| Objective:The changes of serum IL-10,IL-17 and TNF-α in patients with facial herpes zoster before and after 1 week of treatment were detected to preliminaries explore the analgesic effect of the treatment with filiform-fire needle,and the relationship between the analgesic effect and some inflammatory factors.Comparing the therapeutic difference of alleviating facial herpes zoster pain between the high-density filiform-fire needle acupuncture,the local herpes filiform-fire needle acupuncture and the simple oral western medicine,to search for the optimal treatment of facial herpes zoster.It is expected to accumulate data for the treatment of facial herpes zoster in the future.Methods:In this paper,90 patients with facial herpes zoster were chosen as the research objects,who were all patients visited the outpatient department and dermatology ward of our hospital(Affiliated Hospital of Tianjin Academy of Traditional Chinese Medicine)from June 2020 to December 2020.Before the experiment,the experimenter briefly introduced the experiment process to the patients and their families,and all of them had signed the relevant commitment letter.All patients who agreed to participate in the study were statistically randomized into three groups,with 30 patients in each group.The control group was treated with oral valaciclovir hydrochloride tablets(Manufacturer: Guangdong Baike Pharmaceutical Co.,Ltd;Approval Number: National Drug Approval H20056932;Specification: 0.5 g/tablet),Dose: 1g/ time,3times /d,continuous use for 2 weeks.Oral valaciclovir hydrochloride tablets were used as the basic treatment,the experimental group was also treated with the filiform-fire needle,which could be divided into the high-density filiform-fire needle acupuncture group(The frequency of filiform-fire needle acupuncture is about 20 ～ 25 needles per square centimeter)and the local herpes filiform-fire needle acupuncture group(Prick only the herpes in the skin lesions,acupuncture each herpes twice with the filiform-fire needle)according to the different frequency of filiform-fire needle acupuncture.In the later follow-up and treatment process,2 patients lost to outpatient visit,3 patients with tumor,1 patient with hematologic disease,and 4 patients refused to cooperate with the treatment,all of which were excluded.There were 27 patients in the dense acupuncture group,26 patients in the prick acupuncture group,and 27 patients in the control group in practice.Thirty normal persons who came to the hospital for health examination were enrolled into the experiment without any special treatment and were assigned to the normal group Questionnaires were used to record patients’ general information,onset and pain relief during treatment.Fasting blood 3ml was collected from the patients before and 7days after treatment.And Enzyme Linked Immunosorbent Assay was used to measure the concentration of IL-10,IL-17 and TNF-α in serum of all enrolled patients and healthy people.Finally,we used statistical methods to process all the collected data.Results:1 Comparison of age ranges: The 80 patients with facial herpes zoster included in the study were analyzed by age range,and it was found that the patients aged between 60 and 69 accounted for 37% of all collected patients,and the patients aged over 50 accounted for 79.5%.2 Comparison of pain intensity:2.1 Before treatment,All patients had their pain intensity recorded by Visual Analogue Scoring,after comparison,the difference was not statistically significant(P=0.903>0.05),which was comparability;Comparison of three time points in the 3 groups before treatment,1week after treatment and 2 weeks after treatment,and the differences were statistically significant after F test analysis(P<0.05).2.2 The VAS numerical among the three groups after 1 week of treatment were analyzed by F test,F=14.859.And the numerical between the three groups after 2 weeks of treatment were also analyzed by the same method,F=58.204,P values are all less than 0.01,and the difference was statistically significant.2.3 After 1 week of treatment,the VAS numerical of the dense acupuncture group was further compared between the two groups,and the significance of the difference was tested by LSD.We can see that the VAS numerical of the dense acupuncture group was significantly lower than the other groups(P<0.05);There was no significant difference between the prick acupuncture group and the control group(P > 0.05),which may be related to the fact that the patients were more sensitive in the early stage of pain,Low acupuncture frequency and the blisters had not dried up and scabbed.2.4 The VAS numerical of the three groups were further compared after 2 weeks of treatment,and LSD was selected to detect the significance of the difference.We can see that the numerical of the dense acupuncture group were significantly lower than that of the