氦氖激光联合心理干预在急性期带状疱疹治疗中的应用观察

Clinical application of He-Ne laser combined with psychological intervention in the treatment of acute herpes and zoster

目的 "生物-心理-社会"医学模式在现代诊疗过程中发挥着重要作用。文中探讨氦氖激光联合心理干预在急性期带状疱疹治疗中的应用价值。方法回顾性分析2015年1月至2016年1月期间于安徽医科大学第一附属医院确诊的81例急性期带状疱疹患者临床资料。采用随机数字表法将入组患者分为3组:A组(抗病毒+营养神经+心理干预+止痛药)、B组(抗病毒+营养神经+心理干预+氦氖激光)、C组(抗病毒+营养神经+心理干预+氦氖激光+止痛药)。采用疼痛视觉模拟评分法(visual analogue scale,VAS)对所有患者进行入院治疗前、治疗第3、5天疼痛评分,并于治疗后4周电话随访疼痛评分,对比分析各组患者疼痛缓解情况及平均住院日。结果 A、B、C 3组治疗前VAS评分分别为8.1±1.1、8.1±0.9和7.9±1.0,组间比较差异无统计学意义(P>0.05)。患者入院行护理宣教、心理干预及服用安慰剂2 h后,VAS评分分别降至5.4±1.5、6.1±0.9和5.5±1.2,同组干预前后比较,差异有统计学意义(P<0.05),疼痛症状略有缓解。与治疗前比较,治疗第3天及第5天时,3组患者疼痛症状均持续明显改善,VAS评分显著降低(P<0.05);但治疗后4周随访结果显示,A、B组患者维持在轻度疼痛水平,而C组疼痛症状继续得到显著改善,差异有统计学意义(P<0.05),A、B 2组平均住院日分别为(9.5±2.7)和(9.3±1.6)d,较C组(6.4±1.1)d明显延长,差异有统计学意义(P<0.05)。结论常规抗病毒、营养神经治疗,联合应用止痛药物、氦氖激光治疗及心理干预能够有效缓解急性期带状疱疹患者疼痛,且中远期疗效更为显著,并可缩短平均住院日。

Objective The medical code of ＂ biology-psychology-society＂ plays a vital role in modern treatment.The article aimed to investigate the clinical value of He-Ne laser combined with psychological intervention in the treatment of acute herpes and zoster.Methods Retrospective analysis was made on the clinical data of 81 patients with acute herpes and zoster in our hospital from Jan 2015 to Jan 2016.The patients were divided into 3 groups randomly.Patients in group A were treated with antiviral and neurotrophic medication,psychological intervention and analgesic drugs.Patients in group B were treated with antiviral and neurotrophic medication,psychological intervention and He-Ne laser.Patients in group C were treated with antiviral and neurotrophic medication,psychological intervention,analgesic drugs and He-Ne laser.Visual analogue scale（VAS） was evaluated before treatment in hospital on the 3rd day,the 5th day of treatment,and telephone follow-up after 4 weeks of treatment.VAS and average length of stay were analyzed.Results No difference was found as to VAS before treatment in hospital among three groups（8.1 ± 1.1,8.1 ± 0.9 vs 7.9 ± 1.0,P0.05）.VAS was decreased in all groups after nursing propaganda,psychological intervention and placebo（P0.05）.Compared with the VAS before treatment,VAS in three groups decreased significantly on the 3rd day and the 5th day of treatment.From the results on the 5th day and telephone follow-up after 4 weeks of treatment,VAS was still at a low level in group A and group B,on the contrary,VAS was decreased continuously in group C.Conclusion Combined treatment of antiviral,neurotrophic,analgesic drugs and He-Ne laser can relieve pain,decrease VAS and shorten the average length of stay for patients with acute herpes and zoster.