乂针治疗带状疱疹后神经痛的临床疗效观察及机制探讨OA

Objective To observe the clinical effect of yizhen therapy on post-herpetic neuralgia(PHN)and explore its mechanism.Methods Ninety two patients with PHN,visited Foshan Fifth People's Hospital(Foshan Rehabilitation Hospital Co.,Ltd.)from January 2023 to April 2024,were selected as the subjects.These patients were divided into three groups,a sham-acupuncture group(31 cases,one dropped out),an acupuncture group(31 cases,one excluded)and a yizhen therapy group(30 cases),based on a randomized,single-blind method.Pregabalin was administered in each group.Additionally,the sham-acupuncture was delivered in the sham-acupuncture group at same acupoints as in the yizhen group,during which,the needles were not invaded,and the therapy was operated for about 20 min each time.In the acupuncture group,acupuncture was exerted at conventional acupoints,about 20 min each time.In the yizhen therapy group,yizhen therapy was delivered at Jiaji(EX-B2)and Ashi points,15 to 20 min.The treatment was administered consecutively for 5 days in each group,and 2 weeks of treatment were required,at the interval of 2 days.Before and after treatment,and 1 month after treatment completion,the scores of the short-form McGill pain questionnaire(SF-MPQ),Hamilton anxiety scale(HAMA),Pittsburgh sleep quality index(PSQI),and Hamilton depression scale(HAMD)were evaluated,as well as the safety.The contents of substance P(SP),interleukin-6(IL-6),and tumor necrosis factor alpha(TNF-α)in the serum were detected in each group.The clinical effect was evaluated.Results The total effective rates in the yizhen therapy group and the acupuncture group were 93.33%(28/30)and 80.00%(24/30),respectively,higher than 53.33%(16/30)in the sham-acupuncture group(P<0.05).The clinical curative rate in either the yizhen therapy group or the acupuncture group increased in comparison with the sham-acupuncture group(P<0.05);and when compared with the acupuncture group,the curative rate of yizhen therapy group was higher(P<0.05).Compared with those before treatment,the scores of HAMD,HAMA,PSQI and SF-MPQ were reduced after treatment and in 1 month of treatment completion in the yizhen therapy group and acupuncture group(P<0.05);and every indicator in the yizhen therapy group was lower when compared with the acupuncture group and sham-acupuncture group(P<0.05).After treatment and in 1 month of treatment completion,in the yizhen therapy group and the acupuncture group,the contents of SP,TNF-α and IL-6 were reduced in comparison with those before treatment,and these indicators in the yizhen therapy group were lower when compared with the acupuncture group and sham-acupuncture group(P<0.05).There was no significant difference in the incidence of adverse reactions among the three groups.Conclusion The combination of yizhen acupuncture therapy and pregabalin is effective and safe in treatment of PHN.It can regulate the levels of pain and inflammatory factors in the serum,alleviate pain,thereby improving patients'emotional state and sleep quality.