静脉注射环氧合酶-2抑制剂在带状疱疹神经痛患者中的疗效观察

The observation of the clinical effect of intravenous injection of COX-2 inhibitor in patients with herpes zoster

目的:观察环氧合酶-2抑制剂帕瑞昔布钠静脉注射在急性带状疱疹神经痛患者中的临床疗效。方法:选取住院的急性期带状疱疹神经痛患者60例,采用数字表法随机分为两组,每组30例,试验组P组(常规药物治疗+帕瑞昔布钠静脉注射),对照组C组(常规药物治疗组)。观察记录两组患者治疗前、治疗后第1、3、5、8、11天的疼痛VAS评分、睡眠质量(SIS)评分,观察疱疹结痂日期和脱落时间,同时记录药物不良反应。在上诉相同时间点采集患者血清并测量IL-1β、IL-6、TNF-α含量。随访3个月记录带状疱疹后神经痛的发生率。结果:两组患者治疗后VAS评分和SIS评分与治疗前比较降低明显,差异有统计学意义(P<0.05);与C组比较,P组患者在不同时间点VAS评分、SIS评分下降,差异有统计学意义(P<0.05)。P组患者血清中IL-1β、IL-6、TNF-α含量在治疗后不同时间点均明显低于C组,差异有统计学意义(P<0.05)。P组患者在疱疹结痂日期和脱落时间明显早于C组,差异有统计学意义(P<0.05)。P组患者带状疱疹后神经痛的发生率明显低于对照组,差异有统计学意义(P<0.05)。两组患者头晕、嗜睡、恶心、呕吐等不良反应无明显差异。结论:环氧合酶-2抑制剂帕瑞昔布钠40 mg在急性带状疱疹患者中镇痛起效迅速,效果确切,不良反应少,早期使用可降低PHN的发生率,可在临床上推广使用。

Objective To observe the clinical effect of intravenous injection of COX-2 inhibitor parecoxib sodium in patients with acute herpes zoster（HZ）. Method Sixty patients with acute HZ hospitalized in our hospital were selected and divided into two groups（30 cases in each group） by digital table method. Group P： the patients were given the oral drug treatment and received the intravenous injection of Parecoxib sodium. Group C： the patients were only given the oral drug treatment. The VAS scores,SIS scores were recorded before and 1,3,5,8,11 days after treatment. The serums of patients were collected at the same time point and the levels of IL-1β,IL-6 and TNF-α were measured. The date of herpes scab and shedding time and the adverse reactions were recorded. Patients were followed up for 3 months to collect the incidence of PHN statistics. Results The VAS score and SIS score of both groups showed a decreasing trend after treatment were significant lower than those before treatment（P〈0. 05）. The VAS scores and the SIS score in group P were significant lower than those in group C（P〈0. 05）. The serum levels of IL-1β,IL-6 and TNF-α in group P were significant lower than those in group C after treatment（P〈0. 05）. The herpes scab and shedding time in group P were significant earlier than those in group C（P〈0. 05）. The incidence of PHN in group P were significant lower than those in group C（P〈0. 05）. There were no differences of adverse reactions between two groups. Conclusion The early using intravenous injection of parecoxib in patients with acute HZ can enhance the analgesia effect,reduce the inflammation factor and the incidence of PHN.