早期足量抗病毒治疗带状疱疹临床疗效观察

Clinical observation on treatment of herpes zoster with high-dose antiviral therapy at early stage

目的:对比在治疗带状疱疹时早期足量使用阿昔洛韦类抗病毒药物与常规剂量治疗的病例在临床上的疗效。方法:以我科从2011年6月至2012年2月收治的带状疱疹患者为研究来源。以患者自愿为原则,对比分析观察组患者与对照组患者治疗结束后的临床疗效与带状疱疹后遗神经痛(postherpetic neuragia,PHN)的发生率。结果:对比观察治疗带状疱疹在疼痛缓解时间、止庖时间、皮损开始结痂时间、50%皮损结痂时间、皮损消失时间等各方面上,观察组明显短于两组对照组,差异具有统计学意义(P<0.05),但带状疱疹PHN的发生率及疼痛程度治疗后1、2、3、6月观察组与对照组其结果并无差异。对照组A与对照组B因无可比性,故未做对比。结论:对带状疱疹治疗,早期足量使用抗病毒药物其治疗效果显著,应当在临床上提倡,但对于是否可以减少带状疱疹PHN的发生及减缓其疼痛程度需要更进一步的临床研究。

Objective ：To compare the clinical effect of herpes zoster（HZ） treated by routine dose and high-dose valacyclovir（VCV） classical antiviral drugs. Methods：Research source comes from the patients with herpes zoster admitted to our department from June 2011 to February 2012. Based on the principle of voluntary,patients with onset time 〈5 d were treated by high-dose antiviral therapy （observation group） and those with onset time 〈5 d were treated by normal-dose antiviral therapy（control group A） and those with onset time 〉5 d were treated by high-dose antiviral therapy（control group B）. Clinical effects and incidences of postherpetic neuralgia （PHN） of herpes zoster in the three groups at the end of treatment were compared and analyzed. Results：Pain relieving time,cessa- tion time of new lesion, beginning time of skin lesion crusting, 50% lesion crusting time and subsiding time of skin lesions were significantly shorter in observation group than in control groups（A and B） during the treatment of herpes zoster,with statistical signifi- eances（P〈0.05）. There was no significant difference in incidences and pain degrees of PHN of herpes zoster within the first six months after treatment between observation group and control groups. Above factors were not compared between two control groups because of no comparability. Conclusions：In the treatment of herpes zoster,high-dose antiviral therapy at early stage should be advocated in the clinical treatment as it has significant treatment effects. But how to make PHN of herpes zoster occur less and lighter needs further clinical study.