Objective

2

To investigate the dose-effect relationship of collateral bloodletting therapy with different negative pressure in the treatment of postherpetic neuralgia （PHN）.

Methods

2

Forty-three PHN patients were randomly divided into low-pressure group （15 cases）， modium-pressure group （14 cases） and high-pressure group （14 cases）. For the pain area （cupping region）， point bloodletting therapy was performed， and three-edged needles were quickly inserted into 3-5 mm beneath the skin and then removed for five times. When oozing spots were seen on the local skin， the suction cup was placed covering the oozing spots， and the air in it were pumped out with the negative pressure of 25-35 kPa， 36-45 kPa， and 46-55 kPa in the low-， medium- and high-pressure group， respectively. The cupping was maintained for 10 minutes each time， twice a week for four weeks. Visual analogue scale （VAS） score and simplified McGill pain questionnaire （SF-MPQ） score were used to evaluate the pain degree of patients before and after treatment， and Pittsburgh sleep quality index （PSQI） score was used to assess the sleep quality. After each treatment， the bleeding volume was measured for totally 8 times， and the mean value was calculated. The clinical effect and safety were evaluated after treatment. Pearson correlation was used to analyze the correlation between bleeding volume， VAS score， SF-MPQ score and PSQI score.

Results

2

After treatment， the VAS score， SF-MPQ score and PSQI score in all groups significantly decreased （

P

＜0.05）. Lower VAS score， SF-MPQ score and PSQI score were found in high-pressure group than low-pressure group， and lower VAS score was found in high-pressure group than in medium-pressure group （

P

＜0.01）. Higher bleeding volume was seen in the high- and medium-pressure group than low-pressure group， and in high-pressure group than medium-pressure group （

P

＜0.01）. Pearson correlation analysis showed that bleeding volume was negatively correlated with VAS score （

r

= -0.577，

P

＜0.05）， SF-MPQ score （

r

= -0.492，

P

＜0.05）， and PSQI score （

r

= -0.505，

P

＜ 0.05）. The total effective rates of the low-， medium- and high-pressure group were 46.67%， 64.29%， and 85.71%， respectively， with significantly higher value in the high-pressure group than in the low-pressure group （

P

＜0.05）. There was no serious adverse reactions in the three groups.

Conclusion

2

Collateral bloodletting and cupping within the negative pressure range of 25-55 kPa can significantly improve the pain and sleep quality of PHN patients with safety， and better effect was found at high pressure of 46-55 kPa.