Objective  To explore the clinical efficacy of Qingpeng unguentum (QU) combined with auricular acupuncture (AA) and multi-dimensional collaborative intervention (MDCI) in the treatment of postherpetic neuralgia (PHN).

Methods  Patients with PHN who attended the department of dermatology at Zhejiang Provincial Dermatology Hospital from January 2022 to January 2023 were retrospectively selected. According to the intervention regimens, patients were divided into three groups: the QU group (QU external application), the AA group (QU external application combined with AA), and the MDCI group (QU external application combined with AA and MDCI). Changes in negative mood [self-rating anxiety scale (SAS) and self-rating depression scale (SDS)], pain degree (visual analogue scale, VAS score), sleep quality (Pittsburgh sleep quality index, PSQI score), quality of life (mos36-item short form health survey, SF-36 score) and inflammatory markers (IL-6, TNF-α and CRP) were compared before and after intervention using paired sample t-tests. Differences among the groups in these parameters and in nursing satisfaction were analyzed using ANOVA, rank-sum test, or chi-square test.

Results  A total of 110 PHN patients were included in this study, with 30 in the QU group, 41 in the AA group, and 39 in the MDCI group. There were no significant differences among the three groups in negative mood, pain degree, sleep quality, quality of life, and inflammatory markers (P>0.05). After 1 month of intervention, the scores for SAS, SDS, VAS, PSQI, as well as serum levels of IL-6, TNF- α, and CRP, significantly decreased compared to pre-intervention levels (P<0.05). The level of these indicators were lower in the AA group than in the QU group (P<0.05), and the level in the MDCI group were lower than those in the AA group (P<0.05). SF-36 scores were elevated in the 3 groups compared with the pre-intervention period, and were greater in the MDCI group than in the AA group, and in the AA group than in the QU group (P<0.05). Additionally, the total response rate and total satisfaction rate were significantly higher in the AA group than in the QU group (P<0.05), and higher in the MDCI group than in the AA group (P<0.05).

Conclusion  QU combined with AA and MDCI significantly improves negative mood, pain degree, sleep quality, and quality of life in PHN patients, reduces levels of inflammatory markers, and enhances overall treatment efficacy. It is recommended for promotion in clinical practice.

1.张禹, 孟晓敏, 张猛, 等. 调气法针刺联合加巴喷丁治疗带状疱疹后遗神经痛的疗效观察及对血清β-EP和NK-1水平的影响[J]. 上海针灸杂志, 2024, 43(3): 301-306. [Zhang Y, Meng XM, Zhang M, et al. Observation on the therapeutic effect of Qi regulating acupuncture combined with gabapentin in the treatment of postherpetic neuralgia and its effect on serum β-The impact of EP and NK-1 levels[J]. Shanghai Journal of Acupuncture and Moxibustion, 2024, 43(3): 301-306.] DOI: 10.13460/j. issn.1005-0957.2024.03.0301.

2.王波, 张华, 杜忠举. 超声引导下前锯肌平面阻滞治疗老年人胸段带状疱疹性神经痛疗效观察[J]. 全科医学临床与教育, 2021, 19(6): 541-543. [Wang B, Zhang H, Du ZJ. Observation on the therapeutic effect of ultrasound-guided anterior serratus muscle plane block in the treatment of thoracic herpetic neuralgia in the elderly[J]. Clinical Education of General Practice, 2021, 19(6): 541-543.] DOI: 10.13558/j.cnki.issn1672-3686.2021.006.017.

3.张旭杰, 曾丽元, 曹硕. 带状疱疹后遗神经痛病人中医护理研究进展[J]. 护理研究, 2023, 37(12): 2208-2212. [Zhang XJ, Zeng LY, Cao S. Research progress in traditional Chinese medicine nursing for patients with postherpetic neuralgia[J]. Chinese Nursing Research, 2023, 37(12): 2208-2212.] DOI: 10.12102/j. issn.1009-6493.2023.12.022.

4.屈敬阳, 安娜, 刘丁丁, 等. 青鹏膏剂临床应用研究进展概况[J]. 天津药学, 2016, 28(6): 57-59. [Qu JY, An N, Liu DD, et al. Overview of clinical application research progress of Qingpeng ointment[J]. Tianjin Pharmacy, 2016, 28(6): 57-59.] DOI: 10.3969/j.issn.1006-5687.2016.06.021.

5.张洋. 700例带状疱疹后遗神经痛治疗总结及疗效影响因素研究[D]. 贵阳: 贵阳中医学院, 2018. https://cdmd.cnki.com.cn/Article/CDMD-10662-1017092177.htm.

6.夏娟, 黄平. 腕踝针配合耳穴埋针对老年髋部骨折置换术后疼痛及功能恢复的影响[J]. 上海针灸杂志, 2023, 42(1): 50-55. [Xia J, Huang P. The effect of wrist ankle needle combined with ear acupoint implantation on postoperative pain and functional recovery in elderly patients undergoing hip fracture replacement surgery[J]. Shanghai Journal of Acupuncture and Moxibustion, 2023, 42(1): 50-55.] DOI: 10.13460/j.issn.1005-0957. 2023.01.0050.

7.张若思. 耳穴埋针在经阴道超声穿刺取卵术中的镇痛及抗焦虑研究[D]. 上海: 上海中医药大学, 2020. DOI: 10.27320/d.cnki.gszyu.2020.000732.

