【摘要】 目的 观察揿针联合疏肝健脾汤治疗肝郁脾虚型慢性肛窦炎(anal sinusitis, AS)的临床疗效及对血清炎症因子水平的影响。方法 将92例肝郁脾虚型慢性AS患者随机分成药物组(46例,剔除1例、脱落1例)和针药组(43例,剔除2例、脱落1例)。两组均采用肛泰栓纳肛基础治疗,药物组采用疏肝健脾汤灌肠治疗,针药组在药物组基础上采用揿针治疗。观察两组治疗前后中医证候积分、疼痛数字评分表(numerical rating scale,NRS)评分、血清疼痛介质[P物质(substance P, SP)和神经肽Y(neuropeptide Y, NPY)]和血清炎症因子[肿瘤坏死因子-α(tumor necrosis factor-α, TNF-α)和降钙素原(procaicitonin, PCT)]水平变化,并比较两组临床疗效。结果 针药组总有效率为95.4%,高于药物组的77.3%(P<0.05)。治疗后,两组中医证候积分和NRS评分均较治疗前降低(P<0.05),且针药组均低于药物组(P<0.05)。治疗后,两组血清SP和NPY水平均较治疗前降低(P<0.05),且针药组低于药物组(P<0.05)。治疗后,两组血清TNF-α和PCT水平均较治疗前降低(P<0.05),且针药组低于药物组(P<0.05)。结论 在肛泰栓纳肛基础上,揿针联合疏肝健脾汤治疗肝郁脾虚型慢性AS疗效较好,可有效降低疼痛介质和炎症因子水平,改善临床症状。更多还原

【Abstract】 Objective To observe the clinical efficacy of thumb-tack needle therapy plus liver-soothing and spleenreinforcing decoction for chronic anal sinusitis(AS) of liver depression and spleen deficiency type and its effect on serum inflammatory factor levels. Method Ninety-two patients with chronic AS of liver depression and spleen deficiency type were randomized to a medication group(46 cases, one case eliminated, one cases dropping out) and a needle plus medicine group(43 cases, two case eliminated, one cases dropping out). Both groups were given Gangtai suppository rectally as basic treatment. The medication group received liver-soothing and spleen-reinforcing decoction enema and the needle plus medicine group, thumb-tack needle therapy in addition. The TCM symptom score and the numerical rating scale(NRS) score were recorded, and serum pain mediator [substance P(SP) and neuropeptide Y(NPY)] and serum inflammatory factor [tumor necrosis factor-α(TNF-α) and procalcitonin(PCT)) levels were measured in the two groups before and after treatment. The clinical therapeutic effects were compared between the two groups. Result The total efficacy rate was 95.4% in the needle plus medicine group, which was higher than 77.3% in the medication group(P<0.05). After treatment, the TCM symptom score and the NRS score decreased in the two groups compared with before(P<0.05) and were lower in the needle plus medicine group than in the medication group(P<0.05). After treatment, serum SP and NPY levels decreased in the two groups compared with before(P<0.05) and were lower in the needle plus medicine group than in the medication group(P<0.05). After treatment, serum TNF-α and PCT levels decreased in the two groups compared with before(P<0.05) and were lower in the needle plus medicine group than in the medication group(P<0.05). Conclusion On the basis of administering Gangtai suppository rectally, thumb-tack needle therapy plus liver-soothing and spleen-reinforcing decoction produces a better therapeutic effect on chronic AS of liver depression and spleen deficiency type. It can effectively reduce pain mediator and inflammatory factor levels and relieve the clinical symptoms.更多还原