摘要
目的探讨通络益气方联合椎管内阻滞对带状疱疹后遗神经痛(postherpetic neuralgia,PHN)患者中医证候、血清炎症因子、睡眠、负性情绪的影响。方法选取诊治的PHN患者80例,按照随机数字表法分为对照组和观察组,每组40例,对照组采取椎管内阻滞治疗,观察组采取通络益气方联合椎管内阻滞治疗,临床治疗2个月,观察患者治疗前后中医证候积分变化,血清白细胞介素-2(IL-2)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、干扰素-γ(INF-γ)变化,采用匹兹堡睡眠质量指数(PSQI)对睡眠状况进行评估,采取焦虑自评量表(SAS)和抑郁自评量表(SDS)对患者焦虑和抑郁程度进行评估,采用视觉模拟评分法(VAS)对疼痛程度进行评估。结果中医证候积分,血清IL-2、IL-6、TNF-α、INF-γ水平,PSQI、SAS、SDS、VAS评分,上述指标治疗前两组比较差异均无统计学意义(P>0.05)。疱疹消退后色素沉着、疲乏、刺痛、夜寐不安、舌黯紫苔白、脉细等中医证候积分治疗后较治疗前上述证候积分均下降(P<0.05),且观察组下降程度高于对照组(P<0.05);血清IL-2、IL-6、TNF-α、INF-γ水平治疗后较治疗前下降(P<0.05),且观察组下降程度大于对照组(P<0.05);PSQI、SAS、SDS、VAS评分治疗后较治疗前下降(P<0.05),且观察组下降程度大于对照组(P<0.05);观察组治疗总有效率为92.50%(37/40),高于对照组75.00%(30/40),比较差异有统计学意义(P<0.05)。结论通络益气方联合椎管内阻滞治疗PHN有助于减轻患者症状及疼痛程度,抑制血清炎症因子水平,改善睡眠状况,缓解焦虑及抑郁等负性情绪,提高了治疗疗效。
Objective To discuss the effect of Tongluo Yiqi Formula(通络益气方)combined with intraspinal nerve block on syndromes of traditional Chinese medicine(TCM),serum inflammatory factors,sleep and negative emotions in postherpetic neuralgia(PHN)patients.Methods We collected 80 patients with PHN were divided into the control group(40 cases)and the observation group(40 cases).The control group was treated with intraspinal nerve block and the observation group was treated with Tongluo Yiqi Formula combined with intraspinal nerve block nerve block.The two groups were treated for 28 months.We observed TCM syndrome scores,the levels of interleukin-2(IL-2),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and interferon-γ(INF-γ)in serum before and after treatment.The sleep status was assessed by using the Pittsburgh Sleep Quality Index(PSQI).Self-rating Anxiety Scale(SAS)and Self-rating Depression Scale(SDS)were used to evaluate the degree of anxiety and depression.Visual analogue scale(VAS)was used to evaluate pain intensity.Results There was no significant difference between the two groups in TCM syndrome scores,levels of IL-2,IL-6,TNF-αand INF-γin serum,PSQI scores,SAS and SDS scores or VAS scores before treatment(P>0.05).The scores of TCM symptoms such as pigmentation,fatigue,tingling,restless sleep at night,dark purple tongue and white tongue coating and thin pulse were decreased after treatment compared with those before treatment(P<0.05).The decrease degree of observation group was higher than that of the control group(P<0.05).The levels of IL-2,IL-6,TNF-αand INF-γin serum were decreased after treatment compared with those before treatment(P<0.05).The decrease degree of the observation group was higher than that of the control group(P<0.05).PSQI scores,SAS and SDS scores and VAS scores of the two groups after treatment were lower than those before treatment(P<0.05)and the scores of the observation group were lower than those of the control group(P<0.05).The total effective rate of the observation group was 92.50%(37/40)and that of the control group was 75.00%(30/40).The difference was statistically significant(P<0.05).Conclusion Tongluo Yiqi Formula combined with intraspinal block in the treatment of PHN helps to relieve the symptoms and pain of patients,inhibit the levels of serum inflammatory factors,improve sleep conditions,alleviate negative emotions such as anxiety and depression,and improve the therapeutic effect.
作者
侯俊青
倪秀萍
李勇
HOU Junqing;NI Xiuping;LI Yong(Jiangnan Hospital Affiliated to Binjiang College of Zhejiang Chinese Medical University,Hangzhou 311201,Zhejiang,China)
出处
《中华中医药学刊》
CAS
北大核心
2022年第5期47-50,共4页
Chinese Archives of Traditional Chinese Medicine
基金
中华医学会临床医学科研专项(19010085789)
杭州市医药卫生科技项目(B20200155)
关键词
通络益气方
椎管内神经阻滞
带状疱疹后遗神经痛
中医证候
炎症因子
睡眠
负性情绪
Tongluo Yiqi Formula(通络益气方)
intraspinal nerve block
postherpetic neuralgia
TCM symptoms
inflammatory cytokines
sleep
negative emotions
作者简介
侯俊青(1971-),男,黑龙江牡丹江人,副主任医师,硕士,研究方向:麻醉、疼痛治疗、无痛门诊。
