皮内针联合加巴喷丁治疗带状疱疹后遗神经痛的临床随机对照试验

Intradermal Acupuncture Combined with Gabapentin for Postherpetic Neuralgia: A Randomized Controlled Clinical Trial

摘要: 目的：评价在加巴喷丁治疗基础上联合皮内针对带状疱疹后遗神经痛(PHN)的增效作用。方法：纳入60例PHN患者，按随机原则以1:1分配至皮内针组和皮内针假针组。皮内针组给予加巴喷丁联合皮内针治疗，皮内针假针组给予加巴喷丁联合皮内针假针治疗。结局指标包括临床总有效率、疼痛视觉模拟量表(VAS)、匹兹堡睡眠质量指数(PSQI)。结果：两组受试者基线资料比较差异无统计学意义(P > 0.05)。治疗后，皮内针组总有效率为93.33%，皮内针假针组总有效率为66.66%；两组组间总有效率、VAS评分、PSQI评分比较，具有统计学差异(P < 0.05)；两组治疗前后VAS评分差值与PSQI评分对比，具有统计学差异(P < 0.05)。结论：皮内针与皮内针假针联合加巴喷丁治疗带状疱疹后遗神经痛均有效，但在加巴喷丁基础上联合皮内针可进一步减轻PHN患者疼痛并改善其睡眠质量。在30天治疗期内，加巴喷丁联合皮内针的短期疗效优于联合皮内针假针治疗PHN。

Abstract: Objective: To assess the clinical effect of intradermal acupuncture combined with gabapentin in patients with postherpetic neuralgia (PHN). Methods: A total of 60 patients with PHN were enrolled and randomly assigned at a 1:1 ratio to an intradermal needling group and a sham intradermal needling group. The intradermal needling group received gabapentin combined with intradermal needling, while the sham intradermal needling group received gabapentin combined with sham intradermal needling. Outcomes included the overall response rate, Visual Analogue Scale (VAS), and Pittsburgh Sleep Quality Index (PSQI). Results: Baseline characteristics did not differ significantly between groups (P > 0.05). After treatment, the total effective rate was 93.33% in the intradermal acupuncture group and 66.66% in the sham intradermal acupuncture group. Comparisons between the two groups in the total effective rate, VAS score, and PSQI score all showed statistically significant differences (P < 0.05). The differences in VAS score and PSQI score before and after treatment in both groups were also statistically significant (P < 0.05). Conclusions: Both intradermal acupuncture combined with gabapentin and sham intradermal acupuncture combined with gabapentin are effective in the treatment of postherpetic neuralgia; however, the addition of intradermal needling to gabapentin can further alleviate pain and improve sleep quality in patients with PHN. Within the 30-day treatment period, the short-term efficacy of gabapentin combined with intradermal needling is superior to that of gabapentin combined with sham intradermal needling in the treatment of PHN.