目的:比较铺药棉灸配合梅花针叩刺与西药治疗带状疱疹疗效差异和安全性。方法:采用多中心随机对照的方法,将120例带状疱疹患者随机分为综合治疗组和西药组,每组60例。综合治疗组采用梅花针叩刺病灶区、相应夹脊穴、曲池、外关、足三里、太冲等,叩刺后行铺药棉灸。西药组采用阿昔洛韦膏外用和口服盐酸伐昔洛韦片、维生素B1治疗。治疗7天后观察两组临床症状积分、取效时间、疗效和安全性,随访1个月观察复发情况。结果:综合治疗组痊愈率和总有效率分别为80.0%(48/60)和98.3%(59/60),显著优于西药组的45.0%(27/60)和71.7%(43/60),两组比较差异均有统计学意义(P〈0.01,P〈0.05);两组治疗后疼痛分级指数(PRI)、视觉模拟评分(VAS)、现有疼痛强度(PPI)、皮损情况、睡眠积分等各项临床症状积分均显著下降(P〈0.01,P〈0.05),综合治疗组下降更明显(P〈0.01,P〈0.05);综合治疗组止痛时间、止疱时间、结痂时间、痊愈时间均短于西药组(P〈0.01,P〈0.05);综合组随访复发1例(1.6%),西药组复发8例(13.3%),西药组有6例出现轻微不良反应。结论:铺药棉灸配合梅花针叩刺治疗带状疱疹疗效好、起效快、疗程短,明显优于阿昔洛韦膏外用和口服盐酸伐昔洛韦片、维生素B1,是安全有效的治疗方法。
Objective To compare the therapeutic effects and safety of herpes zoster treated by the cotton sheet moxibustion combined with the plum-blossom-needle tapping therapy to western medicine.Methods The multicentral random controlled method was adopted,120 cases of herpes zoster were randomly divided into a comprehensive treatment group and a western medication group,60 cases in each one.In the comprehensive treatment group,the tapping therapy of plum blossom needle was applied to the foci,corresponding Jiaji(EX-B 2),Quchi(LI 11),Waiguan(TE 5),Zusanli(ST 36),Taichong(LR 3),etc.Afterward,the cotton sheet moxibustion was given.In western medication group,Acyclovir ointment for external application,Valaciclovir Hydrochloride tablets and Vitamin B1 for oral administration were prescribed.In 7 days of treatment,the clinical symptom score,effect time,efficacy and safety were observed before and after treatment between two groups.The recurrence of disease was followed up for 1 month.Results In the comprehensive treatment group,the cured rate and the total effective rate were 80.0%(48/60) and 98.3%(59/60) separately,which were significantly better than 45.0%(27/60) and 71.7%(43/60) in western medication group separately(P0.01,P0.05).After treatment,in either group,the scores of clinical symptoms such as pain rating index(PRI),Visual Analogue Scale(VAS),present pain intensity(PPI),skin lesion and sleeping score,etc.were all reduced significantly(P0.01,P0.05).The score reducing was much more obvious in the comprehensive treatment group(P0.01,P0.05).In the comprehensive treatment group,the time of pain stopping,the time of blister stopping,the time of scarring and the time of healing were all shorter than those in western medication group(P0.01,P0.05).In the follow-up observation,1 case(1.6%) was recurred in the comprehensive treatment group and 8 cases(13.3%) were in western medication group.In western medication group,6 cases presented mild adverse reacti