摘要
目的探讨加巴喷丁联合泼尼松对带状疱疹后神经痛患者免疫功能、β-内啡肽及细胞因子水平的影响。方法选取空军总医院2015年3月至2016年3月收治的带状疱疹后神经痛患者95例为研究对象。依据随机数表法将入选患者分为观察组(48例)与对照组(47例)。对照组患者给予泼尼松治疗,观察组患者在对照组治疗基础上联合加巴喷丁治疗。两组患者疗程均为2周。比较两组患者疗效,治疗前后免疫功能、β-内啡肽、细胞因子、视觉模拟评分法(visual analogue scale,VAS)评分变化及不良反应发生情况。结果观察组患者治疗总有效率显著高于对照组(P<0.05)。治疗后两组患者CD3^+、CD4^+水平及CD4^+/CD8^+较治疗前显著升高(P<0.05),CD8^+水平较治疗前显著下降(P<0.05);观察组患者CD3^+、CD4^+水平及CD4^+/CD8^+均显著高于对照组(P<0.05),CD8^+水平显著低于对照组(P<0.05)。治疗后两组患者血浆β-内啡肽水平较治疗前均显著升高(P<0.05),观察组患者血浆β-内啡肽水平显著高于对照组(P<0.05)。治疗后两组患者血清肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)水平较治疗前显著降低(P<0.05),白介素-2(interleukin-2,IL-2)水平较治疗前显著升高(P<0.05);观察组患者血清TNF-α水平低于对照组(P<0.05),IL-2水平高于对照组(P<0.05)。治疗后两组患者VAS评分较治疗前均显著降低(P<0.05),观察组患者VAS评分低于对照组(P<0.05)。两组患者心电图、血常规、尿常规、肝肾功能均未见异常,且未见严重药物不良反应。结论加巴喷丁联合泼尼松治疗带状疱疹后神经痛疗效显著,其作用可能与改善患者免疫功能、减轻炎性反应、增加β-内啡肽水平有关,且安全性良好,值得临床进一步关注。
Objective To investigate the effects of Gabapentin combined with Prednisone on immune function, levels of β-endorphin and cytokines in patients with postherpetic neuralgia. Method 95 patients with postherpetic neuralgia from March 2015 to March 2016 in Air Force General Hospital were selected as the subjects of study, they were randomly divided into observation group (48 cases) and control group (47 cases). Patients in control group were treated with Prednisone, and observation group patients were treated with Gabapentin on the basis of the treatment of control group. Two groups were treated for 2 weeks. The efficacy, immune function, β-endorphin, cytokine, visual analogue scale (VAS) scores before and after treatment and adverse reactions were compared between the two groups. Result The total effective rate of observation group was higher than control group (P 〈 0.05). After treatment, the levels of CD3+, CD4+ and CD4+/CD8+ in the two groups were significantly higher than those before treatment (P 〈 0.05), and the level of CD8+ was significantly lower than that before treatment (P 〈 0.05). The levels of CD3+, CD4+ and CD4+/CD8+ in observation group were significantly higher than control group (P 〈 0.05), and the level of CD8+was significantly lower than control group (P 〈 0.05). After treatment, the levels of plasma β-endorphin in the two groups were significantly increased (P 〈 0.05), and the level of plasma β-endorphin in observation group was significantly higher than control group (P 〈 0.05). After treatment, the level of serum tumor necrosis factor-α (TNF-α) in the two groups decreased significantly (P 〈 0.05), the level of interleukin-2 (IL-2) was significantly higher than that before treatment (P 〈 0.05); the serum TNF-α level in observation group was lower than control group (P 〈 0.05), the level of IL-2 was higher than control group (P 〈 0.05). After treatment, the VAS scores of the two groups were significantly lower than those before treatment (P 〈 0.05), and the score of VAS in observation group was lower than control group (P 〈 0.05). ECG, blood routine, urine routine, liver and kidney function were not abnormal in the two groups, and there was no serious adverse drug reaction. Conclusion Gabapentin combined with Prednisone for post-herpetic neuralgia, has a significant effect, its effect may be associated with improved immune function, increasing β-endorphin, improve inflammation, and security is good, is worth studying.
出处
《中国医学前沿杂志(电子版)》
2017年第5期168-172,共5页
Chinese Journal of the Frontiers of Medical Science(Electronic Version)