胆草活血方通过调控炎症反应缓解带状疱疹神经痛的临床疗效研究

Clinical study on the efficacy of Dancao Huoxue prescription in alleviation of herpes zoster neuralgia by regulating inflammatory response

目的研究带状疱疹患者血清中白介素(IL)-1β、IL-10的水平与视觉模拟评分(VAS)的相关性,探讨中药胆草活血方缓解带状疱疹神经痛临床疗效以及对炎症反应的影响。方法将60例带状疱疹患者随机分为胆草活血方组(试验组)和对照组,每组30例。对照组给予喷昔洛韦治疗,试验组在喷昔洛韦基础上加用胆草活血方,比较两组治疗有效率,以及两组治疗前后VAS评分。同时,采用ELISA检测患者治疗前后血清IL-1β、IL-10水平,并与40例健康者(正常组)进行比较,分析IL-1β、IL-10水平与VAS评分的相关性。结果治疗后,试验组与对照组VAS评分均降低,但试验组VAS评分低于对照组(t=-3.72,P<0.01)、总有效率高于对照组(χ^(2)=4.32,P<0.05)。试验组与对照组IL-1β、IL-10水平在治疗前均较正常组升高(均P<0.01);治疗后,试验组IL-1β水平较治疗前明显降低,且低于对照组(均P<0.01),与正常组比较无明显差异(P>0.05),而IL-10水平较治疗前升高,与对照组比较无明显差异,与正常组比较升高(P<0.01)。患者IL-1β水平与VAS评分呈正相关(r=0.86,P<0.01),而IL-10水平与VAS评分呈负相关(r=-0.81,P<0.01)。结论胆草活血方能够有效缓解带状疱疹患者神经痛,其作用机制可能与调控炎症反应有关。IL-1β、IL-10可作为疼痛严重程度的评估指标。

Objective To study the expression levels of IL-1βand IL-10 in the serum of patients with herpes zoster and their correlation with the visual analog score(VAS),and to observe the efficacy of Dancao Huoxue prescription for herpes zoster neuralgia and its impact on inflammatory response.Methods Thirty patients with herpes zoster were treated with both Dancao Huoxue prescription and penciclovir while 30 patients treated with penciclovir alone served as controls.Both effective rates and VAS were compared between these two groups.Serum levels of IL-1βand IL-10 were compared between 60 patients with herpes zoster and 40 normal controls.Correlations of IL-1βand IL-10 with VAS were also analyzed.Results Although VAS was decreased in both the treatment and the control groups,a more dramatic decrease was observed in the treated group(t=-3.72,P<0.01 vs.controls).The total effective rate was also higher in the treatment group than in the controls(χ^(2)=4.32,P<0.05).Moreover,baseline levels of serum IL-1βand IL-10 were higher in the patients with herpes zoster than in the normal controls.Following the treatment,serum IL-1βlevels in the treatment group were comparable to that in the normal controls and lower than that in the control group(P<0.01 vs.the control group).In contrast,serum levels of IL-10 were increased in both the treatment and the control groups after the treatment(P>0.05 between these two groups),but were higher than in normal controls(P<0.01 vs.patients with herpes zoster).In patients with herpes zoster,serum levels of IL-1βcorrelated positively with VAS(r=0.86,P<0.01),while IL-10 levels correlated negatively with VAS(r=-0.81,P<0.01).Conclusions Dancao Huoxue prescription can effectively alleviate herpes zoster neuralgia,likely via regulation of inflammatory response.IL-1βand IL-10 levels can be used as biomarkers to assess the severity of pain.