腕踝针治疗带状疱疹后神经痛临床疗效及对血清NaV1.7、CGRP含量的影响OA

Objective To observe the clinical efficacy of wrist-ankle acupuncture for postherpetic neuralgia(PHN)and its effects on serum levels of voltage-gated sodium channel 1.7(NaV1.7)and calcitonin gene-related peptide(CGRP).Methods A total of 90 PHN patients were randomized into a wrist-ankle acupuncture group(45 cases,2 cases dropped out)and a western medication group(45 cases,1 case dropped out,1 case was discontinued).In the western medication group,the topical 5%lidocaine gel plaster was used locally.In the wrist-ankle acupuncture group,wrist-ankle acupuncture was applied 30 min each time,once a day,5-day treatment was as one course,with 2-day interval between courses.The treatments lasted for 4 weeks in both groups.The scores of visual analogue scale(VAS),Pittsburgh sleep quality index(PSQI),self-rating anxiety scale(SAS),and self-rating depression scale(SDS)were observed before treatment,after 2 and 4 weeks of treatment,and in the follow-up of 4 weeks after treatment completion.The serum levels of NaV1.7 and CGRP were measured before and after 4 weeks of treatment.The use of rescue analgesics and the occurrence of adverse reactions were recorded,and the clinical efficacy was evaluated after 4 weeks of treatment.Results Compared with those before treatment,the scores of VAS,PSQI,SAS and SDS were decreased after 2 and 4 weeks of treatment,and in follow-up(P＜0.05).After 4 weeks of treatment and in follow-up,the above scores in the wrist-ankle acupuncture group were lower than those in the western medication group(P＜0.05).After 4 weeks of treatment,the serum levels of NaV1.7 and CGRP were decreased compared with those before treatment(P＜0.05),and the serum levels of NaV1.7 and CGRP in the wrist-ankle acupuncture group were lower than those in the western medication group(P＜0.05).During the trial,5 cases in the wrist-ankle acupuncture group and 11 cases in the western medication group required rescue analgesics,with no statistical difference between the two groups(P＞0.05).The incidence of adverse reactions was 9.3%in the wrist-ankle acupuncture group,which was lower than 27.9%in the western medication group(P＜0.05).The total effective rate in the wrist-ankle acupuncture group was 90.7%(39/43),that of the western medication group was 83.7%(36/43),there was no statistical difference between the two groups(P＞0.05).Conclusion Wrist-ankle acupuncture can effectively treat PHN,reduce pain,improve sleep quality and relieve negative emotions.Its mechanism may relate to the down-regulation of serum NaV1.7 and CGRP levels.