The efects of fire acupuncture combined with Zishen Qinggan Decoction on recovery progress, body inflammation and risk of PHN in patients with acute herpes zoster
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摘要:
目的 观察火针刺络联合滋肾清肝汤治疗蛇串疮的疗效及带状疱疹后遗神经痛(PHN)发生情况。 方法 选取2022年1月—2023年9月于承德市中医院针灸科治疗的100例蛇串疮患者，按随机数字表法分为观察组(火针刺络联合滋肾清肝汤治疗，50例)和对照组(火针刺络治疗，50例)。比较2组治疗疗效、中医证候评分、恢复进度、炎症指标[白细胞介素(IL)-2、IL-8、IL-10)]变化以及PHN发生风险。 结果 观察组治疗总有效率高于对照组(88.00% vs. 72.00%, P＜0.05)，各项中医证候评分均低于对照组(P＜0.05)。观察组止痛时间[(2.95±0.46)d vs. (3.57±1.02)d]、止疱时间[(3.77±0.93)d vs. (4.69±1.47)d]、结痂时间[(7.80±1.18)d vs. (8.36±0.61)d]均短于对照组(P＜0.05)。观察组患者治疗后血清IL-2高于对照组(P＜0.05)，IL-8、IL-10低于对照组(P＜0.05)。2组均未发生严重不良反应。观察组治疗后1个月(12.00% vs. 28.00%，χ2=4.000，P=0.046)、2个月(6.00% vs. 20.00%，χ2=4.332，P=0.037)PHN发生率均低于对照组。 结论 火针刺络联合滋肾清肝汤能显著提高蛇串疮患者的治疗效果，缓解症状，降低PHN发生率。 Abstract:Objective To observe the therapeutic effect of fire acupuncture combined with Zishen Qinggan Decoction on acute herpes zoster and the occurrence of postherpetic neuralgia (PHN). Methods From January 2022 to September 2023, 100 patients with acute herpes zoster in the moxibustion Department of Chengde Hospital of Traditional Chinese Medicine were divided into the observation group (n=50, fire acupuncture combined with Zishen Qinggan Decoction) and the control group (n=50, fire acupuncture) by random number table method. The therapeutic effect, traditional Chinese medicine (TCM) syndrome scores, recovery progress, inflammatory indicators [interleukin (IL-2), IL-8, IL-10], and PHN risk were compared. Results The total effective rate in the observation group was higher (88.00% vs. 72.00%, P < 0.05), and the scores of TCM syndrome were lower (P < 0.05). Analgesic time [(2.95±0.46) d vs. (3.57±1.02) d], herpes stopping time [(3.77±0.93) d vs. (4.69±1.47) d], and crusting time [(7.80±1.18) d vs. (8.36±0.61) d] in the observation group was shorter (P < 0.05). After treatment, the serum IL-2 concentration in the observation group was higher (P < 0.05), and the serum IL-8 and IL-10 concentrations were lower (P < 0.05). No adverse reactions occurred in both groups. The incidence of PHN at 1 month (12.00% vs. 28.00%, χ2=4.000, P=0.046) and 2 months (6.00% vs. 20.00%, χ2=4.332, P=0.037) in the observation group was lower than that in the control group. Conclusion Fire acupuncture combined with Zishen Qinggan Decoction can significantly improve the treatment effect of patients with acute herpes zoster, relieve symptoms, and reduce the incidence of PHN. -
Key words:
- Acute herpes zoster /
- Fire acupuncture /
- Zishen Qinggan Decoction /
- Curative effect
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表 1 2组蛇串疮患者一般资料比较
Table 1. Comparison of general data between the two groups of patients with acute herpes zoster
组别 例数 性别[例(%)] 年龄
