| Objective: Herpes zoster(HZ)is a viral infectious skin disease,which pathogen is varicella-zoster virus(VZV),which is susceptible to peripheral nerve,causes skin lesions and pain[1].Lesions are generally erythema or clustered small blisters(size such as rice,green beans,etc.),blister with transparent or light yellow liquid;pain is the typical course of HZ,mostly along with the damaged peripheral nerve distribution and locates on the side of the body,less than the midline,patients often feel needle-like pain,which can also be a knife cut,intermittent dull,or only feel abnormal pain.The neuropathic pain of HZ is associated with age,sex,degree of skin lesion,incidence,immune function status,mental and other factors,which are closely related to age[2-5].The acute pain of HZ is particularly severe uncomfortable,with great influence on the quality of life and mental health in patients,lacking effective and reliable treatments in clinic[6].Fire filiform needle and electroacupuncture(EA)are no-drug,green therapies,curative effects of which had been approved by mostscholars.This research is designed to treat the acute neuropathic pain of HZ in combined means of fire filiform needle and EA,in which we study its clinical curative effect and the changes of serum IL-10,CXCL10 contents in the process.We aimed to determine the effect of this combined treatment on peripheral neuropathic pain and improve the molecular mechanism of acupuncture analgesia.Method: During January 2014 and December 2016,we recruited 48 patients of neuropathic pain in acute phase of HZ from outpatient and inpatient department of Wuhan Hospital of integrated traditional Chinese and Western Medicine and Wuhan Center Hospital.Using the number of random table method,all patients were divided into three groups: Treatment group 1(the group of fire filiform needle combined with low frequency EA),Treatment group 2(low frequency EA group),Treatment group 3(western medicine group).After the treatment group 1 was given fire filiform needle pricking,taken the corresponding(corresponding nerve segment and up and down a segment to lesions)Jiaji points(Posterior midline spinous process next to open 0.5 inch)with oblique needling in skin lesions,brought about the desired sensation,followed by G6805 EA apparatus(EA parameters: frequency 2Hz,continuous wave,needle 30min)then;While the Jia Ji points selected and EA operation of treatment group 2 were the same as treatment group 1;while treatment group 3 was given the intravenous injection of ganciclovir sodium,and intramuscular injection of mouse nerve growth factor for injection.All the above patients in three groups were treated with a course of treatment(10d)and observed the results,evaluated the visual analogue scale(VAS)and herpes observation indexes(the time of blister stopping,crusting and falling off)before and after thetreatment,determined serum IL-10,CXCL10 concentration of patients simultaneously.Using SPSS19.0 software to analyze the pain intensity score,herpes changes and the levels of cytokines IL-10 and CXCL10,then explore the mechanism of the combined means of fire filiform needle and EA in the treatment of acute neuropathic pain in HZ.Results:(1)After treatment,the VAS pain scores of three groups were significantly lower than those before treatment(P<0.05).It indicated that all three treatments had analgesic effect on acute HZ;The analgesia intensity of three groups had significant difference(P<0.05),from high to low in order,treatment group 1,2,3;There were significant differences in the time of blister stopping,crusting and falling off in three groups(P<0.05),of which the aging of treatment group 1,2 were shorter than that of treatment group 3,treatment group 1 was the shortest.(2)Longitudinal observation before and after treatment: The concentration of serum IL-10 reduced significantly in treatment group 1 and 3(P<0.05),while there was no significant difference in serum IL-10 levels in treatment group 2(P> 0.05);the levels of serum CXCL10 in treatment group 1 and 2 were all no significant difference(P>0.05),and the levels of serum CXCL10 reduced significantly in treatment group 3(P<0.05).Lateral observed between groups: There were no significant differences in serum IL-10 level in treatment group 1,2 and 3,and no significant difference in serum CXCL10 levels between treatment group 1 and 2(P> 0.05),while the contents of serum CXCL10 in treatment group 3 was significantly lower than group 2(P<0.05).Conclusion:(1)The therapy of fire filiform needle combined with EA had quite good clinical efficacy,which could significantly alleviate acute neuropathic pain of HZ,and control herpes growth effectively,promote skin crust,fall of,shorten HZ course.(2)The treatment effect of the therapy of fire filiform needle combined with EA in acute neuropathic pain of HZ was better than simple EA,and the effect of simple EA was better than western medicine.(3)The fire filiform needle combined with EA and western medicine treatment on acute neuropathic pain of HZ could condition immune function,reduce the release of inflammatory factors,result in anti-inflammatory analgesic effects by reducing serum IL-10 levels,while there was no significant difference in controlling serum IL-10 levels between the two therapies.However,we cannot prove that cytokines CXCL10 involved in the mechanism of fire filiform needle combined with EA analgesia,and aslo cannot prove that cytokines IL-10 involved in simple EA treatment process of acute neuropathic pain in HZ. |
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