【目的】 观察火针联合滋肾清肝汤治疗肝经郁热证带状疱疹的临床疗效。【方法】 将60例肝经郁热证带状疱疹患者随机 分为观察组和对照组，每组各30例，对照组给予火针刺入疱疹处治疗，观察组在对照组治疗的基础上，给予滋肾清肝汤联 合治疗。2组均治疗 4周。治疗 1个月后，评价 2组临床疗效，观察 2组患者治疗后临床症状消退时间，包括疱疹停止出现 （无新水疱出现的时间）、疱疹完全消退（疱疹出现至完全消退的时间）、疼痛消失（疼痛发作至开始减轻的时间）、结痂（疱疹 治疗后至结痂的时间）、脱痂（结痂至脱痂的时间）。比较2组患者治疗前后疼痛视觉模拟量表（VAS）评分以及P物质（SP）、前 列腺素 E2（PGE2）和 β-内啡肽（β-EP）的变化情况，以及免疫球蛋白 A（IgA）、免疫球蛋白 G（IgG）、免疫球蛋白 M（IgM）的情 况。并评价 2 组的安全性及不良反应的发生情况。【结果】（1）观察组总有效率为 96.67%（29/30），对照组为 80.00%（24/30）。 观察组疗效优于对照组，差异有统计学意义（P＜0.05）。（2）治疗后，观察组的疱疹停止出现时间、疱疹完全消退时间、疼痛 消失时间、结痂时间、脱痂时间均明显优于对照组，差异有统计学意义（P＜0.05）。（3）治疗后，2组患者的SP、PGE2、β-EP 水平均明显改善（P＜0.05），且观察组在改善 SP、PGE2、β-EP 水平方面明显优于对照组，差异有统计学意义（P＜0.05）。 （4）治疗后，2组患者的 VAS 评分明显改善（P＜0.05），且观察组在改善 VAS 评分方面明显优于对照组，差异有统计学意义 （P＜0.05）。（5）治疗后，2组患者的IgA、IgG、IgM水平明显改善（P＜0.05），且观察组在改善IgA、IgG、IgM水平方面明显优 于对照组，差异有统计学意义（P＜0.05）。（6）观察组不良反应发生率为10.00%（3/30），对照组为6.67%（2/30）。观察组与对照 组的不良反应发生率比较，差异无统计学意义（P＞0.05）。【结论】 火针联合滋肾清肝汤治疗肝经郁热证带状疱疹，能明显缩 短患者临床症状的消退时间，减轻患者的疼痛症状，疗效显著，且安全性高。

Objective To observe the clinical efficacy of fire needling combined with Zishen Qinggan Decoction in the treatment of herpes zoster with heat stagnation in the liver channel syndrome. Methods Sixty patients with herpes zoster of heat stagnation in the liver channel type were randomly divided into observation group and control group，30 cases in each group. The control group was treated with fire needling into herpes，and the observation group was treated with Zishen Qinggan Decoction on the basis of the control group. Both groups were treated for four weeks. After one month of treatment，the clinical efficacy of the two groups was evaluated. The regression time of clinical symptoms after treatment in the two groups was observed，including the stop of herpes（the time when no new blister appeared），the complete regression of herpes（the time from the appearance of herpes to the complete regression），the disappearance of pain（the time from the onset of pain to the beginning of relief），scab formation （the time from herpes treatment to scab formation）， and decrustation（the time from scab formation to decrustation）. The changes of Visual Analogue Scale（VAS）of pain score，substance P（SP），prostaglandin E2 （PGE2） and β -endorphin（β -EP）， as well as immunoglobulin A（IgA）， immunoglobulin G（IgG） and immunoglobulin M（IgM）were compared between the two groups before and after treatment. The safety and adverse reactions of the two groups were evaluated. Results （1）The total effective rate was 96.67%（29/30） in the observation group and 80.00%（24/30）in the control group. The curative effect of the observation group was superior to that of the control group，and the difference was statistically significant（P＜0.05）.（2）After treatment， the herpes stopping time，herpes complete regression time，pain disappearance time，scab formation time and scab removal time in the observation group were significantly superior to those in the control group， and the differences were statistically significant（P＜0.05）.（3）After treatment，the levels of SP，PGE2 and β-EP in the two groups were significantly improved （P＜0.05）， and the improvement of SP， PGE2 and β -EP in the observation group was significantly superior to that in the control group（P＜0.05）.（4）After treatment，the VAS scores of the two groups were significantly improved （P＜0.05）， and the improvement of VAS score in the observation group was significantly superior to that in the control group，the difference was statistically significant （P＜0.05）.（5）After treatment，the levels of IgA，IgG and IgM in the two groups were significantly improved （P＜0.05），and the improvement in the levels of IgA，IgG and IgM in the observation group was superior to that in the control group，the difference being significant（P＜0.05）.（6）The incidence of adverse reactions in the observation group was 10.00%（3/30），the control group was 6.67%（2/30）. There was no significant difference in the incidence of adverse reactions between the observation group and the control group（P＞0.05）. Conclusion Fire needling combined with Zishen Qinggan Decoction in the treatment of herpes zoster with heat stagnation in the liver channel syndrome can significantly shorten the regression time of clinical symptoms and reduce the pain symptoms of patients. The curative effect is significant and the safety is high.

R246.9

承德市科技计划资助项目（编号：202301A026）