火针针刺触发点联合硬膜外神经阻滞治疗顽固性带状疱疹后遗神经痛临床研究

目的:观察火针触发点联合硬膜外神经阻滞治疗顽固性带状疱疹后遗神经痛(PHN)的临床疗效。方法:将120例顽固性PHN患者随机分为观察组、对照组各60例。观察组采取火针针刺触发点联合硬膜外神经阻滞治疗,对照组予单纯硬膜外神经阻滞治疗。2组疗程均为2周。治疗前后评定疼痛视觉模拟评分法(VAS)评分、睡眠VAS评分、焦虑自评量表(SAS)评分和抑郁自评量表(SDS)评分。比较2组的临床疗效。结果:治疗后,观察组临床疗效优于对照组(P<0.05)。2组疼痛VAS、睡眠VAS、SAS、SDS评分均较治疗前下降,差异均有统计学意义(P<0.01)。观察组疼痛VAS、睡眠VAS、SAS、SDS评分均低于对照组,差异均有统计学意义(P<0.01)。结论:采用火针针刺触发点联合硬膜外神经阻滞治疗顽固性PHN患者,可显著减轻疼痛,在减轻疼痛的同时也可改善睡眠与焦虑、抑郁等负性情绪,临床疗效优于单纯使用硬膜外神经阻滞疗法。

Clinical Study of Fire Needle at Trigger Points Combined with Epidural Nerve Block for Intractable Post-herpetic Neuralgia

Objective:To observe the clinical effect of fire needle at trigger points combined with epidural nerve block for intractable post-herpetic neuralgia(PHN).Methods:A total of 120 cases of intractable PHN patients were randomly divided into the observation group and the control group,60 cases in each group.The control group was treated with epidural nerve block,and the observation group was additionally treated with fire needle at trigger points based on the treatment of the control group.Both groups were treated for two weeks.Before and after treatment,the scores of pain and sleep in Visual Analogue Scale(VAS),the Self-rating Anxiety Scale(SAS)and the Self-rating Depression Scale(SDS)were evaluated.The clinical effect in the two groups was compared.Results:After treatment,the clinical effect in the observation group was better than that in the control group(P<0.05).After treatment,the scores of pain and sleep in VAS,the SAS and the SDS in the two groups were all decreased when compared with those before treatment,differences being significant(P<0.01);the above scores in the observation group were all lower than those in the control group,differences being significant(P<0.01).Conclusion:The therapy of fire needle at trigger points combined with epidural nerve block for intractable PHN can significantly relieve pain and improve sleep and negative emotions including anxiety and depression,whose clinical effect is better than that of simple epidural nerve block.