摘要
目的:比较基于电针的综合外治法对带状疱疹后遗神经痛(PHN)的镇痛效应及对患者生活质量的影响。方法:选取2017年6月—2021年6月在陕西省中医医院针灸四科就诊的90例门诊PHN患者,随机分为电针组,电针+叩刺拔罐组和电针+铺棉灸组,每组30例。3组均以10 d为1个疗程,共治疗3个疗程。分别于第1、30、90天记录视觉疼痛量表(VAS)评分、皮肤病生活质量指数(DLQI)评分。结果:3组患者第30、90天VAS值均较治疗前下降(P<0.05),其中电针+叩刺拔罐组优于电针组、电针+铺棉灸组,电针+铺棉灸组优于电针组(P<0.05)。DLQI 10项分类中,3组患者第30、90天DLQI值均较治疗前下降(P<0.05)。其中电针+叩刺拔罐组和电针+铺棉灸治疗组对皮肤痛痒感觉、家务影响、穿衣影响、社交影响、工作影响、关系处理影响、性生活影响、日常生活影响的评分,第90天与第30天差异无统计学意义(P>0.05)。而电针组患者10项评分第90天均较第30天明显回升(P<0.05)。电针+叩刺拔罐组第30天皮肤痛痒感觉、难过情绪感受、家务影响、穿衣影响、社交影响的评分低于电针组(P<0.05)。3组治疗方案第30天对运动影响、工作影响、关系处理影响、性生活影响、日常生活影响的评分差异无统计学意义(P>0.05),第90天,电针+叩刺拔罐组以上5类评分优于电针组及电针+铺棉灸组(P<0.05),VAS评分与DLQI评分呈显著正相关。结论:3组治疗方案均具有镇痛效应,可以有效提高患者生活质量。其中电针+叩刺拔罐组具有更持久的镇痛效应和提升生活质量作用,尤其表现在对皮肤痛痒感觉、家务影响、穿衣影响、社交影响、工作影响、关系处理影响、性生活影响、日常生活影响的提升方面,且电针+铺棉灸组对降低性生活影响、日常生活影响的评分方面也具有一定的长效作用。
Objective:To compare the pain-relieving effects and impacts on quality of life of a comprehensive external treatment method based on electroacupuncture in patients with postherpetic neuralgia(PHN).Methods:Ninety outpatients with PHN from the Acupuncture Department of Shaanxi Provincial Hospital of Chinese Medicine,treated from June 2017 to June 2021,were randomly divided into three groups:the electroacupuncture group,the electroacupuncture+tapping and cupping group,and the electroacupuncture+cotton moxibustion group,with 30 patients in each group.Each group received treatment for 10 days per course,with a total of 3 courses.Visual Analog Scale(VAS)scores and Dermatology Life Quality Index(DLQI)scores were recorded on days 1,30,and 90.Results:On days 30 and 90,VAS scores in all three groups decreased compared to before treatment(P<0.05),with the electroacupuncture+tapping and cupping group performing better than the electroacupuncture group and the electroacupuncture+cotton moxibustion group,and the electroacupuncture+cotton moxibustion group performing better than the electroacupuncture group(P<0.05).Among the 10 categories of DLQI,scores in all three groups decreased on days 30 and 90 compared to before treatment(P<0.05).The electroacupuncture+tapping and cupping group and the electroacupuncture+cotton moxibustion group showed no statistically significant differences in scores for skin pain and itching,impact on housework,dressing,social interactions,work,relationship management,sexual life,and daily life between days 30 and 90(P>0.05).In contrast,scores for these 10 categories in the electroacupuncture group significantly rebounded on day 90 compared to day 30(P<0.05).On day 30,the electroacupuncture+tapping and cupping group had lower scores for skin pain and itching,emotional distress,impact on housework,dressing,and social interactions compared to the electroacupuncture group(P<0.05).There were no significant differences among the three treatment groups in scores for impact on exercise,work,relationship management,sexual life,and daily life on day 30(P>0.05).On day 90,the electroacupuncture+tapping and cupping group performed better than the electroacupuncture group and the electroacupuncture+cotton moxibustion group in these five categories(P<0.05).VAS scores were significantly positively correlated with DLQI scores.Conclusion:All three treatment methods have pain-relieving effects and can effectively improve patients'quality of life.The electroacupuncture+tapping and cupping group demonstrates more sustained pain relief and better quality of life improvements,particularly in terms of skin pain and itching,impact on housework,dressing,social interactions,work,relationship management,sexual life,and daily life.The electroacupuncture+cotton moxibustion group also has a notable long-term effect in reducing the impact on sexual life and daily life.
作者
鲁瑶
何佳
杨改琴
秦彩娟
蔡艳
张莉君
左甲
LU Yao;HE Jia;YANG Gaiqin;QIN Caijuan;CAI Yan;ZHANG Lijun;ZUO Jia(Shaanxi University of Chinese Medicine,Xianyang 712000,China;Xi'an Red Cross Hospital,Xi'an 710054,China;Shaanxi Provincial Hospital of Chinese Medicine,Xi'an 710003,China)
出处
《中医药学报》
2025年第5期52-57,共6页
Acta Chinese Medicine and Pharmacology
基金
陕西省中医药管理局科研项目(15-LC023)
陕西省重点研发计划项目(2020SF-350)。
关键词
电针
带状疱疹后遗神经痛
叩刺拔罐
铺棉灸
镇痛效应
生活质量
Electroacupuncture
Postherpetic neuralgia
Tapping and cupping
Cotton moxibustion
Pain relief
Quality of life
