甲泼尼龙联合甲钴胺、阿昔洛韦治疗带状疱疹临床效果分析

Clinical effect of methylprednisolone combined with mecobalamin and acyclovir in treatment of herpes zoster

(1)目的探讨甲泼尼龙联合甲钴胺、阿昔洛韦治疗带状疱疹的临床效果。(2)方法选择2017年2月~2018年1月于河北武警总队医院就诊的带状疱疹患者49例,应用随机数字表法分为两组,观察组25例、对照组24例。对照组给予抗病毒联合营养神经药物治疗,观察组在对照组常规治疗基础上联合甲泼尼龙治疗。治疗10天后比较两组患者疼痛缓解时间、止疱时间、完全结痂时间、脱痂时间等症状改善情况,疼痛视觉模拟量表(VAS)评分和皮肤病生活质量指数量表(DLQI)评分以及治疗期间的不良反应发生率和随访后遗神经痛发生率。(3)结果治疗10天后,观察组总有效率96.0%(24/25),对照组83.3%(20/24),两组比较差异有统计学意义(χ~2=3.981,P<0.001);疼痛缓解时间、止疱时间、完全结痂时间以及脱痂时间均短于对照组,差异均有统计学意义(P<0.001)。治疗前,两组患者VAS评分和DLQI评分比较差异均无统计学意义(P>0.05);治疗10天后,两组VAS评分和DLQI评分均低于治疗前,且观察组显著低于对照组[(2.9±0.8)分:(5.3±1.7)分,(2.7±0.9)分:(6.1±1.2)分],差异均有统计学意义(t=5.427、6.001,P<0.001)。观察组不良反应发生率8.0%(2/25),对照组8.3%(2/24),差异无统计学意义(P=1.000)。治疗1个月后门诊和电话随访,观察组后遗神经痛发生率4.0%(1/25),对照组20.8%(5/24),差异有统计学意义(χ~2=11.046,P<0.001)。(4)结论甲泼尼龙联合甲钴胺、阿昔洛韦治疗带状疱疹有助于提高患者的临床效果、缩短症状改善时间、提高生活质量、降低后遗神经痛发生率,且不增加不良反应。

Objective To explore the clinical effect of methylprednisolone combined with mecobalamin and acyclovir in the treatment of herpes zoster.Methods From February 2017 to January 2018,49 patients with herpes zoster were randomly divided into two groups,25 in the observation group and 24 in the control group. The control group was given antiviral combined with nutritional neurodrugs,and the observation group was treated with glucocorticoid on the basis of routine treatment in the control group.The two groups were treated for 10 days.The clinical efficacy,the time of pain relief,the time of blister stopping,the time of complete scab forming and the time of scab removing were compared.The VAS score and DLQI score were used to evaluate the adverse reactions and the incidence of sequelae neuralgia during the treatment.Results After 10 days of treatment,the total effective rate of the observation group was higher than that of the control group [96.0%(24/25) vs 83.3%(20/24)],the difference was statistically significant(χ~2=3.981, P<0.001),the time of pain relief,blister stopping,complete scab forming and scab removing were shorter than that of the control group,the difference was statistically significant(P<0.001).Before treatment,there was no significant difference in VAS score and DLQI score between the two groups(P>0.05).After 10 days of treatment, VAS score and DLQI score of the two groups were lower than before treatment,and the observation group was significantly lower than the control group [(2.9±0.8) score vs(5.3±1.7) score,(2.7±0.9) score vs(6.1±1.2) score]. The difference was statistically significant(t=5.427, 6.001, P<0.001). The incidence of adverse reaction was 8.0% in the observation group and 8.3% in the control group,there was no significant difference in the incidence of adverse reactions between the two groups(P=1.000).One month after treatment,the incidence of postherpetic neuralgia in the observation group was significantly lower than that in the control group [4.0%(1/25) vs 20.8%(5/24)], the difference was statistically significant(χ~2=11.046, P<0.001).Conclusion Methylprednisolone combined with mecobalamin and acyclovir in the treatment of herpes zoster is helpful to improve the clinical effect,shorten the time of symptom improvement,improve the quality of life,reduce the incidence of sequelae neuralgia,and do not increase adverse reactions.