常规与大剂量伐昔洛韦治疗带状疱疹临床效果对比研究

A Comparative Study on the Clinical Effect of Routine and High-dose Valacyclovir in the Treatment of Herpes Zoster

目的探讨对带状疱疹患者分别采用常规剂量伐昔洛韦以及大剂量伐昔洛韦药物进行治疗后获得临床效果。方法将该院2016年5月—2020年6月门诊80例带状疱疹患者数字奇偶法分组;大剂量组(40例):采用大剂量伐昔洛韦药物完成带状疱疹治疗;常规剂量组(40例):采用常规剂量伐昔洛韦药物完成带状疱疹治疗;就组间带状疱疹疗效总有效率、总并发症(关节痛、恶心呕吐以及皮肤瘙痒)率、新发水疱评分、水疱面积评分、结痂评分、脱痂评分以及神经痛评分展开对比。结果大剂量组带状疱疹患者总疗效数据(97.50%)高于常规剂量组(72.50%),差异有统计学意义(χ^(2)=9.803,P<0.05);两组带状疱疹患者并发症集中于关节痛、恶心呕吐以及皮肤瘙痒几方面;大剂量组带状疱疹患者总并发症率(5.00%)同常规剂量组(5.00%)比较差异无统计学意义(P>0.05);大剂量组带状疱疹患者新发水疱评分(0.53±0.11)分、水疱面积评分(0.66±0.13)分、结痂评分(0.85±0.21)分以及脱痂评分(0.70±0.16)分均低于常规剂量组新发水疱评分(0.80±0.09)分、水疱面积评分(0.90±0.26)分、结痂评分(1.06±0.41)分以及脱痂评分(0.99±0.33)分,差异有统计学意义(t=12.014、5.221、2.883、5.001,P<0.05);治疗前,大剂量组带状疱疹患者神经痛评分(6.25±2.11)分同常规剂量组(6.29±2.13)分比较差异无统计学意义(t=0.084,P>0.05);治疗后,大剂量组神经痛评分(1.02±0.25)分低于常规剂量组(3.15±1.22)分,差异有统计学意义(t=10.817,P<0.05)。结论大剂量伐昔洛韦药物运用,同常规剂量伐昔洛韦药物应用效果比较,可将带状疱疹用药效果显著提升,不会导致关节痛、恶心呕吐以及皮肤瘙痒系列并发症增加,使新发水疱评分、水疱面积评分、结痂评分以及脱痂评分获得显著降低,显著改善神经痛症状,最终实现带状疱疹患者病症改善以及有效预后。

Objective To explore the clinical effects of patients with herpes zoster treated with conventional doses of valacyclovir and large doses of valacyclovir.Methods From May 2016 to June 2020 in the hospital,80 cases of herpes zoster patients were divided into groups by digital parity;high-dose group(40 cases):high-dose valacyclovir was used to complete the treatment of herpes zoster;conventional dose group(40 cases):the usual dose of valacyclovir was used to complete herpes zoster treatment;the total effective rate of herpes zoster curative effect between the groups,the total complications(arthralgia,nausea and vomiting,and skin itching)rate,new blisters score,Blister area score,scab score,scab removal score and neuralgia score were compared.Results The total curative effect data(97.50%)of patients with herpes zoster in the high-dose group was significantly higher than that in the conventional-dose group(72.50%),the difference was statistically significant(χ^(2)=9.803,P<0.05);the complications of the two groups of patients with herpes zoster focused on arthralgia and nausea Vomiting and skin pruritus;the total complication rate of patients with herpes zoster in the high-dose group(5.00%)was not significantly different from that in the conventional dose group(5.00%)(χ^(2)=0.000,P>0.05);in the high-dose group herpes zoster,the patients'new blisters score(0.53±0.11)points,blister area score(0.66±0.13)points,scab score(0.85±0.21)points,and scab removal score(0.70±0.16)points were lower than those in the conventional dose group(0.80±0.09)points,blister area score(0.90±0.26)points,scab score(1.06±0.41)points,and scab removal score(0.99±0.33)points,the difference was statistically significant(t=12.014,5.221,2.883,5.001,P<0.05);before treatment,the neuralgia score(6.25±2.11)points of the high-dose group of herpes zoster patients was not significantly different from that of the conventional dose group(6.29±2.13)points(t=0.084,P>0.05);after treatment,the neuralgia score(1.02±0.25)points of the high-dose group was significantly lower than that of the conventional dose group(3.15±1.22)points,the difference was statistically significant(t=10.817,P<0.05).Conclusion The application of high-dose valacyclovir can significantly improve the effect of valaciclovir with conventional doses,and it will not cause joint pain,nausea,vomiting,and pruritus complications.The new vesicle score,blister area score,scab score,and scab removal score were significantly reduced,which significantly improved the symptoms of neuralgia,and finally achieved improvement in the symptoms of shingles patients and an effective prognosis.