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投稿时间：2024-04-21 网络发布日期：2025-06-20
投稿时间：2024-04-21 网络发布日期：2025-06-20
中文摘要: 目的 观察逐瘀通络方联合超声引导下胸椎旁神经阻滞（TPVB）治疗气滞血瘀型带状疱疹后神经痛（PHN）的临床疗效。方法 选取2024年3月至12月无锡市中医医院收治的气滞血瘀型PHN患者60例，用随机数字表法分成对照组和观察组，各30例，对照组予加巴喷丁胶囊和超声引导下TPVB治疗，观察组在对照组基础上口服逐瘀通络方煎剂。比较两组治疗前后视觉模拟评分（VAS）、阿森斯失眠量表评分（AIS）、辅助性T细胞1/2（Th1/Th2）细胞因子［白细胞介素?2（IL?2）、IL?6、IL?10］水平，并比较两组疗效和不良反应。结果 治疗2、3、4周后，两组VAS评分、AIS评分均下降，且观察组低于对照组（P＜0.05）。治疗4周后，两组血清Th1型细胞因子IL?2水平均升高，Th2型细胞因子IL?6、IL?10水平均降低，且观察组较对照组的IL?2水平更高，IL?6、IL?10水平更低（P＜0.05）。观察组总有效率93.33%，优于对照组的73.33%（P < 0.05）。结论 逐瘀通络方联合超声引导下TPVB治疗气滞血瘀型PHN能有效减轻疼痛，改善患者睡眠质量，调节Th1/Th2细胞因子水平，提高机体免疫。
Abstract:Objective To observe the clinical efficacy of Zhuyu Tongluo Decoction combined with ultrasound - guided thoracic paravertebral nerve block（TPVB）in treating postherpetic neuralgia（PHN）of Qi stagnation and blood stasis type. Methods Sixty PHN patients of Qi stagnation and blood stasis type admitted to Wuxi Hospital of Traditiona lChinese Medicine from March to December 2024 were selected and randomly divided into control group and observation group，with 30 cases in each. The control group received gabapentin capsule and ultrasound - guided TPVB，while the observation group additionally took Zhuyu Tongluo Decoction orally. Visual Analog Scale （VAS）scores，Athens Insomnia Scale（AIS）scores，and Th1/Th2 cytokine［interleukin-2（IL-2），IL-6，IL-10］levels were compared before and after treatment between the two groups，along with treatment efficacy and adverse reactions. Results After 2，3，and 4 weeks of treatment，the VAS scores and AIS scores of both groups decreased，and those of the observation group were lower than those of the control group（P<0.05）. After 4 weeks of treatment，the serum level of Th1-type cytokine IL-2 increased，and the levels of Th2-type cytokines IL-6 and IL-10 decreased in both groups，with the observation group showing higher IL -2 and lower IL -6 and IL -10 levels（P<0.05）. The total effective rate was 93.33% in the observation group，superior to the control group（73.33%，P<0.05）. Conclusion Zhuyu Tongluo Decoction combined with ultrasound - guided TPVB effectively can alleviate pain，improves sleep quality，regulate Th1/Th2 cytokine levels，and enhance immunity in PHN patients of Qi stagnation and blood stasis type.
keywords: Zhuyu Tongluo Decoction Postherpetic neuralgia Qi stagnation and blood stasis type Thoracic paravertebral nerve block Gabapentin capsule
文章编号： 中图分类号：R289.5 文献标志码：B
基金项目:江苏省中医药管理局项目（MS2022057）；江苏省中医流派研究院项目（JSZYLP2024028）；南京中医药大学自然科学基金项目（XZR2023025）；无锡市中医药管理局科技项目（ZYYB13）；无锡市卫健委适宜技术推广项目（T202304）
附件
| Author Name | Affiliation |
| LIU Shajin*，ZHANG Jiannan，BIAN Zhenhua，ZHOU Hongmei，JIANG Chenhao，LI Ronghua，CAO Wei，CAI Liangyu | *Nanjing University of Chinese Medicine，Nanjing，Jiangsu 210023，China |
引用文本：
刘砂金,张建楠,卞振华,等.逐瘀通络方联合胸椎旁神经阻滞治疗带状疱疹后神经痛的疗效[J].中国临床研究,2025,38(6):936-939.
刘砂金,张建楠,卞振华,等.逐瘀通络方联合胸椎旁神经阻滞治疗带状疱疹后神经痛的疗效[J].中国临床研究,2025,38(6):936-939.