臭氧大自血疗法联合常规药物疗法治疗带状疱疹后神经痛患者的短期疗效及对T淋巴细胞亚群介导的细胞免疫功能的影响

Short-term efficacy of ozone autohemotherapy combined with conventional drug therapy for postherpetic neuralgia and the effect on T-lymphocyte subsets mediated cellular immune function

目的研究臭氧大自血疗法联合常规药物疗法治疗带状疱疹后神经痛(PHN)患者的短期疗效及对T淋巴细胞亚群介导的细胞免疫功能的影响。方法收集2018年2月至2018年12月河北医科大学第二医院疼痛科诊断为PHN的住院患者共40例,年龄40~85岁,性别不限,按随机数字表法分为常规药物治疗组(药物治疗组),臭氧大自血疗法联合常规药物治疗组(联合治疗组),每组20例。药物治疗组患者给予口服普瑞巴林胶囊、氨酚羟考酮片及盐酸阿米替林片,静脉滴注牛痘疫苗致炎兔皮提取物注射液治疗;联合治疗组患者在药物治疗组治疗基础上加用臭氧大自血疗法。两组疗程均为14 d。比较两组患者治疗前和治疗后第8、15日的视觉模拟评分(VAS)以及外周血CD3^(+)、CD4^(+)、CD8^(+)T淋巴细胞百分比、CD4^(+)/CD8^(+)的变化;评估并比较两组患者疗程结束第15日时疗效。结果与治疗前相比,治疗后第8、15日时两组患者VAS评分均明显降低,差异均有统计学意义(P均<0.05)。与药物治疗组比较,在治疗后第15日时联合治疗组患者的VAS评分降低更明显,差异有统计学意义(P<0.001)。与治疗前比较,药物治疗组在治疗后第8日时CD3^(+)、CD4^(+)T淋巴细胞百分比降低,差异有统计学意义(P均<0.05)。与治疗后第8日比较,药物治疗组在治疗后第15日CD4^(+)T淋巴细胞百分比升高,差异有统计学意义(P<0.05);其他观察指标组内及组间比较,差异均无统计学意义(P均>0.05)。治疗后第15日联合治疗组患者优良率与药物治疗组比较差异无统计学意义(P均>0.05)。结论臭氧大自血疗法联合常规药物疗法可有效控制PHN患者的疼痛,短期疗效与常规药物治疗相当,短期内对T淋巴细胞亚群介导的细胞免疫功能无影响。

Objective To study the short-term efficacy of ozone autohemotherapy combined with conventional drug therapy in the treatment of postherpetic neuralgia(PHN)and the effect on T-lymphocyte subsets mediated cellular immune function.Methods From February 2018 to December 2018,40 PHN patients in the Painology Department of the Second Hospital of Hebei Medical University,aged 40-85 years,regardless of gender,were randomly divided into conventional drug treatment group(drug treatment group)and ozone autohemotherapy combined with conventional drug treatment group(combined treatment group)according to random number table method,with 20 cases in each group.The patients in the drug treatment group were given pregabalin capsules,paracetamol oxycodone tablets and amitriptyline hydrochloride tablets orally,and intravenous infusion of the extract of rabbit skin inflamed by cowpox vaccine.The patients in the combined treatment group were treated by ozone autotransfusion therapy in addition to the drug treatment group.The course of the treatments lasted for 14 days in both groups.Visual analogue scale(VAS),peripheral blood CD3^(+),CD4^(+),CD8^(+)T lymphocyte percentage,and CD4^(+)/CD8^(+)were compared before and at the 8th and 15th d after the treatment between two groups.The efficacy were evaluated and compared at the 15th d after the treatment in two groups.Results Compared with before the treatment,VAS significantly decreased at the 8th and 15th d after the treatment in both groups(all P<0.05),and the combined treatment group was better than the drug treatment group(P<0.001).The percentage of CD3^(+)and CD4^(+)T lymphocytes were decreased significantly at the 8th d after the treatment than that before the treatment(all P<0.05)and the percentage of CD4^(+)T lymphocytes were increased at the 15th d after treatment than at the 8th d after the treatment in the drug treatment group(P<0.05).Compared with the drug treatment group,there was no significant change in the effective and good rate of patients in the combined treatment group at the 15th d after the treatment(P>0.05).Conclusions Ozone autohemotherapy combined with conventional drug therapy can effectively relieve the pain in PHN patients,but the short-term efficacy was similar to conventional drug therapy,and no effect on the T-lymphocyte subpopulations mediated cellular immune function.