| Objective:Herpes Zoster（HZ）is a self-limiting skin disease caused by the violation of the Varicella zoster virus（VZV）.The main symptoms can be manifested as unilateral somatic skin areas that regularly appear in accordance with the range of neural distribution of string size ranging from blisters,accompanied by characteristic neuralgia,radial or burning,with or without systemic symptoms.The pain is closely related to lesions of HZ.Compared with pain,skin lesions are easier to repair.Pain can easily lead to anxiety in patients,severe sleep disorders,poor food intake,and emotional depression,and severely reduce the quality of life of patients.Therefore,attention to insomnia in patients during the acute phase should also attract the attention of clinicians.If the acute pain relief is not timely or incomplete treated,postherpetic neuralgia（PHN）is easily left and enters the chronic period,which causes painful lingering pains,prolonged course of disease,and treatment with PHN appear to be more difficult,and affects the patient’s follow-up quality of life.Therefore,there is a clinically urgent need for a treatment that can relieve pain in a timely and effective manner to resolve pain,as well as solving the pain,improving the quality of life by improving sleep,adjusting emotions,and reducing the occurrence of long-term PHN.At the same time,the occurrence of HZ is closely related to the immune status of patients:It has been reported that the incidence of herpes zoster is 14.5‰to53.6‰[1-2]per year in people with low immune function,such as AIDS,cancer,and immunosuppressive therapy.The incidence of herpes zoster in the global immunologically normal population is about 1.2‰4.8‰[3-4]per year.When the body is infected with VZV for the first time,it is lurking in the body.When the body’s immunity declines,VZV is activated again,invading the nerves and leading to HZ.There are studies[5-7]showing that the complement system plays an important role in neuropathic pain.If we can actively seek out a treatment that can improve the immune status,it will be of great help to the treatment of this disease.The use of electroacupuncture（EA）at Jiaji points in clinical treatment of HZ has a good analgesic effect[8-9].The EA at Jiaji points can encourage positive Qi and can improve the immune status theoretically,but the current research on the immunological mechanism of HZ treatment is still relatively lack and needs further improvement.The purpose of this study was to object the analgesic effect of EA at Jiaji points in the treatment of HZ and the sleeping improvement,and to provide a theoretical basis for the treatment of acute HZ and the reduction of PHN happening rate,and to explore the humoral immune mechanism of EA at Jiaji points in the treatment of HZ.Method:In this study,a total of 80 patients diagnosed with HZ in the Department of Acupuncture and Dermatology at the Wuhan No.1Hospital during the period from 2015.12 to 2017.10 were collected.Randomized digitization was used to divide the patients into the drug group and the treatment group.There were 30 cases in each group.A total of 54 patients were eventually completed,including 29 in the drug group（One case was removed）and 25 in the the treatment group（2cases fell off,and 3 cases were excluded）.The drug group oral basic drug（valaciclovir hydrochloride tablets 300mg/time,2times/day;methylcobalamin tablets 0.5mg,3 times/day）.If the patient who has severe pain,severely affect sleep,and was seen poor mental health during the day can be temporarily added to oxycodone controlled release tablets 10mg,but the number of daily intake of is no more than twice.This was treated for 10 days.The treatment group was selected the corresponding segment of lesion Jiaji obliquely toward the spine and Ashi points acupuncture.According to the position of Ashi points,we choosed the direction of acupuncture.After getting needled,according to the size of the lesion,we select 1 or 2 groups of Jiaji points to connect the upper and lower segments.At the same time,the remote Ashi points will be connected to a group of EA needles.Give the frequency of 2HZ,continuous wave,and appropriate intensity of EA which the patient can endure.Keep the needle for 30 minutes,and give oral basic drugs（taking the same method with the drug group）.Being treated for 10 days.The two groups were observed as follows:VAS and AIS scores before and after treatment,pain relief time,serum C3、C4levels before and after treatment,and follow-up records of PHN after one month of treatment.Statistical analysis using SPSS17.0,select the appropriate statistical methods to analyze the changes in the above observations.Results:（1）Comparison of VAS before and after treatment in both groups:VAS decreased significantly after treatment in both groups compared with that before.After testing,both were statistically significant（P<0.05）.The differences between the two groups before and after treatment were compared,P<0.05.Indicating that in the aspect of analgesia,the treatment group was significantly better than the drug group.（2）Comparing the pain relief time between the two groups:The pain relief time was significantly shorter in the treatment group than in the drug group,after testing,P<0.05,and the difference was statistically significant.The time the treatment group began to relieve pain is earlier than the drug group.（3）Comparison of AIS before and after treatment in both groups:AIS decreased significantly after treatment in both groups compared with that before treatment（P<0.05）.After testing,both had a significant difference（P<0.05）,indicating that both groups can improve sleep after treatment;The difference between the two groups before and after treatment were significant,P<0.05,indicating that in terms of improving sleep,the treatment group was significantly better than the drug group.（4）Changes in C3 and C4 levels before and after treatment in both groups:After treatment,the contents of C3 and C4 in both groups decreased compared with that before（P<0.05）and the difference in C3and C4 levels in treatment group was more significant than that in drug group,P<0.05,with statistical significance.（5）The occurrence of PHN and evaluation of curative effect:The incidence of PHN in treatment group was lower than that in drug group,indicating that EA at Jiaji points in the treatment of HZ can effectively reduce the incidence of PHN.The total effective rate in treatment group was significantly higher than that in drug group（P<0.05）.The difference was statistically significant,indicating that the efficacy of the treatment group was generally better than that of the drug group.Conclusion:（1）EA at Jiaji Points and oraling medicine are effective for the treatment of HZ,but the overall efficacy of EA at Jiaji points is more dominant,and the incidence of PHN in the former is lower than that of the latter,indicating that the former can reduce PHN well;（2）EA at Jiaji Points and oraling medicine treatment of HZ can both relieve pain,but EA at Jiaji points has better analgesia effect and can more quickly exert its analgesic effect.（3）Both EA at Jiaji Point and oraling medicine can improve sleep at the same time of HZ treatment,but EA at Jiaji points is better for sleep improvement.（4）The contents of C3 and C4 both decreased in EA at Jiaji Points group and the drug group,and the latter is more obvious,indicating that EA at Jiaji points may involve humoral immunity in the treatment of HZ.The probable mechanism may to reduce the content of C3 and C4,and then reduce the occurrence of neuralgia pain mediated by C3 and C4. |
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