加巴喷丁胶囊联合小剂量泼尼松对带状疱疹神经痛患者免疫功能及疼痛物质的影响

Effect of gabapentin capsules with low dosage of prednisone on immunologic function and pain-producing substances in patients with shingles

目的探讨加巴喷丁胶囊联合小剂量泼尼松治疗对带状疱疹患者血清神经肽Y(NPY)、P物质(SP)及T细胞亚群的影响及近期临床疗效。方法选择海南省人民医院2015年1月—2016年12月期间收治的带状疱疹患者128例,随机数表法分为对照组与观察组,每组各64例。其中对照组患者给予小剂量泼尼松治疗,观察组患者给予加巴喷丁胶囊联合小剂量泼尼松治疗。比较两组患者近期疗效,治疗前后患者视觉模拟尺评分(VAS)、T淋巴细胞亚群变化情况(CD3+和CD4+、CD8+、CD4+/CD8+)及NPY和SP水平。结果经不同方案治疗后,观察组的总有效率为95.31%,对照组总有效率为85.94%,两组相比差异显著且具有统计意义(χ2=8.67,P<0.05)。与治疗前相比,两组患者治疗后的VAS评分显著降低,同组治疗前后比较差异有统计学意义(P<0.05);治疗后,观察组VAS评分显著低于对照组,差异有统计学意义(P<0.05)。与治疗前相比,两组患者治疗后T淋巴细胞亚群CD3+和CD4+、CD4+/CD8+明显增高,同组治疗前后比较差异有统计学意义(P<0.05);观察组治疗后T淋巴细胞亚群CD3+和CD4+、CD4+/CD8+较对照组增加更显著,差异有统计学意义(P<0.05)。两组NPY和SP水平较治疗前均显著下降,同组治疗前后比较差异有统计学意义(P<0.05);治疗后,观察组NPY和SP水平均显著低于对照组,差异有统计学意义(P<0.05)。结论加巴喷丁胶囊联合小剂量泼尼松治疗对带状疱疹患者能够有效改善患者临床症状,缓轻患者的神经疼痛,改善患者机体免疫功能功能,降低外周血NPY、SP水平,值得临床推广和应用。

Objective To investigate the effect of gabapentin capsules with low dosage of prednisone on T lymphocyte subsets and serum NPY and SP levels in the patients with shingles, and its recent therapeutical effect. Methods 128 cases of patients with shingles were selected from Jan. 2015 to Dec. 2016 in our hospital. Patients were divided into control group and observation group according to random number table method with 64 cases, respectively. Patients in control group were treated with low dosage of prednisone. Patients in observation group were treated with gabapentin capsules with low dosage of prednisone. The recent therapeutical effect, the VAS scores, the change of T lymphocyte subsets（including CD3＋, CD4＋, CD8＋ and CD4＋/CD8＋） and the serum NPY and SP levels were observed in the two groups before and after treatment. Results The recent therapeutical effect rate of observation group was 95.31%, and the recent therapeutical effect rate of control group was 85.94% after treatment with different options, and the difference was statistically significant between two groups（χ^2= 8.67, P〈0.05）. After treatment, the VAS scores of two groups were significantly lower than the pre-therapy, and the observation group were significantly lower than the control group. The indexes of T lymphocyte subsets CD3＋, CD4＋, CD8＋ and CD4＋/CD8＋ in two group were significantly increased compared with pre-therapy, and the observation group were significantly increased compared with control group. And the serum NPY and SP levels were significantly decreased compared with pre-therapy, and the observation group were significantly decreased compared with the control group. The difference was statistically significant between two groups（P〈0.05）. Conclusion gabapentin capsules with low dosage of prednisone can effectively improve the recent therapeutical effect in the treatment of the patients with shingles, and reduce the nerve pain, and improve the immune function, and decrease the serum NPY and SP levels. And it is worthy of clinical promotion and application.