穴位注射配合药物治疗带状疱疹后遗神经痛的临床研究

目的观察穴位注射配合药物治疗带状疱疹后遗神经痛的临床疗效。方法将64例带状疱疹后遗神经痛患者随机分为治疗组和对照组,每组32例。治疗组采用夹脊穴注射丹参注射液配合口服加巴喷丁片治疗,对照组采用单纯口服加巴喷丁片治疗。两组如疼痛严重可加服盐酸曲马多缓释片治疗。观察两组治疗前后视觉模拟评分法(visual analogue scale, VAS)评分、SF-36健康量表(the MOS 36-item short-form health survey,SF-36)各项评分的变化情况,并比较两组不同时间点服用加巴喷丁片和盐酸曲马多缓释片的剂量及各项不良反应的发生率。结果两组治疗后不同时间点(治疗1周、3周、6周、12周、24周后)VAS评分与同组治疗前比较,差异均有统计学意义(P<0.01)。治疗组治疗后不同时间点VAS评分与对照组比较,差异具有统计学意义(P<0.01)。两组治疗3周、6周、12周、24周后加巴喷丁片和盐酸曲马多缓释片的服用剂量比较,差异均具有统计学意义(P<0.05)。两组治疗12周、24周后SF-36各项评分(PF、RP、BP、GH、VT、SF、RE、MH)与同组治疗前比较,差异均具有统计学意义(P<0.05)。治疗组治疗12周、24周后SF-36中PF、RP、BP、VT、MH评分与对照组比较,差异均具有统计学意义(P<0.05)。治疗组治疗后头晕、嗜睡、恶心的发生率分别为6.7%、3.3%和3.3%,对照组分别为24.1%、17.2%和20.7%,两组比较差异均具有统计学意义(P<0.05)。结论穴位注射配合药物是一种治疗带状疱疹后遗神经痛的有效方法,能减少服用加巴喷丁片的剂量,从而减少不良反应。

Clinical Study on Acupoint Injection plus Medication in Treating Postherpetic Neuralgia

Objective To observe the clinical efficacy of acupoint injection plus medication in treating postherpetic neuralgia. Method Sixty-four patients with postherpetic neuralgia were randomized into treatment and control groups, with 32 cases in each group. The treatment group was intervened by Huatuo jiaji (Ex-B2) point injection of Salvia miltiorrhiza injection plus oral administration of gabapentin tablets, while the control group was intervened by oral administration of gabapentin tablets alone. Both groups took tramadol hydrochloride sustained release tablets additionally if the pain was severe. Visual analogue scale (VAS) score and the MOS 36-item short-form health survey (SF-36) scores in the two groups were observed before and at the end of the treatment, and the dosages of gabapentin tablets and tramadol hydrochloride sustained release tablets at different time points and the incidences of adverse reactions of the two groups were compared. Result The VAS score showed a significant change after 1-week, 3-week, 6-week, 12-week, 24-week treatment in the two groups (P<0.01). After 1-week, 3-week, 6-week, 12-week, 24-week treatment, the VAS score in the treatment group was significantly different from that in the control group (P<0.01). After 3-week, 6-week, 12-week, 24-week treatment, the dosages of gabapentin tablets and tramadol hydrochloride sustained release tablets in the treatment group were significantly different from those in the control group (P<0.05). The SF-36 scores physical functioning (PF), role physical (RP), bodily pain (BP), general health (GH), vitality (VT), social functioning (SF), role emotional (RE) and mental health (MH)] showed a significant change after 12-week, 24-week treatment in the two groups (P<0.05). After 12-week, 24-week treatment, the SF-36 scores (RF, RP, BP, VT and MH) in the treatment group were significantly different from those in the control group (P<0.05). The incidences of dizziness, drowsiness and nausea were respectively 6.7%, 3.3% and 3.3% in the treatment group versus 24.1%, 17.2% and 20.7% in the control group, there was a statistically significant difference between the two groups (P<0.05). Conclusion Acupoint injection plus medication is an effective method in treating postherpetic neuralgia. It can reduce the dosage of gabapentin tablets, and therefore reduce adverse reactions.