鼠神经生长因子治疗老年带状疱疹临床疗效及血清IgG、IgM、IgA的变化观察

Clinical efficacy of mouse nerve growth factor on the elderly patients with herpes zoster and variations of serum IgG,IgM and IgA

目的观察鼠神经生长因子治疗老年带状疱疹患者的临床疗效及对患者血清IgG、IgM和IgA的影响。方法采用前瞻性病例对照研究方法,将2016年1月—2018年10月合肥市第三人民医院皮肤科收治的100例老年带状疱疹患者按随机数字表法分成观察组(予以鼠神经生长因子+常规抗病毒治疗,50例)和对照组(予以常规抗病毒治疗,50例)。观察2组患者有效率的差异、治疗前后简化McGill疼痛问卷积分(SF-MPQ评分)以及血清IgG、IgM、IgA的变化情况。结果观察组有效率为96.00%,对照组有效率为74.00%,组间差异有统计学意义(P<0.05)。观察组治疗前、治疗后以及出院后1个月时SF-MPQ评分分别为28.60±6.35、10.50±1.60和3.16±0.70;而对照组则分别为27.90±6.70、15.15±2.35和7.50±1.96,治疗后不同时间段2组患者SF-MPQ评分均较治疗前明显下降(均P<0.001)。观察组治疗后血清IgG、IgM、IgA指标均明显优于对照组[(18.60±2.55)mg/L vs.(15.50±2.16)mg/L、(2.06±0.60)mg/L vs.(1.43±0.46)mg/L、(3.20±0.56)mg/L vs.(2.80±0.76)mg/L],均P<0.05;而出院1个月时2组患者血清IgG、IgM、IgA较治疗前显著上升(均P<0.05)。治疗后不同时间段观察组SF-MPQ评分及血清IgG、IgM、IgA指标均明显优于对照组(均P<0.001)。2组患者均未出现严重不良反应。结论鼠神经生长因子联合常规抗病毒治疗老年带状疱疹是一种安全、有效的治疗方案,能显著提高患者IgG、IgM和IgA水平,增强机体体液免疫应答,可能是治疗带状疱疹的机制之一。

Objective To observe the clinical efficacy of mouse nerve growth factor on the elderly patients with herpes zoster and the influence of serum IgG,IgM and IgA.Methods Using a prospective case-control study,100 elderly pa-tients with herpes zoster in Dermatology Department of our hospital from January 2016 to October 2018 were randomly di-vided into observation group(treated with mouse nerve growth factor plus conventional antiviral therapy,n=50)and control group(treated with conventional antiviral therapy,n=50).The difference of effective rate,scores of simplified McGill pain questionnaire(SF-MPQ)before and after treatment,and changes of serum IgG,IgM and IgA were ob-served.Results The effective rate was 96.00%in the observation group and 74.00%in the control group,with a sig-nificant difference between the two groups(P<0.05).The SF-MPQ scores of the observation group before treatment,af-ter treatment and one month after discharge were 28.60±6.35,10.50±1.60 and 3.16±0.70,while the control group were 27.90±6.70,15.15±2.35 and 7.50±1.96,respectively.After treatment,the serum IgG,IgM and IgA indexes of the observation group were significantly better than those of the control group(18.60±2.55 vs.15.50±2.16,2.06±0.60 vs.1.43±0.46,3.20±0.56 vs.2.80±0.76).The SF-MPQ scores of both groups were significantly lower than those before treatment,and the serum IgG,IgM and IgA indexes were significantly higher than those before treatment at different periods after treatment(all P<0.05).The SF-MPQ scores and serum IgG,IgM and IgA indexes in the observation group were significantly better than those of the control group at different periods after treatment(all P<0.001).There were no serious side effects in both groups.Conclusion Mouse nerve growth factor combined with con-ventional antiviral therapy is a safe and effective treatment for elderly patients with herpes zoster.It can significantly im-prove the level of IgG,IgM and IgA in patients,and enhance the humoral immune response.It may be one of the mecha-nisms for the treatment of herpes zoster.