经颅重复针刺情感区对带状疱疹后遗神经痛的临床疗效观察

Clinical Observation of the Efficacy of Repeated Transcranial Acupuncture on the Emotional Region for Postherpetic Neuralgia

摘要: 目的：观察经颅重复针刺情感区联合常规针刺对带状疱疹后遗神经痛患者疼痛程度、情绪状态、睡眠质量及外周炎症因子与神经递质的影响，系统评价其临床疗效与安全性。方法：选取2024年10月至2025年10月就诊于黑龙江中医药大学附属第二医院针灸二门诊的70例PHN患者，随机分为试验组与对照组，各35例。对照组予常规针刺治疗，试验组在对照组基础上加用经颅重复针刺情感区治疗，疗程均为4周。比较两组治疗前后视觉模拟量表(VAS)评分、简明McGill疼痛问卷(SF-MPQ)评分、汉密尔顿焦虑量表(HAMA)评分、汉密尔顿抑郁量表(HAMD)评分、匹兹堡睡眠质量指数(PSQI)，采用ELISA法检测外周血单核细胞趋化蛋白-1 (MCP-1)、白细胞介素-6 (IL-6)、肿瘤坏死因子-α (TNF-α)及5-羟色胺(5-HT)水平。结果：治疗后，两组VAS、SF-MPQ、HAMA、HAMD、PSQI评分均较治疗前显著降低(P < 0.05)，且试验组各评分均低于对照组(P < 0.05)；两组外周血MCP-1、IL-6、TNF-α水平显著降低，5-HT水平显著升高(P < 0.05)，试验组指标变化幅度大于对照组(P < 0.05)；试验组总有效率为91.43%，高于对照组的74.29%，差异有统计学意义。两组均未发生严重不良事件，试验组出现1例轻微头晕，对照组出现1例晕针，均经对症处理后缓解。结论：经颅重复针刺情感区联合常规针刺可有效减轻PHN患者疼痛程度，改善焦虑抑郁情绪与睡眠质量，调节外周炎症因子及神经递质水平，疗效优于单纯常规针灸，且安全性良好，值得临床推广应用。

Abstract: Objective: To observe the effects of transcranial repetitive acupuncture on the emotional zone combined with conventional acupuncture on pain intensity, emotional state, sleep quality, peripheral inflammatory factors, and neurotransmitters in patients with postherpetic neuralgia (PHN), and to systematically evaluate its clinical efficacy and safety. Methods: A total of 70 PHN patients treated at the Acupuncture and Moxibustion Department II of the Second Affiliated Hospital of Heilongjiang University of Chinese Medicine from October 2024 to October 2025 were selected and randomly divided into an experimental group and a control group, with 35 cases each. The control group received conventional acupuncture therapy, while the experimental group additionally received transcranial repetitive acupuncture on the emotional zone. Both groups underwent a treatment course of 4 weeks. The Visual Analog Scale (VAS), Brief McGill Pain Questionnaire (SF-MPQ), Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), and Pittsburgh Sleep Quality Index (PSQI) scores were compared before and after treatment. Peripheral blood monocyte chemoattractant protein-1 (MCP-1), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and serotonin (5-HT) levels were measured using the ELISA method. Results: After treatment, the VAS, SF-MPQ, HAMA, HAMD, and PSQI scores in both groups were significantly lower than before treatment (P < 0.05), with the experimental group’s scores being lower than those of the control group (P < 0.05). Peripheral blood MCP-1, IL-6, and TNF-α levels were significantly reduced, while 5-HT levels were significantly increased (P < 0.05), with greater changes in the experimental group compared to the control group (P < 0.05). The total effective rate in the experimental group was 91.43%, higher than that of the control group (74.29%), with a statistically significant difference. No severe adverse events occurred in either group, but one case of mild dizziness was reported in the experimental group and one case of acupuncture syncope in the control group, both of which resolved after symptomatic treatment. Conclusion: Transcranial repetitive acupuncture on the emotional zone combined with conventional acupuncture can effectively alleviate pain intensity in PHN patients, improve anxiety and depression, enhance sleep quality, and regulate peripheral inflammatory factors and neurotransmitter levels, demonstrating superior efficacy compared to conventional acupuncture alone with good safety, making it worthy of clinical promotion and application.