柴胡疏肝散联合桃红四物汤加减治疗带状疱疹后遗神经痛临床研究

目的：观察柴胡疏肝散联合桃红四物汤加减治疗带状疱疹后遗神经痛（PHN） 的疗效。方法：选取140例气滞血瘀型PHN患者，按随机数字表法分为对照组及观察组各70例。对照组给予加巴喷丁胶囊口服治疗，观察组在对照组基础上予以桃红四物汤联合柴胡疏肝散加减治疗。2组均治疗4周。比较2组临床疗效及不良反应发生率，比较2组治疗前后疼痛视觉模拟评分法（VAS） 评分、皮肤病生活质量指数量表（DLQI）评分、血清神经肽Y（NPY）、P物质（SP）、β-内啡肽（β-EP）、中枢神经特异蛋（S100β）、神经元特异性烯醇化酶（NSE） 的变化。结果：治疗4周后，观察组临床疗效总有效率为91.43%，对照组为74.28%，2组比较，差异有统计学意义（P＜0.05）。治疗4周后，2组VAS、DLQI评分均较治疗前降低（P＜0.05），观察组VAS、DLQI评分均低于对照组（P＜0.05）。治疗后，2组血清NPY、SP水平均较治疗前下降，β-EP水平均较治疗前上升（P＜0.05）。观察组NPY、SP水平均低于对照组（P＜0.05），β-EP水平高于对照组（P＜0.05）。治疗4周后，2组血清S100β、NSE含量均较治疗前下降（P＜0.05），观察组血清S100β、NSE含量均低于对照组（P＜0.05）。观察组不良反应发生率为8.57%，对照组不良反应发生率为7.14%，2组不良反应发生率比较，差异无统计学意义（P＞0.05）。结论：柴胡疏肝散联合桃红四物汤加减治疗PHN可有效改善神经免疫功能，抑制神经损伤，缓解疼痛，提高生活质量。

Clinical Study on Modified Chaihu Shugan San Combined with Taohong SiwuDecoction for Postherpetic Neuralgia

Abstract：Objective：To observe the clinical effect of Chaihu Shugan San combined with Taohong SiwuDecoction on postherpetic neuralgia (PHN). Methods：A total of 140 PHN patients of qi stagnation and bloodstasis type were selected and divided into the control group and the observation group according to randomnumber table method，with 70 cases in each group. The control group was orally treated with GabapentinCapsules，and the observation group was additionally treated with Taohong Siwu Decoction combined withChaihu Shugan San based on the treatment of the control group. Both groups were treated for four weeks.The clinical effects and incidence of adverse reactions were compared between the two groups. Thechanges of Visual Analogue Scale of pain (VAS)， Dermatology Life Quality Index (DLQI)， serumneuropeptide Y (NPY)， Substance P (SP)， β-endorphin (β-EP)， central nerve specific egg (S100β) andneuron-specific enolase (NSE) were compared between the two groups before and after treatment.Results：After four weeks of treatment，the total effective rate was 91.43% in the observation group and74.28% in the control group，the difference being significant (P＜0.05). After four weeks of treatment，thescores of VAS and DLQI in the two groups were decreased when compared with those before treatment(P＜0.05)，and the scores of VAS and DLQI in the observation group were lower than those in the controlgroup (P＜0.05). After treatment， the serum NPY and SP levels in the two groups were decreased whencompared with those before treatment， and the β-EP levels were increased when compared with thosebefore treatment (P＜0.05)； the levels of NPY and SP in the observation group were lower than controlgroup (P＜0.05)， and the level of β-EP was higher than the control group (P＜0.05). After four weeks oftreatment， the levels of serum S100β and NSE in the two groups were decreased when compared withthose before treatment (P＜0.05)，and the levels of serum S100β and NSE in the observation group werelower than the control group (P＜0.05). The incidence of adverse reactions was 8.57% in the observationgroup and 7.14% in the control group， there being no significant difference between the two groups (P>0.05). Conclusion： The therapy of Chaihu Shugan San combined with Taohong Siwu Decoction caneffectively improve nerve immune function，inhibit nerve injury，relieve pain and improve quality of life ofPHN patients.