| Objectives1.Through the establishment of modern literature database of the medicated thread moxibustion,combined with evidence-based medicine,bibliometrics and other research methods,to provide reference for clinical research of Medicated Thread Moxibustion in the treatment of herpes zoster and to carry out the treatment of the standard medicated thread moxibustion.2.Through the systematic review of modern literature of different therapeutic methods of herpes zoster,to provide evidence-based medicine reference for different methods in the treatment of herpes zoster clinical research and clinical application of moxibustion treatment of febrile symptoms.3.To provide clinical evidence for the standard medicated thread moxibustion treatment of liver meridian stagnated-heat type of herpes zoster in acute phase,and verify its clinical effectiveness and safety through randomized controlled clinical study.Methods1.Contemporary literature researchBy determining the "Medicated Thread Moxibustion" or "medicated thread"or "Linemedicine Moxibustion " as the search terms,provisions of the inclusion and exclusion criteria,retrieval of the modern literature,screening of qualified medical literature by MedRef,and set up a<The modern literature information database of Medicated Thread Moxibustion>.By using the method of content analysis on key factors of the literature reviewed the analysis,such as:distribution and variation and the number of relationships and quantitative management,disease,disease spectrum statistics etc.2.Systematic review of modern literatureExtensive randomised controlled trials on the treatment of moxibustion for herpes zoster at home and abroad the database since to September 2016 in the official academic journals published in the quality analysis and evaluation of Meta,The objective evaluation to improve the situation of different moxibustion on herpes zoster lesions and pain symptoms and clinical efficacy.Determine the key words of "herpes zoster"or "HZ"and "Moxibustion"or " Acupuncture and Moxibustion " and "random" or "randomized" or "randomized controlled trials" or "clinical trials".The selected Chinese document database,such as:China biomedical literature database(CBM),Chinese Academic Journal Network Publishing Database(CNKI),Chinese scientific journal database(VIP),WangFang Medline,(WF).The selected English Document Database,such as:Cochrane library,PubMed,Embase.The bias risk assessment tool was used to assess the risk of bias in the Cochrane Handbook 5.3.0.RevMan5.3 software was used for statistical analysis and Meta-analysis or separate descriptive analysis..3.Clinical StudyThe subjects were from the Department of Dermatology of Guangdong Province Traditional Chinese Medical Hospital inpatient department and the Guangzhou Red Cross Hospital Department of traditional Chinese medicine inpatient treatment of the liver meridian stagnated-heat type of herpes zoster in acute phase.Based on the minimum sample size requirements for clinical trials,A total of 99 eligible subjects were recruited,According to the ratio of 1:1:1,were randomly divided into three groups with 33 in-each group:Basic treatment group(group A),Moxibustion group(group B),Medicated thread moxibustion group(group C).Treatment regimen:Basic treatment group(group A):Treatment with traditional Chinese medicine and Western medicine and combined with basic skin caring.Select according to TCM syndrome standard of zoster in "Diagnostic criteria of TCM Syndrome" from the liver meridian stagnated-heat type in Longdan Xiegan Decoction.A daily dose of each agent,decocting two times,take sooner or later for 2 weeks.Conventional Western medicine:Oral administration of Valaciclovir Hydrochloride Tablets(Commodity name:Wei Rachel,Zhunzi H10960079):0.3g oral,2 times a day,Fasting morning and evening services and Mecobalamin Tablets(Commodity name:methylcobalamin,Zhunzi H20030812):0.5mg oral,3 times a day,Taking cycle:continuous oral 1 weeks.Skin routine nursing by local Calamine Lotion wet drying and disinfection,2 times a day,every 15-20 minutes,can be coated with Calamine Lotion blister generation.Moxibustion group(group B):Moxibustion combined with basic treatment.The Moxa sticks that made in Suzhou city moxa factory had used to this treatment.