【作者】 李乃奇；

【导师】 张全明；

【作者基本信息】 广州中医药大学 ， 中医学， 2012， 硕士

【摘要】 目的：本课题依照临床随机对照原则,对鼠爪刺针法治疗急性期带状疱疹进行临床观察,并研究穴组处方及刺法的治病机理,为鼠爪刺针法治疗急性期带状疱疹的有效性提供临床依据。方法：1.采用随机对照方法,将60例符合纳入标准的带状疱疹患者随机分为鼠爪刺针法组(治疗组)和口服西药组(对照组)。2.治疗组采用鼠爪刺针法,穴位选用大椎、身柱、灵台、筋缩、脊中、腰阳关、腰俞。患者俯卧位,取5根30号1寸毫针,用医用橡皮膏将针柄缠成一束,针刺穴位常规消毒后,选取大椎作为针刺起点,依次按穴位顺序从上到下垂直进针约3-5分深,得气后即缓慢出针,出针后不按压针孔,使之轻微出血,用消毒棉球擦干净渗出物及血迹,隔日一次,5次为1个疗程,共计1个疗程。对照组采用口服西药盐酸伐昔洛韦,300mg／次,2次／日；维生素B1,10mg／次,3次／日,10天为一个疗程。治疗过程中,两组均记录治疗前后疼痛情况及疱疹情况,在治疗结束后,于第22、30、60、90天进行随访,观察疼痛、疱疹及后遗神经痛情况。试验结束后利用数据软件对两组疗效及安全性等进行评价。结果：1.综合疗效结果两组治疗后总有效率比较,治疗组为90%,对照组为80%,两组比较无统计学意义(P>0.05)。两组疗效经Ridit分析,P<0.05,比较有统计学意义。两组治疗前后综合疗效评分比较均有显著性差异(P<0.01)；两组间治疗后综合评分、治疗前后评分差值比较有统计学意义(P<0.05)。2.VAS疼痛评分结果两组治疗前后疼痛强度评分统计学比较有显著性差异(P<0.01)；两组治疗后疼痛强度VAS评分无统计学意义(P>0.05)；两组治疗前后评分差值上比较有统计学意义(P<0.05)。两组患者在疼痛开始缓解时间、疼痛持续时间上比较有统计学意义(P<0.05)。3.疱疹疗效结果两组在止疱时间、结痂时间、脱痂时间方面比较,两组患者在带状疱疹止疱时间比较无统计学意义(P>0.05),治疗组在结痂时间、脱痂时间方面比较,差异有统计学意义(P<0.05)。4.随访PHN发生率比较在减少带状疱疹后遗神经痛方面上,两组治疗后比较,P>0.05,无统计学意义5.两种疗法依从性、耐受性及安全性比较患者对两种疗法的耐受性及依从性均良好。两组在发生不良事故发生率比较上有统计学意义(P<0.05),治疗组安全性优于对照组。结论：鼠爪刺针法能有效治疗急性期带状疱疹,在减轻带状疱疹疼痛及减少带状疱疹后遗神经痛发生率上与西药治疗相当；在更快缓解带状疱疹疼痛时间、缩短带状疱疹疼痛时间,加速带状疱疹恢复及减少不良事故发生率上优于西药治疗。综合以上临床研究结果,初步证明了采用鼠爪刺针法治疗急性期带状疱疹,效果显著,安全可靠,可推广应用。更多还原

【Abstract】 ObjectiveTo observe the clinical effect and the safety of the therapy by Shu Zhua Ci method to treat acute herpes zoster according to randomize controlled principle, and study the acupuncture prescription and manipulation so as to provide clinical evidence for its efficiency.Methods1. Adopted randomize controlled principle, divided60patients with acute herpes zoster who meet the standards of the disease’s diagnosis into two groups:the Shu Zhua Ci group(treatment group) and the medication group (control group).2. Treatment group was given Shu Zhua Ci method. Acu-points used were Dazhui(DU14), Shenzhu(DU12), Lingtai (DU10), Jinsuo(DU8), Jizhong(DU6), Yaoshu(DU2). The patients were taken the prone position, used the medical plaster banded five one-inch needle altogether, after sterilized the acupoints, punctured perpendicularly0.3-0.5inch each points from Dazhui to Yaoshu, withdrew the needle slowly after the qi arrived, and blood-letting puncturing slightly in the points and cleaning it. One day every other day and5times altogether. The control group was given Aciclovir Sodium(300mg, bid) and vitamin B1(10mg, tid) for oral use, ten days a course, and both groups received one course in total. During the test, the situations of the pain and the herpes of both groups were recorded. After the10-day treatment, the pain, herpes and the PHN were observed in the follow-ups in the22nd,30th,60th and90th testing days. Used the software to evaluate the efficiency and safety of both groups.Results1. The Result of Comprehensive EffectAfter the treatment, the total effective rates as follow:the treatment group was90%, control group was80%. There was no significant difference between two groups (P>0.05). There was significant difference between two groups in curative effect by Ridit analyzed (P<0.05).There were significant difference between the anterior and posterior of treatment on comprehensive efficacy score of both groups (P<0.01). There was significant difference on comprehensive efficacy score posterior of treatment (P<0.05)2. The Result of Visual Analogue Score(VAS)There were significant difference on VAS between the anterior and posterior of treatment of two groups (P<0.01). There was no significant difference between two groups on VAS after treatment. There were significant difference on the time of pain duration and pain start to release (P<0.05).3. The Result of Herpes Curative EffectComparing the time of new blister ceasing, old herpes incrustation and decrustation, there was no significant difference on the time of new blister ceasing between two groups (P>0.05), there were significant difference on the time of old herpes incrustation and decrustation between two groups.4. Follow-up Observation of the Incidence of Post Herpetic NeuralgiaThe incidence of the post herpetic neuralgia between two groups was no significant difference (P>0.05).5. Comparison of Assessment of Tolerance and SafetyThe tolerability of both groups is good. There was significant difference on the incidence of adverse events between the groups, it indicated the safety of treatment group was better than control groupConclusionShu Zhua Ci method can treat herpes zoster effectively. The treatment group was equivalent to western medical therapy on releasing pain and reducing the incidence of the post herpetic neuralgia, and the Shu Zhua Ci method can relieve the pain of HZ patients sooner and shorten the time of the blister recovered, it can also reduce the incidence of adverse events. In summary, Shu Zhua Ci method is an effective and safe way to treat herpes zoster.更多还原