| 李义君.针刺联合西药治疗带状疱疹肝经郁热证临床研究[J].浙江中西医结合杂志,2026,36(6): |
| 针刺联合西药治疗带状疱疹肝经郁热证临床研究 |
| Clinical study on acupuncture combined with western medicine for the treatment of herpes zoster with liver meridian stagnation and heat syndrome |
| 投稿时间：2025-07-03 修订日期：2025-10-27 |
| DOI： |
| 中文关键词: 带状疱疹 针刺 肝经郁热证 疼痛介质 细胞免疫功能 |
| 英文关键词:Herpes zoster Acupuncture Liver meridian stagnation heat syndrome Pain mediators cellular immunity |
| 基金项目:浙江省中医药科技计划项目(2023ZL673) |
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| 中文摘要: |
| 目的? 研究观察针对带状疱疹(HZ)肝经郁热证患者采用针刺联合西药治疗的临床效果。方法? 采取前瞻性对照研究法。纳入余姚市人民医院针灸科收治HZ肝经郁热证患者共96例,按随机数字表法分为对照组与治疗组(各48例),对照组完成试验45例(剔除3例),治疗组完成试验46例(剔除2例)。对照组给予西药(阿昔洛韦片+甲钴胺片)治疗,治疗组在对照组基础上给予针刺治疗,连续治疗2个疗程后评估2组临床疗效、肝经郁热证候积分、疼痛程度[视觉模拟评分法(VAS)]及疱疹改善情况[止疱时间、结痂时间、脱痂时间],并检测血清疼痛相关介质[P物质(SP)、β-内啡肽(β-EP)、前列腺素E2(PGE2)]、细胞免疫功能(CD3+、CD4+、CD8+、CD4+/CD8+)水平。结果? 治疗后,治疗组总有效率93.62%(3/46),高于对照组75.56%(11/45)(P＜0.05)；治疗后,2 组肝经郁热证候积分、VAS评分较治疗前均降低(P＜0.05),治疗组2项评分均低于对照组(P＜0.05)；治疗后,治疗组止疱、结痂及脱痂时间均早于对照组(P＜0.05)；治疗后,2组血清疼痛介质(SP、β-EP、PGE2)水平低于治疗前(P＜0.05),治疗组3项指标水平均低于对照组(P＜0.05)；治疗后,2组T淋巴细胞亚群CD3+、CD4+、CD4+/CD8+水平均提高,治疗组高于对照组(P＜0.05),2组CD8+水平均下降,治疗组低于对照组(P＜0.05)。结论? 针刺联合西药治疗HZ肝经郁热证可明显提高治疗效果,改善临床症状,促进疱疹愈合,有效调节血清疼痛介质水平,减轻疼痛程度,提高患者机体免疫功能。 |
| 英文摘要: |
| Objective: To study and observe the clinical effect of acupuncture combined with Western medicine treatment on patients with herpes zoster (HZ) and liver meridian stagnation heat syndrome. Method:The adopts a prospective controlled study approach. A total of 96 patients with HZ liver meridian stagnation heat syndrome were admitted to the acupuncture and moxibustion Department of Yuyao People"s Hospital and divided into the control group and the treatment group (48 cases each) according to the random number table. The control group completed the test in 45 cases (3 cases were excluded), and the treatment group completed the test in 46 cases (2 cases were excluded). The control group was treated with Western medicine (acyclovir tablets+methylcobalamin tablets), while the treatment group was treated with acupuncture on the basis of the control group. After two consecutive courses of treatment, the clinical efficacy, liver meridian heat syndrome score, pain level [Visual Analog Scale (VAS)], and improvement of herpes [stopping time, scab formation time, scab removal time] of the two groups were evaluated. Serum pain related mediators [substance P (SP), β - endorphin (β - EP), prostaglandin E2 (PGE2)], and cellular immune function (CD3+, CD4+, CD8+, CD4+/CD8+) levels were also detected. Results:After treatment, the total effective rate of the treatment group was 93.62% (3/46), which was higher than the control group"s 75.56% (11/45) (P<0.05); After treatment, both groups showed a decrease in liver meridian stagnation heat syndrome scores and VAS scores compared to before treatment (P<0.05), and both scores in the treatment group were lower than those in the control group (P<0.05); After treatment, the treatment group had earlier times of stopping blisters, scabbing, and desquamation than the control group (P<0.05); After treatment, the levels of serum pain mediators (SP, β - EP, PGE2) in both groups were lower than before treatment (P<0.05), and the levels of all three indicators in the treatment group were lower than those in the control group (P<0.05); After treatment, the levels of CD3+, CD4+, and CD4+/CD8+subsets of T lymphocytes in both groups increased, with the treatment group higher than the control group (P<0.05). The levels of CD8+in both groups decreased, with the treatment group lower than the control group (P<0.05). Conclusion: Acupuncture combined with Western medicine can significantly improve the treatment effect of HZ liver meridian stagnation heat syndrome, improve clinical symptoms, promote herpes healing, effectively regulate serum pain mediator levels, alleviate pain severity, and enhance the patient"s immune function. |
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