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中国中医科学院广安门医院针灸科,北京 100053
北京中医药大学国际针灸创新研究院
北京中医药大学针灸推拿学院
中国中医科学院广安门医院南区门诊办公室
✉郭玉峰,主任医师。E-mail:finefireneedleGYF@hotmail.com
收稿:2025-06-06,
网络首发:2026-03-27,
纸质出版:2026-06-12
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孙唯嘉, 郭玉峰, 闫世艳, 等. 毫火针排针浅刺法治疗神经性皮炎瘙痒症状:随机对照试验[J]. 中国针灸, 2026,46(6):917-923.
SUN Weijia, GUO Yufeng, YAN Shiyan, et al. Shallow needling with filiform fire-needle for pruritus of neurodermatitis: a randomized controlled trial[J]. Chinese Acupuncture & Moxibustion, 2026, 46(6): 917-923.
孙唯嘉, 郭玉峰, 闫世艳, 等. 毫火针排针浅刺法治疗神经性皮炎瘙痒症状:随机对照试验[J]. 中国针灸, 2026,46(6):917-923. DOI: 10.13703/j.0255-2930.20250606-0003.
SUN Weijia, GUO Yufeng, YAN Shiyan, et al. Shallow needling with filiform fire-needle for pruritus of neurodermatitis: a randomized controlled trial[J]. Chinese Acupuncture & Moxibustion, 2026, 46(6): 917-923. DOI: 10.13703/j.0255-2930.20250606-0003.
目的:
2
观察毫火针排针浅刺法治疗神经性皮炎(ND)瘙痒症状的临床疗效。
方法:
2
将86例ND瘙痒患者随机分为观察组(43例)和对照组(43例)。对照组采用卤米松乳膏外涂,阶梯减量法治疗4周;观察组采用毫火针排针浅刺法治疗,刺激面积以覆盖90%的皮损区域为度,每周2次,共4周。于治疗前,治疗2、4周后及随访4、8周,观察两组患者瘙痒峰值数值评定量表(PP-NRS)、湿疹面积及严重度指数(EASI)评分,计算PP-NRS应答率,进行PP-NRS评分亚组分析;于治疗4周内8个时点,评价观察组火针致痛程度[视觉模拟量表(VAS)评分],并与治疗前后PP-NRS评分差值进行相关性分析。
结果:
2
治疗2、4周后及随访4、8周,两组患者PP-NRS、EASI评分均低于治疗前(
P
<
0.05);随访4、8周,观察组PP-NRS评分低于对照组(
P
<
0.01),PP-NRS应答率高于对照组(
P
<
0.05)。亚组分析显示,两组实证与虚证患者治疗2、4周后及随访4、8周PP-NRS评分均低于治疗前(
P
<
0.05);观察组实证患者随访4周及虚证患者治疗4周后、随访8周PP-NRS评分低于对照组(
P
<
0.05)。治疗4周内各时点,火针致痛VAS评分与PP-NRS评分差值呈正相关(
r
=0.316~0.425,
P
<
0.05)。
结论:
2
毫火针排针浅刺法能有效改善ND患者瘙痒症状,修复皮损,尤其对虚证患者更持久,并与火针致痛程度相关。
Objective
2
To observe the clinical efficacy of shallow needling with filiform fire-needle for pruritus symptoms of neurodermatitis (ND).
Methods
2
A total of 86 patients with ND pruritus were randomly divided into an observation group(43 cases) and a control group (43 cases). The control group was treated with topical halometasone cream using a stepwise dose reduction method for 4 weeks; the observation group was treated with shallow needling using filiform fire-needle
with the stimulation area covering 90% of the lesion area
twice a week for 4 weeks. Peak pruritus numerical rating scale(PP-NRS) and eczema area and severity index (EASI) scores were assessed before treatment
after 2 and 4 weeks of treatment
and at 4 and 8 weeks of follow-up in the two groups. The PP-NRS response rate was calculated
and subgroup analysis of PP-NRS scores was performed. At 8 time points within 4 weeks of treatment
the pain caused by fire-needle was evaluated using the visual analogue scale (VAS)
and correlation analysis was conducted between VAS scores and the differences between pre-treatment and post-treatment PP-NRS scores.
Results
2
After 2 and 4 weeks of treatment and at 4 and 8 weeks of follow-up
PP-NR
S and EASI scores in both groups were lower than those before treatment (
P
<
0.05). At 4 and 8 weeks of follow-up
PP-NRS scores in the observation group were lower than those in the control group (
P
<
0.01)
and the PP-NRS response rate was higher than that in the control group (
P
<
0.05). Subgroup analysis showed that PP-NRS scores of patients with excess pattern and deficiency pattern in both groups after 2 and 4 weeks of treatment and 4 and 8 weeks of follow-up were lower than those before treatment (
P
<
0.05); in the observation group
PP-NRS scores of patients with excess patterns at 4 weeks of follow-up
and PP-NRS score of patients with deficiency pattern after 4 weeks of treatment and 8 weeks of follow-up
were lower than those in the control group (
P
<
0.05). At each time point within 4 weeks of treatment
the VAS scores of fire-needle-induced pain were positively correlated with the differences in PP-NRS scores (
r
=0.316-0.425
P
<
0.05).
Conclusion
2
The Shallow needling with filiform fire-needle can effectively improve pruritus symptoms in patients with ND
and repair skin lesions. It is more persistent in patients with deficiency pattern and is related to the degree of pain caused by fire-needle.
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