免疫调节剂的应用对带状疱疹患者的病程及后遗神经痛的影响

Influence of Herpes Zoster Patients’Disease Course and Postherpetic Neuralgia of the Application of Immunomodulator

目的:评价免疫调节剂甘露聚糖肽及匹多莫德在治疗带状疱疹过程中的有效性及安全性。方法:采用回顾性分析我院540例带状疱疹病毒患者,按照纳入排除标准,随机抽取采用了甘露聚糖肽治疗的病例100例,抽取匹多莫德的治疗的病例100例,空白治疗者60例。免疫修饰药物应用疗程均为2周,2周内评价近期疗效,并对随访1年的患者做远期效果分析。结果:甘露聚糖肽组的总有效率和近期痊愈率均高于匹多莫德组及空白组,三组比较具有明显的统计学差异(P<0.05或P<0.01)。另外,甘露聚糖肽组的止疱时间、开始结痂时间、开始脱痂时间与匹多莫德及空白组相比具有显著差异(P<0.05或P<0.01),即甘露聚糖肽可能会缩短带状疱疹的愈合时间。随访至第3周末,甘露聚糖肽组的疱疹完全消失率、疼痛消失率均优于匹多莫德组及空白组(P<0.05或P<0.01),即甘露聚糖肽缩短了患者的病程。随访观察1年,甘露聚糖肽组、匹多莫德组和空白组的后遗神经痛的发生率分别为3.6%,12%,43%。患者治疗前后血常规,肝肾功能检查未见异常,匹多莫德组和甘露聚糖肽组均有少数患者有轻微发热。结论:免疫修饰剂在带状疱疹中的临床受益是缩短病程,减少后遗神经痛的发生。本研究中采用甘露聚糖肽的免疫调节效果似乎好于匹多莫德,限于试验方法学,结论尚须谨慎对待。

Objective：To evaluate the efficacy and safety of mannatide and pidotimod in the treatment of herpes zoster.Methods：A retrospective analysis of 540 cases of herpes zoster virus in patients,according to the inclusion and exclusion criteria,patients were randomly assigned mannatide treatment group 100 cases,100 cases of pidotimod treatment group,no treatment,60 cases.The treatment lasted 2 weeks,2 weeks to evaluation of short-term effect,and follow-up of 1 year,the patient’s long-term effect analysis.Results：The efficiency and recent recovery of mannatide group were higher than pidotimod and control groups,three groups with a statistically significant difference（P0.05 or P 0.01）.Compared with pidotimod and blank group,the ended blister time,began to scab time and scab off time of mannatide group was significantly shorter（P0.05 or P0.01）,the mannatide may shorten the healing time of herpes zoster.Follow-up observation to the the 3 weekend,the herpes completely disappears rate and pain disappeared rates of mannatide group were better than pidotimod and control groups（P0.05 or P0.01）,mannatide could shorten diserse duration of patient.1-year followup observation,the incidence of postherpetic neuralgia of mannatide group,pidotimod,group and blank group were 3.6%,12%,43%.Before and after treatment in patients with liver and kidney function tests were normal,pidotimod group and mannatide group have a small number of patients have mild fever.Conclusion：The clinical benefit of immune modifier in the treatment of herpes was shortening the course of disease,reducing the incidence of postherpetic neuralgia.Results of this research showed that the immunomodulatory effects of mannatide was better than pidotimod,but limited to test methodology,conclusions yet to be treated with caution.