【摘 要】
：
目的 探讨中医多模式镇痛应用于带状疱疹后遗神经痛(Post-herpetic neuralgia,PHN)的疗效及对预后的影响.方法 选取2018年5月—2020年5月期间于广州中医药大学第三附属医院治疗的PHN患者88例,按随机数字表法分为对照组(常规西医治疗44例)和研究组(常规西医治疗联合中医多模式镇痛治疗44例).两组患者均治疗1个月后,观察比较两组患者临床疗效,治疗前后血清P物质(Serum substance P,SP)、神经激肽-1(Neurokinin-1,NK-1)水平以及肿瘤坏死因子-
【机 构】
：
广州中医药大学第三附属医院,广东 广州510000
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目的 探讨中医多模式镇痛应用于带状疱疹后遗神经痛(Post-herpetic neuralgia,PHN)的疗效及对预后的影响.方法 选取2018年5月—2020年5月期间于广州中医药大学第三附属医院治疗的PHN患者88例,按随机数字表法分为对照组(常规西医治疗44例)和研究组(常规西医治疗联合中医多模式镇痛治疗44例).两组患者均治疗1个月后,观察比较两组患者临床疗效,治疗前后血清P物质(Serum substance P,SP)、神经激肽-1(Neurokinin-1,NK-1)水平以及肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)、白介素-6(In-terleukin-6,IL-6)、C反应蛋白(c-reactive protein,CRP)等炎性因子水平,治疗前后比较数字疼痛强度量表(nu-meric rating scales,NRS)评分、匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)评分与生活质量综合评定量表(Generic quality oflife inventory-74,GQOLI-74)评分,记录不良反应发生率及复发率.结果 治疗后研究组总有效率92.68％(38/41)明显高于对照组71.43％(30/42),差异有统计学意义(P<0.05).治疗后两组患者血清SP、NK-1水平均较治疗前明显降低,差异有统计学意义(P<0.05);且研究组治疗后血清SP、NK-1水平均较对照组明显降低,差异均有统计学意义(P<0.05).治疗后两组患者血清TNF-α、IL-6、CRP水平均较治疗前降低,差异均有统计学意义(P<0.05);且研究组治疗后血清TNF-α、IL-6、CRP水平均较对照组明显降低,差异有统计学意义(P<0.05).治疗后两组患者RNS、PSQI评分均较治疗前降低,GQOLI-74评分均较治疗前升高,差异有统计学意义(P<0.05),且研究组治疗后RNS、PSQI评分均较对照组明显降低,GQOLI-74评分较对照组明显升高,差异均有统计学意义(P0.05).随访6个月,研究组复发率2.44％(1/41)低于对照组16.67％(7/42),两组比较,差异有统计学意义(P<0.05).结论 中医多模式镇痛治疗PHN疗效更为显著,可有效减轻患者疼痛症状,改善其睡眠与生活质量,下调炎症因子水平,降低疾病再发风险,且安全性高.
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