(x±s，岁)病程
(x±s，d)男性 女性 观察组 50 29(58.00) 21(42.00) 54.90±12.83 4.60±1.02 对照组 50 22(44.00) 28(56.00) 50.60±11.02 5.10±1.57 统计量 1.961a 1.798b 1.888b P值 0.161 0.075 0.062 注：a为χ2值，b为t值。 
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表 2 2组蛇串疮患者总有效率比较[例(%)]
Table 2. Comparison of total effective rates between the two groups of patients with acute herpes zoster [cases (%)]
组别 例数 痊愈 显效 好转 无效 总有效 观察组 50 10(20.00) 14(28.00) 20(40.00) 6(12.00) 44(88.00) 对照组 50 8(16.00) 10(20.00) 18(36.00) 14(28.00) 36(72.00) 注：2组总有效率比较，χ2=4.000，P=0.046。
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表 3 2组蛇串疮患者中医证候评分比较(x±s，分)
Table 3. Comparison of TCM syndrome scores between the two groups of patients with acute herpes zoster (x±s, points)
组别 例数 簇集性水疱 t值 P值 自觉灼热疼痛 t值 P值 皮肤红斑 t值 P值 治疗前 治疗后 治疗前 治疗后 治疗前 治疗后 观察组 50 4.28±0.42 1.15±0.05 45.491 ＜0.001 3.80±0.44 0.94±0.21 41.320 ＜0.001 3.70±0.77 1.28±0.41 24.519 ＜0.001 对照组 50 4.43±0.85 2.46±0.59 16.600 ＜0.001 3.65±0.38 1.53±0.29 25.409 ＜0.001 3.42±0.94 2.07±0.38 14.315 ＜0.001 统计量 1.119a 42.492b 1.824a 34.955b 1.629a 25.774b P值 0.266 ＜0.001 0.071 ＜0.001 0.106 ＜0.001 组别 例数 口苦口渴 t值 P值 烦躁 t值 P值 舌质红 t值 P值 治疗前 治疗后 治疗前 治疗后 治疗前 治疗后 观察组 50 3.52±0.39 1.00±0.34 33.033 ＜0.001 4.84±1.08 2.01±0.31 22.920 ＜0.001 3.48±0.97 0.77±0.08 41.761 ＜0.001 对照组 50 3.31±0.73 1.34±0.09 25.515 ＜0.001 5.08±0.25 2.59±0.49 22.177 ＜0.001 3.65±0.15 1.69±0.53 22.296 ＜0.001 统计量 1.794a 18.032b 1.531a 18.512b 1.225a 33.984b P值 0.076 ＜0.001 0.129 ＜0.001 0.224 ＜0.001 注：a为t值，b为F值。
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表 4 2组蛇串疮患者恢复进度比较(x±s，d)
Table 4. Comparison of recovery progress between the two groups of patients with acute herpes zoster (x±s, d)
组别 例数 止痛时间 止疱时间 结痂时间 观察组 50 2.95±0.46 3.77±0.93 7.80±1.18 对照组 50 3.57±1.02 4.69±1.47 8.36±0.61 t值 3.918 3.740 2.981 P值 ＜0.001 ＜0.001 0.004
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表 5 2组蛇串疮患者炎症指标比较(x±s，pg/mL)
Table 5. Comparison of inflammatory indicators between the two groups of patients with acute herpes zoster (x±s, pg/mL)
组别 例数 IL-2 t值 P值 IL-8 t值 P值 IL-10 t值 P值 治疗前 治疗后 治疗前 治疗后 治疗前 治疗后 观察组 50 11.20±2.51 13.86±3.57 7.051 ＜0.001 282.50±44.13 235.00±23.45 13.043 ＜0.001 53.60±4.79 30.36±5.01 19.516 ＜0.001 对照组 50 10.92±1.34 12.28±1.32 9.962 ＜0.001 283.99±30.52 248.60±40.83 12.385 ＜0.001 54.34±3.98 41.22±4.70 15.510 ＜0.001 统计量 0.696a 8.805b 0.196a 6.125b 0.840a 30.856b P值 0.488 0.004 0.845 0.042 0.403 ＜0.001 注：a为t值，b为F值。
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表 6 2组蛇串疮患者PHN发生率对比[例(%)]
Table 6. Comparison of PHN incidence between the two groups of patients with acute herpes zoster [cases (%)]
组别 例数 1个月 2个月 3个月 观察组 50 6(12.00) 3(6.00) 2(4.00) 对照组 50 14(28.00) 10(20.00) 6(12.00) χ2值 4.000 4.332 1.223 P值 0.046 0.037 0.269
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