(Zhunzi Z32021060).Moxibustion site:The skin lesions and surrounding skin blisters cluster group.Each moxibustion for 20 minutes,1 times a day,first weeks of continuous treatment for 6 days,the middle of the rest of the day,the second week treat every other day,a total of 10 times treatment in 2 weeks.The basic treatment was the same as the basic treatment group.Medicated thread moxibustion group(group C):Medicated thread moxibustion plus basic treatment.The medicated thread moxibustion by Guangxi Traditional Chinese Medical University Zhuang medicine research center.Point moxibustion:According to the principle of "three principles" of Zhuang medicine and the principle of "picking up the eldest son of skin diseases",When the first clinical moxibustion herpes originating snakeheads.And then around the edge of the skin lesions around the edge of 1.5cm moxibustion,In order to prevent the spread of herpes,such as the eldest son of points,sunflower hole.1 times a day,first weeks of continuous treatment for 6 days,the middle of the rest of the day,the second week treat every other day,a total of 10 times treatment in 2 weeks.The basic treatment was the same as the basic treatment group.The three groups were followed up at the end of the treatment,followed up for 1 month,followed up for a total of 3 months(range,1 month).All the data were analyzed by SPSS19.0 statistical software package.Results1.Contemporary literature researchA total of 2671,after perusing the exclusion of irrelevant 952 literatures,repeated 1318 literature,401 articles included in the final.Among them,the disease system 15,the disease of the 117.Beginning in 1987,there are records,the number of articles in the literature began to rise in 1995,after a brief decline in between 2001 and 2005,in the beginning of 2006,the number of documents presented a more stable growth trend;The number of diseases in the forefront of the system has skin and subcutaneous tissue disease,urogenital diseases,etc.,The frequency of more concentrated symptoms of herpes zoster and postherpetic neuralgia,dysmenorrhea,treatment with combined treatment of TCM and Western medicine;The classification of literature,suggesting that the medicated thread moxibustion for herpes zoster.2.Systematic review of modern literatureAccording to the search strategy and the method of literature search,a total of 732 articles were published in the academic journals,among which,there were only 687 articles in Chinese and English texts in 45.After reading the title,abstract,full text and bias risk assessment,33 randomized controlled literatures were screened.The 33 studies included 2777 patients who were included in the study.In the 33 studies,there were 6 reports of adverse reactions in the controllable group.All have clear diagnostic criteria,and the symptoms of the skin lesions,pain assessment standards.3.Clinical StudyAfter two weeks treatment later,the three groups of liver meridian stagnated-heat type of Herpes zoster patients,a total loss in 6 cases,3 cases removed.Among them,3 cases were lost in group A,0 case were lost and 2 case were excluded in group B,3 case were lost and 1 case were excluded in group C,Finally,the data of the patients were 30 cases of A group,B group of 31 cases,C group of 29 cases.(1)Baseline analysisIn order to determine the comparability of the results of the three groups after treatment,Which of the three groups of patients with gender,age and course of disease,disease location,VAS score,self-rating scale of sleep score,self-rating Anxiety Scale score,self-rating Depression Scale score and quality of life scale SF-36 baseline analysis,There was no significant difference(P>0.05)between the three groups.(2)Visual Analogue ScaleThe VAS scores of three groups were measured before treatment,after treatment for 2 weeks and at the end of treatment for 1 month,at the end of treatment for 2 months and at the end of the treatment for 3 months,There was significant difference between the groups(P<0.05);Between group effects:F=3.794,P=0.026;The difference was statistically significant(P<0.05);A,B,C three groups were compared between the results of multivariate statistics,A group,B group and C group,the difference was statistically significant(P<0.05),B group and A group,the difference was not statistically significant(P>0.05).(3)Time comparison of blister and analgesic and scabbyComparison of three groups of patients with herpes zoster of blisters,analgesic and scabby time,the difference was statistically significant(P<0.05).(4)Quality of life scale SF-36Three groups of patients were treated before treatment,2 weeks after treatment and at the end of treatment for 1 months,after the end of treatment for 2 months and the end of treatment for 3 months after the follow-up of the total quality of life score of 5 points,here was significant difference between the groups(P<0.05).Between group effect:F=3.368,P=0.039;the difference was statistically significant(P<0.05);A,B,C three groups were compared between the results of multivariate statistics,A group,B group and C group,the difference was statistically significant(P<0.05),B group and A group,the difference was not statistically significant(P>0.05).The mental health and physical pain score in SF-36 scale score statistics,group differences were statistically significant(P<0.05);Pairwise comparison among the three groups A,B,C,and multivariate statistical results suggest that the A group compared with C group,the difference was statistically significant(P<0.05),no statistical significance of A group and C group respectively compared with group B(P>0.05).