大剂量伐昔洛韦治疗带状疱疹有效性和安全性的临床观察

Clinical observation on efficacy and safety of high dose valaciclovir in the treatment of herpes zoster

目的观察大剂量伐昔洛韦治疗带状疱疹的有效性和安全性。方法按照治疗方式的不同将75例带状疱疹患者分为观察组和对照组,观察组予大剂量伐昔洛韦片;对照组予小剂量伐昔洛韦片,于第4、7、10、14天观察疗效和不良反应,皮疹消退后1个月随访后遗神经痛的发生情况。结果两组患者均在第4天开始皮疹评分下降,但第4、7、10天观察组的皮疹评分比对照组更低;观察组(第4天)NRS评分下降较对照组(第7天)要早,观察组第4天及以后疼痛均较对照组减轻明显(P<0.05)。14 d后观察组皮疹的改善与对照组相比无显著性差异,但疼痛的减轻优于对照组(P<0.05)。观察组后遗神经痛发生率(5.26%)低于对照组(21.62%)(P<0.05)。观察组和对照组分别出现4例和3例不良反应,均为轻到中度。结论大剂量伐昔洛韦治疗带状疱疹可加快皮疹消退,迅速缓解急性期疼痛,并有效预防后遗神经痛的发生。

Objective To observe the efficacy and safety of high dose valaciclovir in the treatment of herpes zoster.Methods According to different treatment methods,75 patients with herpes zoster were divided into observation group and control group.The observation group was given high dose valaciclovir tablets,the control group was treated with low dose valaciclovir,and the efficacy and adverse reactions were observed on the 4th,7th,10th and 14th days.The incidence of postherpetic neuralgia was followed up 1 month after the rash subsided.Results The scores of the rash in both groups decreased at the 4th day,but the scores of the rash in the observation group at the 4th,7th and 10th day were lower than that in the control group(P<0.05).The NRS scores of the observation group(4th d)decreased earlier than that of the control group(7th d),and the pain of the observation group decreased significantly compared with that of the control group at the 4th day and after(P<0.05).After 14 days,the resolution of the rash in the observation group was not significantly different from that in the control group,but the reduction of pain was better than that in the control group(P<0.05).The incidence of postherpetic neuralgia in the observation group(5.26%)was lower than that in the control group(21.62%)(P<0.05).There were 4 and 3 adverse reactions in the observation group and the control group,all of which were mild to moderate.Conclusion The treatment of herpes zoster with high dose of valaciclovir can accelerate the resolution of the rash,quickly relieve acute pain,and effectively prevent the occurrence of postherpetic neuralgia.