8.蔡慧倩, 粟胜勇, 张熙, 等. 耳穴埋针对抑郁症患者减停盐酸舍曲林疗效的影响: 随机对照试验[J]. 中国针灸, 2021, 41(9): 1005-1009. [Cai HQ, Su SY, Zhang X, et al. The effect of ear acupoint implantation on reducing the efficacy of sertraline hydrochloride in patients with depression: a randomized controlled trial[J]. Chinese Acupuncture & Moxibustion, 2021, 41(9): 1005-1009.] DOI: 10.13703/j.0255-2930.20200721-k0002.

9.陈土文, 陈晓传, 罗庆波. 归脾汤联合耳穴埋针治疗心脾两虚型失眠的效果及对患者睡眠质量的影响[J]. 大医生, 2023, 8(23): 79-82. [Chen TW, Chen XC, Luo QB. The Effect of Guipi Tang combined with ear acupoint embedding acupuncture in treating insomnia of heart spleen deficiency type and its impact on sleep quality of patients[J]. Doctor, 2023, 8(23): 79-82.] DOI: 10.3969/j. issn.2096-2665.2023.23.025.

10.赵向琴, 王丽娜. 多维度协同护理对老年带状疱疹后遗神经痛患者负性情绪、疼痛的影响[J]. 中国老年学杂志, 2016, 36(21): 5407-5409. [Zhao XQ, Wang LN. The impact of multidimensional collaborative nursing on negative emotions and pain in elderly patients with postherpetic neuralgia[J]. Chinese Journal of Gerontology, 2016, 36(21): 5407-5409.] DOI: 10.3969/j.issn.1005-9202.2016.21.089.

11.中国医师协会皮肤科医师分会带状疱疹专家共识工作组. 带状疱疹中国专家共识[J]. 中华皮肤科杂志, 2018, 51(6): 403-408. DOI: 10.3760/cma.j.issn.0412-4030.2018.06.001.

12.李丽, 张秀秀, 巴蕊. ABC-X模型在改善结肠癌负性情绪和生活质量中的应用效果分析[J]. 实用中医内科杂志, 2022, 36(3): 141-143. [Li L, Zhang XX, Ba  R. Analysis of the application effect of ABC-X model in improving negative emotions and quality of life in colon cancer[J]. Journal of Practical Traditional Chinese Internal Medicine, 2022, 36(3): 141-143.] DOI: 10.13729/j.issn.1671-7813.Z20211421.

13.Huskisson EC, Jones J, Scott PJ. Application of visual-analogue scales to the measurement of functional capacity[J]. Rheumatol Rehabil, 1976, 15(3): 185-187. DOI: 10.1093/rheumatology/15.3.185.

14.Buysse DJ, Reynolds CF, Monk TH, et al. The Pittsburgh sleep quality index: a new instrument for psychiatric practice and research[J]. Psychiatry Res, 1989, 28(2): 193-213. DOI: 10.1016/0165-1781(89)90047-4.

15.李群, 陈优民, 吴战坡, 等. 全髋关节置换术127°小颈干角和135°大颈干角假体的比较[J]. 中国骨伤, 2020, 33(11): 1027-1031. [Li Q, Chen YM, Wu ZP, et al. Comparison of 127° small neck stem angle and 135° large neck stem angle prostheses in total hip arthroplasty[J]. China Bone Injury, 2020, 33(11): 1027-1031.] DOI: 10.12200/j.issn.1003-0034.2020.11.008.

16.Rodríguez-Herrera C, López-Jiménez JDJ, Toro-Valero AD, et al. The Newcastle satisfaction with nursing scales in a Mexican Oncology Hospital[J]. Afr Health Sci, 2021, 21(1): 60-66. DOI: 10.4314/ahs. v21i1.10.

17.朱海洋, 吴芳, 周玉兰. 多维度协同护理对带状疱疹后遗神经痛患者负性情绪及疼痛状况改善的影响[J]. 护理实践与研究, 2021, 18(6): 898-900. [Zhu HY, Wu  F, Zhou YL. The impact of multidimensional collaborative nursing on the improvement of negative emotions and pain status in patients with postherpetic neuralgia[J]. Nursing Practice and Research, 2021, 18(6): 898-900.] DOI: 10.3969/j.issn.1672-9676.2021.06.032.

18.钟思羽. 耳穴压豆联合电针夹脊穴配合患处带状针刺治疗带状疱疹后神经痛伴焦虑抑郁的临床研究[D]. 成都: 成都中医药大学, 2023. DOI: 10.26988/d.cnki.gcdzu.2023.000202.

19.范小婷, 赵明阳, 梁弘, 等. 壮医药线点灸治疗老年带状疱疹后遗神经痛效果及对血清TNF-α、IL-6水平的影响[J]. 中国老年学杂志, 2024, 44(3): 565-568. [Fan XT, Zhao MY, Liang H, et al. The therapeutic effect of Zhuang medicine thread moxibustion on postherpetic neuralgia in the elderly and its effect on serum TNF-α、 IL-6 levels[J]. Chinese Journal of Gerontology, 2024, 44(3): 565-568.] DOI: 10.3969/j.issn. 1005-9202.2024.03.015.

20.王志剑. 带状疱疹后遗神经痛的相关血清学因子、临床风险因素和预防策略研究[D]. 南昌: 南昌大学, 2023. DOI: 10.27232/d.cnki.gnchu.2022.004409.

21.罗睿韬, 谭嵘. 神经阻滞治疗带状疱疹后神经痛的疗效及对血清白介素-6的影响[J]. 现代疾病预防控制, 2024, 35(1): 68-70. [Luo RT, Tan R. The therapeutic effect of nerve block therapy on postherpetic neuralgia and its effect on serum interleukin-6[J]. Modern Disease Control and Prevention, 2024, 35(1): 68-70.] DOI: 10.13515/j.cnki.hnjpm.1006-8414.2024.01.017.