(5)Self-rating scale of sleepThree groups of patients were measured before treatment,2 weeks after treatment and at the end of treatment for 1 months,after the end of treatment for 2 months and at the end of treatment after the follow-up of the 5 months of the score of the measurement,Group differences were statistically significant(P<0.05);group effect:F=3.147,P=0.048;the difference was statistically significant(P<0.05);Pairwise comparison among the three groups A,B,C,and multivariate statistical results suggest that the B group compared with C group,the difference was statistically significant(P<0.05),B group and C group were compared with the A group had no significant difference(P>0.05).(6)Self-rating anxiety scaleThree groups of patients were measured before treatment,2 weeks after treatment and at the end of treatment for 1 months,after the end of treatment for 2 months and at the end of treatment for 3 months after the follow-up of the 5 points of the self-rating anxiety scale,There was significant difference between the groups(P<0.05).Group effect:F=3.115,P=0.049;the difference was statistically significant(P<0.05);Pairwise comparison among the three groups A,B,C,and multivariate statistical results suggest that,compared with A group,B group and C group,the difference was statistically significant(P<0.05),B group and A group had no significant difference(P>0.05).(7)Self-rating depressive scaleThree groups of patients were performed before and 2 weeks after treatment and 1 months after the end of treatment,2 months after the end of treatment and 3 months after the end of treatment were followed up for 5 point self-rating depressive Scale score measurement,group differences were statistically significant(P<0.05).Group effect:F=4.191,P=0.018;the difference was statistically significant(P<0.05);Pairwise comparison among the three groups A,B,C,and multivariate statistical results suggest that,compared with A group,B group and C group,the difference was statistically significant(P<0.05),B group and A group had no significant difference(P>0.05).(8)Clinical comprehensive efficacyNon parametric test was used to compare the efficacy of the three groups after treatment.The results showed that the difference of A,B and C between the three groups was statistically significant(P<0.05).The data showed that there were significant differences between the three groups in improving the comprehensive efficacy of patients with herpes zoster.(9)The occurrence rate of postherpetic neuralgiaCompared the cases of postherpetic neuralgia occur after 2 weeks of treatment between three groups of herpes zoster patients.Comparison between group effects:F=6.506,P=0.039;the difference was statistically significant(P<0.05).(10)Correlation analysis of the influencing factors and curative effectThe factors such as age,course of disease,VAS score,general health status,quality of life scale SF-36 mental health score and intervention measures make by Stepwise Regression Analytical Technique.The results showed that there was a linear regression relationship between the intervention and VT and the curative effect;Analysis of blood routine and T lymphocyte subsets and the effect of the correlation,results are significantly related lymphocyte counts,lymphocyte percentage,total T lymphocytes,CD4+/CD8+ and curative effect.(11)Safety indicators and adverse reactionsAfter 2 weeks of treatment,blood routine and liver function indicators were not unusual in three groups of herpes zoster patients;statistical analysis results showed that the difference was statistically significant adverse reactions between the three groups(P<0.05).Conclusion1.The modern literature study showed that herpes zoster advantage of medicated thread moxibustion therapy.2.According to the different moxibustion treatment of modern literature by a systematic review,we found that the moxibustion treatment for herpes zoster is effective,can significantly improve the skin lesions and symptoms of pain,and no adverse reactions.clinical application of moxibustion treatment of febrile symptoms were validated.3.The Clinical study of Medicated Thread Moxibustion in the treatment of acute herpes zoster showed that Medicated Thread Moxibustion contrast with moxibustion or western medicine,can significantly improve the skin lesions pain,sleep,mood of patients with acute herpes zoster,and it can also reduce the incidence of postherpetic neuralgia and there had adverse reactions.It has a good application prospect and promotion value in clinical application.4.Through the analysis of correlation between T-lymphocyte and the hemogram of patients with efficacy,The results suggest that the occurrence,development and prognosis of herpes zoster may be related to the decrease of immune cells.And further explore the immune mechanism of medicated thread moxibustion treatment of herpes zoster is provided. |
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