放血疗法联合口服抗病毒药物治疗急性期肝胆湿热证带状疱疹的临床效果

Clinical Effect of Bloodletting Therapy Combined with Oral Antiviral Drugs in the Treatment of Acute Hereditary Liver and Gallbladder Damp-heat Syndrome with Herpes Zoster

目的探讨放血疗法联合口服抗病毒药物治疗急性期肝胆湿热证带状疱疹的临床效果及作用机制。方法选取2018年1 月—12 月住院部收治的396 例急性期肝胆湿热证带状疱疹患者,采用随机数表法分为对照组196 例和观察组200 例。对照组给予阿昔洛韦片0.2 g,4 次/d,龙胆泻肝汤于饭后半小时服用;观察组在对照组的基础上给予放血疗法,比较两组的临床效果,治疗后疼痛、水疱变化情况以及发生后遗神经痛情况。结果对照组和观察组总有效率分别为75.51%和97.50%,观察组显著高于对照组,差异有统计学意义(P<0.05);观察组疼痛减轻时间、疼痛消失时间均短于对照组,观察组水疱愈合情况显著优于对照组,差异有统计学意义(P<0.05);两组治疗前VAS评分比较,差异无统计学意义(P>0.05),治疗后疼痛均明显减轻,观察组治疗后VAS评分显著低于对照组,差异有统计学意义(P<0.05);对照组和观察组后遗神经痛发生率分别为3.21%和1.03%,差异无统计学意义(P>0.05);两组在治疗过程中均未见明显的不良反应。结论放血疗法联合口服抗病毒药物治疗急性期肝胆湿热证带状疱疹的临床效果显著,可促进水疱结痂脱落,减轻患者疼痛,且安全性高。

OBJECTIVE To investigate the clinical effect and mechanism of bloodletting therapy for acute herpes zoster in patients with acute liver and gallbladder dampness syndrome. METHODS A total of 396 patients with acute hereditary liver and gallbladder damp-heat syndrome with herpes zoster admitted to the inpatient department of from January 20 to 2018 in 2018 were enrolled. The random number table method was used to divide 196 patients into the control group and 200 patients into the observation group. The control group was given acyclovir tablet 0.2g,4 times/d,LongdanXiegan Decoction was taken half an hour after meals;the observation group was given bloodletting therapy on the basis of the control group. The clinical effects of the two groups were compared,the pain after treatment,the changes of blisters and the occurrence of postherpetic neuralgia. RESULTS The total effective rate of the control group and the observation group were 75.51% and 97.50%,respectively. The observation group was significantly higher than the control group,the difference was statistically significant(P<0.05). The pain relief time and pain disappearance time in the observation group were shorter than the control group. The blister healing of the observation group was significantly better than the control group,and the difference was statistically significant(P<0.05). There was no significant difference in the VAS score between the two groups before treatment(P>0.05). The pain was significantly reduced after treatment. The VAS score after treatment was significantly lower than the control group(P<0.05). The incidence of postoperative neuralgia in the control group and the observation group were 3.21% and 1.03%,respectively,and the difference was not statistically significant(P<0.05). There were no significant adverse reactions in the two groups during the treatment. CONCLUSION Bloodletting therapy combined with oral antiviral drugs for the treatment of acute phase of liver and gallbladder damp-heat syndrome with herpes zoster was effective,which could promote blister scarring,reduce pain and have high safety.