3种方案治疗带状疱疹后遗神经痛的效果及安全性分析

The efficacy and safety of three methods for the treatment of postherpetic neuralgia

目的:比较分析不同方案治疗带状疱疹后遗神经痛(PHN)的效果及安全性。方法:选择2013年5月至2015年5月在北京市昌平区医院就诊的114例PHN患者,按随机数字表法将其分为A、B、C 3组,每组38例。A组给予单纯西药治疗,B组给予单纯中药治疗,C组给予中西药结合治疗,比较3组临床疗效、不良反应、治疗前、后疼痛视觉模拟评分(VAS)及炎症因子指标。结果:C组治疗总有效率(89.47%)显著高于A组(68.42%)和B组(71.05%)(P<0.05)。C组疼痛完全消失时间、术后VAS评分均明显低于A组和B组,组间比较差异有统计学意义(P<0.05),而A组与B组比较差异无统计学意义(P>0.05)。3组均无明显不良反应发生。与治疗前比较,C组治疗后白介素(IL)-10水平明显升高,IL-1β水平明显降低,差异均有统计学意义(均P<0.05);C组治疗后IL-10水平明显高于A组和B组,IL-1β水平明显低于B组,组间比较差异有统计学意义(P<0.05)。结论:中西药结合治疗带状疱疹后遗神经痛疗效明确,不良反应少,能明显调整炎症指标,安全可行。

Objective： To compare the efficacy and safety of different regimens for the treatment of postherpetic neuralgia （PHN）. Methods： A total of 114 patients with PHN were enrolled and divided into three groups （38 cases in each） ：group A in which the patients were treated with western medicine, group B in which the patients were treated with traditional Chinese medicine, and group C in which the patients received the combination of traditional Chinese medicine and western medicine. The clinical curative effect, adverse reactions, visual analogue scale （VAS） scores before and after treatment and the levels of inflammatory factors were compared. Results： The total response rate in group C （89.47%） was significantly higher than those in group A （68.42%） and group B （71.05%） （ P 〈0.05）. The pain relief time and postoperative VAS score of group C were significantly lower than those of group A and group B （ P 〈 0.05）, but there was no significant difference between group A and group B （ P 〉0.05）. There was no obvious adverse reaction in all groups. After treatment, the interleukin-10 （IL-10） level was significantly higher, while the interleukin-1β （IL-1β） level was significantly lower than those before treatment in group C （ P 〈0.05）. Furthermore, the IL-10 level in group C was significantly higher than those in group A and group B, and the IL-1β level in group C was significantly lower than that in group B （ P 〈0.05）. Conclusion： Traditional Chinese medicine combined with western medicine could achieved a significant effect on the treatment of PHN via regulating the inflammatory response. This regiment seemed to be safe and feasible.