inflammatory factors.Methods:A total of 88 PHN patients admitted to our hospital from May 2023 to March 2024 were selected and randomly divided into control group and observation group according to the random number table method.The control group was treated with Pregabalin,and the observation group was given wrist and ankle needle treatment for 4 weeks.Visual analogue Scale (VAS) scores of the two groups were observed before treatment, as well as at 7 days,14 days,and 28 days after treatment to evaluate the improvement of pain.To compare Pittsburgh Sleep Quality Index(PSQI)score,Self-Rating Anxiety Scale(SAS)score,Self-Rating Depression Scale(SDS)score and serum inflammatory factor level changes before and after treatment.Clinical efficacy was also compared between the two groups.The occurrence of adverse events during treatment was also observed.Results:With two drop-outs both in the treatment group and control group,and 42 cases in each group were included in the analysis.The VAS scores of pain 7d,14d and 28d after treatment in the two groups were significantly lower than those before treatment(P<0.05),and the VAS scores of pain at each time point in the observation group were lower than those in the control group(P<0.05).The VAS score of the observation group decreased more rapidly than that of the control group(P<0.05).Compared with the control group before treatment, PSQI score, SAS score, SDS score and serum IL-6, TNF-α and CRP levels were significantly reduced in both groups after treatment (P<0.05), and the reduction in observation group was more significant than that in control group (P<0.05).The total effective rate of the observation group was 90.5%,which was not less than 83.3%of the control group(P>0.05).During the treatment,the adverse reaction rate was 9.52%(4/42)in the observation group,which was significantly lower than 28.57%(12/42)of the control group(P<0.05).Conclusion:Wrist and ankle acupuncture is effective in the treatment of PHN patients,which can effectively reduce the VAS score,improve sleep quality,regulate negative emotions,and inhibit the level of inflammatory factors.The overall clinical efficacy is not inferior to the Pregabalin group,and the adverse reactions are lower than the drug group,so it is worthy of clinical application.