| Objectives:Herpes Zoser（HZ）is a disease caused by varicella-zoster virus invading local nerves and skin,resulting in banded blisters along the corresponding segmental skin area of the sensory nerve,with obvious neuralgia[1].Herpes area skin lesions and neuralgia are two of the most important symptoms[2].HZ skin lesions are generally banded distribution of erythema or clustered of small blisters,ranging in size,such as corn,mung bean,etc.,there is a transparent or light yellow liquid in the iliac crest;neuralgia main clinical manifestations are distributed along the damaged peripheral nerve Skin irritation,burning,numbness,acupuncture-like pain,can also be expressed as burning,beating,electric shock,tear-like pain,often on the side of the body,less than the midline,often two or three kinds of pain coexist.The pain usually lasts for a long time and the pain is fierce.The patient usually shows irritability,loss of appetite,and even sleepless nights.Most patients may have secondary anxiety,depressive symptoms,and even suicidal tendencies,which seriously affect their physical and mental health[3-5].At present,Western medicine treats the disease with anti-viral and symptomatic analgesia.There is no effective clinical diagnosis and treatment program,and its medical cost is high.It has certain side effects,pain is easy to relapse,and the probability of left residual neuralgia is high.The overall treatment effect is poor[6-8].In our clinical practice,we found that:the combination of minimal fire needle acupuncture and Jiaji electro-acupuncture treatment of herpes zoster can speed up the improvement of skin lesions and pain symptoms,shorten the course of the disease,and effectively reduce the incidence of PHN.The method is simple,unique,green,safe,and effective,with few side effects,has been widely recognized by most scholars and clinicians.Studies have shown[9]:humoral immune responses are involved in the onset,evolution,and outcome of HZ.Complement can enhance phagocytosis and phagocytic cell tropism,increase vascular permeability,and there is cell lysis,immune response regulation,IgG conditioning,neutralizing toxin and virus efficacy;IgA can mediate,modulate,phagocytose ADCC,and have virus Antibody activity;IgM can be combined with complement to promote phagocytosis and agglutination.This subject will be the combination of fire needle pricking and electro-acupuncture at Jiaji points in the diagnosis and treatment of HZ acute phase neuralgia in order to observe its clinical effects and to study the effect of the treatment process on serum IgM,IgG and IgA levels of HZ patients to further clarify Fire needle pricking and Jiaji electro-acupuncture treatment of neuropathic pain,the study of humoral immunological mechanism of acupuncture analgesia.Methods:From November 2015 to December 2017,93 patients enrolled in the Department of Acupuncture and Dermatology at Wuhan Central Hospital for Integrated Acupuncture and Dermatology were recruited in accordance with the criteria for the diagnosis and inclusion criteria of acute neuropathic pain in HZ.According to the number of randomized table method was divided into three groups,namely:treatment group A（milliopyotid acupuncture combined with Jiaji electroacupuncture group）,treatment group B（clip electroacupuncture group）,treatment group C（Western medicine group）.Treatment group C was given acute herpes zoster acute phase antiviral and nutritional neurological treatment,namely Valaciclovir Hydrochloride（Violet）300mg po Bid,Mecobalamin tablets 0.5mg po Tid,5d/1 course of treatment（patients with neuralgia is difficult Endure,severely affect daily life and sleep at night,can be temporarily added oxycodone controlled release tablets 10mg po）;In group B,on the basis of antiviral and nutritional neurological treatment,choose the ridge corresponding to the distribution range of rash（The corresponding nerve segment and the upper and lower segments of the lesion,followed by a 0.5 inch incision under the spinous process at the posterior midline）.The needle was pointed toward the spine and the gas was connected to the G6805 electroacupuncture device（parameter:frequency 2 Hz,continuous wave,Leave the needle for 30 min）,treat once a day,5d/1 treatment cycle;The treatment group A was on the basis of antiviral and neurotrophic therapy,after performing local firearm needle prick on the local herpes,cupping at the position of the magnolotal needle and leaving the jar About 5min,after the cans are cleaned with an iodophor swab and disinfected（the course of treatment should be based on the condition of the herpes.If there is no herpes,then the needle will be treated with a needle and cupping until the herpes is completely scarred）,then row EA treatment（acupoints principles,methods of operation,with the period treatment group B）.The above three groups of patients were treated for 2 days（10 days）and their clinical effects were observed.The pain indicators of the three groups were evaluated before and after treatment,namely:pain intensity（Visual Analogue Scale,VAS）,the pain began to relieve time and duration,and the incidence of PHN was counted.Simultaneously,the serum IgM,IgG and IgA concentrations were measured before and after treatment.SPSS19.0 software was used for statistical analysis to analyze the effects of comprehensive curative effect,changes in pain index,and the changes of IgM,IgG,and IgA concentrations of humoral immune factors.The effects of milli-fire needle acupuncture combined with Jiaji electro-acupuncture on HZ neuralgia and serum IgM,IgG,and IgA were evaluated.The effect of IgG,IgA,and the humoral immunological mechanisms of this regimen in the treatment of neuropathic pain.Results:（1）Longitudinal observation before and after treatment of pain indicators and horizontal comparison between groups:VAS scores,pain relief time and duration of the first 3 groups of HZ patients before treatment were compared,P>0.05,the differences were comparable;after 2 After the diagnosis and treatment of the cycle,the VAS scores of pain intensity in the three groups decreased compared with that before treatment（P<0.05）.All three programs had analgesic effect on acute HZ;the analgesic intensity of the three groups was high.The lowest was treatment group A,group B and group C,and there were significant differences（P<0.05）.The differences in the time and duration of pain relief between the three groups were also significant（P<0.05）.The time-effects of group A and B were shorter than those of group C,and the time-effect of group A was the best.（2）Longitudinal observation before and after treatment of humoral immune factors:The serum IgM,IgG and IgA concentrations in the three groups before the treatment of HZ were compared,all P>0.05,the differences were comparable;after two cycles of diagnosis and treatment,the three groups of patients The levels of serum IgM,IgG,and IgA were significantly higher than those before administration.Paired t-test analysis showed a significant difference（P<0.05）.Between groups,the levels of serum IgM,IgG,and IgA increased in the three groups after treatment.The high-amplitude order from high to low was:treatment group A>group B>group C.By independent t test and one-way analysis of variance,P<0.05,there are significant differences.Conclusion:（1）The clinical efficacy of combined fire needle acupuncture combined with Jiaji electro-acupuncture treatment of herpes zoster neuralgia is quite good,and the analgesic effect is significant.It can significantly reduce thesymptoms of neuralgia in patients with HZ acute phase,shorten the course of the disease,and effectively reducethe incidence of PHN;（2）The clinical efficacy of minimal fire needle acupuncture combined with Jiaji electro-acupuncture treatment of HZ acute phase neuralgiaissignificantlybetterthanthatofsimpleJiaji electro-acupuncture,and the effect of Jiaji spine electroacupuncture is significantly better than western medicine treatment;（3）The combination of pulsed needle acupuncture and Jiaji electro-acupuncture can significantly increase the serum IgM,IgG and IgA concentrations in patients with acute HZ,improve the body’s humoral immune function,effectively kill and remove herpes zoster virus,so as to achieve analgesic effect.And its analgesic effect is better than simply Jiaji electro-acupuncture and Western medicine treatment. |
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