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Title: [Pricking-cupping combined with auricular thumbtack needle for postherpetic neuralgia of qi stagnation and blood stasis on chest and waist: a randomized controlled trial].
Author: Le W, Yao H, Jia W, Wu Y, Yang G, Wu C.
Journal: Zhongguo Zhen Jiu; 2024 Aug 12; 44(8):899-904. PubMed ID: 39111788.
Abstract:
OBJECTIVE: To observe the clinical effect of pricking-cupping combined with auricular thumbtack needle for postherpetic neuralgia (PHN) of qi stagnation and blood stasis on chest and waist. METHODS: A total of 98 patients with PHN of qi stagnation and blood stasis on chest and waist were randomized into an observation group (49 cases, 1 case was eliminated, 1 case dropped out) and a control group (49 cases, 1 case dropped out). In the observation group, treatment of pricking-cupping combined with auricular thumbtack needle was delivered, pricking and cupping were applied at Jiaji points (EX-B 2) at the related spinal segments corresponding to the pain sites and regional ashi points, once every other day, auricular thumbtack needle was applied at Xin (CO₁₅), Shenmen (TF₄), Neifenmi (CO₁₈), Pizhixia (AT₄), etc., once every 3 days. In the control group, pregabalin capsule was taken orally, 75 mg a time, twice a day. The treatment of 4 weeks was required in the two groups. Before and after treatment, the scores of TCM symptom, visual analogue scale (VAS), Pittsburgh sleep quality index (PSQI), self-rating depression scale (SDS) and self-rating anxiety scale (SAS) were observed, the serum levels of immunoglobulin G (IgG), interleukin-6 (IL-6), C-reactive protein (CRP) were detected, and the clinical efficacy and safety were evaluated in the two groups. RESULTS: After treatment, the item scores and total scores of TCM symptom, as well as the scores of VAS, PSQI, SDS and SAS were decreased compared with those before treatment (P<0.05); the item scores of pruritus degree, tactile sensitivity, skin numbness and total score of TCM symptom, as well as the scores of VAS, PSQI, SDS and SAS in the observation group were lower than those in the control group (P<0.05). After treatment, the serum levels of IgG were increased (P<0.05), while the serum levels of IL-6 and CRP were decreased (P<0.05) compared with those before treatment in the two groups; in the observation group, the serum level of IgG was higher (P<0.05), while the serum levels of IL-6 and CRP were lower (P<0.05) than those in the control group. The total effective rate was 95.7% (45/47) in the observation group, which was superior to 77.1% (37/48) in the control group (P<0.05). The incidence rate of adverse reaction was 6.4% (3/47) in the observation group, which was lower than 12.5% (6/48) in the control group (P<0.05). CONCLUSION: Pricking-cupping combined with auricular thumbtack needle can effectively relieve the clinical symptoms in patients with PHN of qi stagnation and blood stasis on chest and waist, reduce the pigmentation of herpes and improve itch or burning, numb sensations in the skin lesions, improve the sleep quality and relieve anxiety and depression. 目的：观察刺络拔罐联合耳穴揿针治疗气滞血瘀型胸腰部带状疱疹后遗神经痛（PHN）的临床疗效。方法：将98例气滞血瘀型胸腰部PHN患者随机分为观察组（49例，剔除1例，脱落1例）和对照组（49例，脱落1例）。观察组采用刺络拔罐联合耳穴揿针治疗，于疼痛部位相应脊髓节段的夹脊穴、局部阿是穴行刺络拔罐，隔日1次，于心、神门、内分泌、皮质下等耳穴行揿针治疗，隔2日1次；对照组予口服普瑞巴林胶囊治疗，每次75 mg，每日2次。两组均治疗4周，分别于治疗前后观察两组患者中医症状、疼痛视觉模拟量表（VAS）、匹兹堡睡眠质量指数（PSQI）、抑郁自评量表（SDS）、焦虑自评量表（SAS）评分，检测两组患者血清免疫球蛋白G（IgG）、白细胞介素6（IL-6）、C反应蛋白（CRP）水平，并评定两组临床疗效及安全性。结果：治疗后，两组患者中医症状各项评分与总分，以及VAS、PSQI、SDS、SAS评分均较治疗前降低（P<0.05）；观察组患者瘙痒程度、触觉敏感程度和皮肤麻木感3项评分与中医症状总分，以及VAS、PSQI、SDS、SAS评分均低于对照组（P<0.05）。治疗后，两组患者血清IgG含量较治疗前升高（P<0.05），血清IL-6、CRP含量较治疗前降低（P<0.05）；观察组血清IgG含量高于对照组（P<0.05），血清IL-6、CRP含量低于对照组（P<0.05）。观察组总有效率为95.7％（45/47），高于对照组的77.1％（37/48，P<0.05）。观察组不良反应发生率为6.4%（3/47），低于对照组的12.5%（6/48，P<0.05）。结论：刺络拔罐联合耳穴揿针治疗可有效缓解气滞血瘀型胸腰部PHN患者的临床症状，减轻皮损区疱疹的色素沉着，改善皮损区的瘙痒感或烧灼感、麻木感，提高患者睡眠质量，缓解焦虑、抑郁情绪。.

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