三叉神经带状疱疹临床分析

Clinical analysis and treatment of trigeminal herpes zoster

目的针对三叉神经带状疱疹的临床特征及治疗进行分析。方法选择2012-01—2013-12在我院接受治疗的90例三叉神经带状疱疹患者,依据患者就诊日期随机将患者分为实验组与对照组。实验组患者每天服用规格为0.15g的盐酸伐昔洛韦片0.3g,2次/d,并且每天使用半导体激光治疗仪照射疼痛部位10min;对照组静滴阿昔洛韦针剂0.5g,2次/d,疗程7d。2组用药期间均配合神经营养药物肌内注射及少量糖皮质激素口服,在用药的第7、14天观察疗效。结果实验组总有效率88.37%(38/43),对照组总有效率53.19%(25/47),差异具有统计学意义(P<0.05)。治疗组发生后遗神经痛8例(18.60%),对照组21例(44.68%),差异具有统计学意义(P<0.05)。结论带状疱疹要及早明确诊断,及时有效治疗;不同抗病毒药物疗效不同;抗病毒药物、营养神经药物、小剂量糖皮质激素、免疫调节剂的联合应用能有效抑制病毒扩散,阻止或减轻病毒对神经的损伤,以提高临床疗效。

Objective To analyze the clinical features and treatments of trigeminal nerve herpes zoster.Methods 90 cases with herpes zoster collected from January 2012 to December 2013 were randomly divided into the experimental group and the control group .The experimental group was given 0.3g valaciclovir twice a day ,and was treated with HN-1660 helium-neon la-ser for 10 minutes everyday ;while the control group was given 0.5g acyclovir intravenously twice daily for 7 days.Both groups were coordinated with neurotrophic drugs intramuscularly and glucocorticoid orally ,and the effect was observed after 7-day and 14-day treatment.Results The total effective rates in experimental group and control group respective were 88.37% （38/43） and 53.19% （25/47） with a significant difference. Occurrence rates of postherpetic neuralgia in the two groups were 18.60%（8/43） and 44.68% （21/47） respectively ,with a significant difference.Conclusion Early treatment will reduce inflammation and neuropathic pain and prevent the incidence of postherpetic neuralgia. Different combination therapy will improve immunity , effectively inhibit virus from spreading and improve clinical outcomes.