摘要
目的 探究火针赞刺法结合滋肾清肝汤治疗带状疱疹的临床效果及对T淋巴细胞亚群的影响.方法 选择2021 年2 月—2023 年6 月收治的带状疱疹94 例.依据随机数字表法分为对照组、观察组,每组 47 例.在常规治疗基础上对照组予以火针赞刺法治疗,观察组在对照组基础上予以滋肾清肝汤治疗.比较2 组临床疗效、疱疹皮损愈合评价指标(止疱时间、结痂时间、脱痂时间),观察治疗前及治疗1、2、3、5、10d疼痛缓解情况[视觉模拟评分量表(VAS)评分],以及治疗前后外周血T淋巴细胞亚群(CD3+、CD4+、CD8+、CD4+/CD8+),并记录带状疱疹后遗神经痛的发生率.结果 治疗后,观察组治疗总有效率为 95.74%(45/47),高于对照组的 80.85%(38/47)(P＜0.05).观察组止疱时间、结痂时间、脱痂时间均短于对照组(P＜0.05).治疗1、2、3、5、10 d,2 组疼痛VAS评分均低于治疗前(P＜0.05),且随着治疗时间推移2 组疼痛VAS评分均呈不断下降趋势;观察组治疗3、5、10d疼痛VAS评分低于对照组(P＜0.05).治疗后,2 组CD8+水平较治疗前明显降低,CD4+/CD8+、CD4+、CD3+水平较治疗前明显升高,且观察组CD4+/CD8+、CD3+、CD4+及CD8+水平升高或降低程度显著优于对照组(P＜0.05).治疗后1个月观察组带状疱疹后遗神经痛发生率10.64%(5/47),低于对照组的25.53%(12/47)(P＜0.05).结论 火针赞刺法结合滋肾清肝汤治疗带状疱疹可促进水疱收敛结痂,快速缓解神经痛症状,改善外周血T淋巴细胞亚群,降低带状疱疹后遗神经痛发生率,从而进一步提高临床疗效.
Abstract
Objective To explore the clinical effect of the combination of repeated shallow needling with fire needle and Zishen Qinggan decoction in the treatment of herpes zoster and its impact on T lymphocyte subsets.Methods A total of 94 patients with herpes zoster treated from February 2021 to June 2023 were selected.According to the random number table method,they were divided into a control group and an observation group,with 47 cases in each group.On the basis of the conventional treatment,the control group was treated with repeated shallow needling with fire needle,while the observation group was treated with Zishen Qinggan decoction on the basis of the control group.Clinical efficacy and evaluation indicators for herpes skin lesion healing(blister stop time,scab formation time,scab removal time)were compared between the two groups,and pain relief before treatment and at 1,2,3,5,and 10 days after treatment[Visual Analog Scale(VAS)score],as well as peripheral blood T lymphocyte subsets(CD3+,CD4+,CD8+,CD4+/CD8+)before and after treatment were observed.The incidence of postherpetic neuralgia was recorded.Results After treatment,the total effective rate of the obser-vation group was95.74%(45/47),which was higher than that in the control group[80.85%(38/47)](P＜0.05).The observation group had shorter blister arrest time,scab formation time,and scab removal time than the control group(P＜0.05).At1,2,3,5,and10 days after treatment,the VAS scores of both groups were lower than those before treatment(P＜0.05),and with the prolongation of treatment time,the VAS scores of both groups showed a continuous downward trend.The VAS score of the observation group at 3,5,and 10 days after treatment was lower than that of the control group(P＜0.05).After treatment,the levels of CD8+in both groups were significantly reduced compared to before treatment,while CD4+/CD8+,CD4+,and CD3+were significantly increased compared with those before treatment.Moreover,the obser-vation group showed significantly higher or lower levels of CD4+/CD8+,CD3+,CD4+,and CD8+,as compared with the control group(P＜0.05).At one month after treatment,the incidence of postherpetic neuralgia in the observation group was 10.64%(5/47),which was lower than that in the control group[25.53%(12/47)](P＜0.05).Conclusion The combination of repeated shallow needling with fire needle and Zishen Qinggan decoction can promote the convergence and scabbing of blisters in the treatment of herpes zoster,quickly alleviate neuralgia symptoms,improve peripheral blood T lym-phocyte subsets,reduce the incidence of postherpetic neuralgia,and further improve clinical efficacy.
基金项目
2023年度承德市科技局项目(202301A026)
维普
万方数据