prick acupuncture group and lower than that of the control group,with statistical significance(P <0.05).3 Comparison of pain relief time: the results were analyzed with statistical significance(F=73.896,P < 0.01).Further pairwise comparison of the three groups showed that the time in the dense acupuncture group and the prick acupuncture group was shorter than that in the control group(6.667±1.330),and the time in dense acupuncture group(3.000±0.832)was shorter than that in the prick acupuncture group(5.154±1.120).4 Comparison of pain duration: The patients were followed up for 30 days,the pain duration was recorded and compared,and the difference was statistically significant(F=20.328,P < 0.01).Further comparison of the three groups showed that the pain duration in the dense acupuncture group and the prick acupuncture group was shorter than that in the control group(24.630±4.829),and the duration in the dense acupuncture group(16.519±3.179)was shorter than that in the prick acupuncture group(20.692±5.705).It is suggested that the dense acupuncture group has a better effect on shortening the pain duration of patients with facial herpes zoster.5 The incidence of postherpetic neuralgia in the three groups was comparedA total of 9 patients of PHN were enrolled in the 80 patients with facial herpes zoster,with an incidence of 11.25%.Among them,there were 6 patients in the control group,3 patients in the prick acupuncture group,and 0 patients in the dense acupuncture group,with an incidence respectively of 22.22%、11.54%、0%.After the chi-square analysis,P=0.011 < 0.05.The results indicated that the prick acupuncture group and the dense acupuncture group could significantly reduce the incidence of PHN,and the dense acupuncture group had a more significant effect.6 The changes of serum IL-10,IL-17 and TNF-α levels in the three groups with facial herpes zoster before and after 1week treatment were compared:6.1 The serum IL-10,IL-17 and TNF-α content of the 3 groups was measured before treatment,and the results were analyzed,p values were greater than 0.05,no statistically significant difference,comparable;6.2 The IL-10,IL-17 and TNF-α content of each group before and after treatment was compared within the group,and the results showed that the content after treatment was decreased compared with that before treatment,and t-test analysis showed that the difference was statistically significant(P < 0.01).6.3 After treatment,the serum IL-10,IL-17 and TNF-α content in the three groups was recorded and analyzed,and the difference was statistically significant(P < 0.01);pairwise comparison of the three groups showed that the content in the dense acupuncture group and the prick acupuncture group was significantly lower than that in the control group,and the decrease in the dense acupuncture group was the most significant.7 The contents of IL-10,IL-17 and TNF-α in 80 patients with facial herpes zoster were statistically analyzed with the contents of serum factors in the healthy group before treatment,and the T-test analysis showed that the difference was statistically significant(P < 0.01).Conclusion:1 The proportion of patients with facial herpes zoster aged 50 and above was the largest,accounting for 79.5% of the total population,which may be related to the increasing age of patients and the decline of immunity;2 Compared with the oral western medicine group,the treatment of facial herpes zoster with filiform-fire needle can greatly shorten the time of pain relief and pain duration,and reduce the incidence of PHN;3 Compared with the local herpes filiform-fire needle acupuncture,the high-density filiform-fire needle acupuncture can reduce the pain and the incidence of PHN more obviously in the early stage of herpes zoster patients more obviously;4 After 1 week of treatment,the serum levels of inflammatory factors IL-10,IL-17 and TNF-α in patients with facial herpes zoster in the 3 groups were significantly lower than those before treatment,and the levels in the dense acupuncture group and the prick acupuncture group were significantly lower than those in the control group,and the decrease was most significant in the dense acupuncture group.The results showed that the treatment of facial herpes zoster with filiform-fire needle to relieve neuropathic pain may be related to the reduction of serum inflammatory factors and the reduction of local inflammatory response,and the effect of the high-density filiform-fire needle acupuncture is better than that of local herpes filiform-fire needle acupuncture.5 The serum levels of IL-10,IL-17 and TNF-α in 80 patients with facial herpes zoster before treatment were all higher than those in the healthy group,indicating that the activity of inflammatory factors of IL-10,IL-17 and TNF-α may be related to the occurrence and development of facial herpes zoster. |
PDF Full Text Request