早期使用神经节苷脂预防带状疱疹后遗神经痛的临床观察

Clinical Observation of Preventing Postherpetic Neuralgia by GM1 Gangliosid Engaged at the Acute Stage of Herpes Zoster

目的:观察带状疱疹急性期使用神经修复药物单唾液酸四己糖神经节苷脂钠(神经节苷脂)预防带状疱疹后遗神经痛(PHN)的临床疗效。方法:带状疱疹急性期的老年患者被随机分入实验组(37例)和对照组(40例),实验组接受神经节苷脂注射剂、更昔洛韦注射剂及对症治疗,对照组接受除神经节苷脂外的上述治疗,疗程7d,在治疗的前后用视觉模拟评分法(VAS)观察患者疼痛的变化,用汉密尔顿焦虑量表(HAMA)、睡眠障碍评定量表(SDRS)分别观察患者的焦虑状况和睡眠质量变化。治疗结束1个月和2个月后对患者进行回访,计算并比较两组PHN的发生率。结果:共有31例实验组和33例对照组患者完成了疗程和回访,他们的资料被纳入分析。治疗7d后,实验组VAS、HAMA、SDRS评分的下降幅度均显著高于对照组(P<0.05);治疗结束2个月后,对照组PHN的发生率为21.2%,而实验组仅为3.2%,实验组PHN的发生率显著低于对照组(C2=4.728,P=0.030)。结论:在带状疱疹急性期使用神经节苷脂可更快速有效地缓解神经痛,并降低带状疱疹后遗神经痛的发生率。

Objective:GM1 ganglioside was engaged in elderly patients with acute herpes zoster in this study,and a clinical evaluation was done to reveal its effect on preventing postherpetic neuralgia(PHN).Methods:Elderly patients at early stage of herpes zoster were separated into experimental group or control group by randomly,and they were all treated with a 7-day therapy.The therapy plans of the two groups were the same except that GM1 ganglioside was added to the plan of the experimental group.VAS,HAMA and SDRS scores were used to evaluate patients’ conditions before and after the therapy.All cases were followed up at the end of 1 month and 2 months after the therapy,and the incidence of PHN was calculated for each group.Results:There were31 patients in experimental group and 33 patients in control group to finish the process,and theirdata were analyzed.After the 7-day therapy,declined rates of VAS,HAMA and SDRS scores in experimental group were significantly greater than those in control group(P<0.05).The incidence of PHN in control group was about 21.2%,which was significantly higher than 3.2%in experimental group.Conclusion:GM1 engaged at acute stage of zoster helps relieving neuralgia effectively and rapidly,which can also help reducing PHN incidence.