伐昔洛韦联合膦甲酸钠治疗老年人头面部带状疱疹的疗效

Efficacy of valacyclovir combined with foscarnet sodium in the treatment of elderly facial herpes zoster

目的:探讨伐昔洛韦联合膦甲酸钠治疗老年人头面部带状疱疹的临床疗效。方法:收集2012年1月至2017年12月在湖北省中山医院皮肤科住院的74例头面部带状疱疹患者(年龄≥65岁)临床资料,其中,40例给予伐昔洛韦联合膦甲酸钠治疗,34例给予膦甲酸钠治疗。两组患者均治疗10 d。对两组患者治疗前后的临床疗效、临床症状改善的时间、VAS评分、后遗神经痛(PHN)及不良反应进行观察及统计分析。结果:止痛时间、止疱时间、皮损开始结痂时间、50%皮损结痂时间、全部脱痂时间,联合用药组均较膦甲酸钠组短(P<0. 05),且带状疱疹后遗神经痛出现例数少(P<0. 05)。结论:伐昔洛韦联合膦甲酸钠可以有效治疗老年头面部带状疱疹,具有止痛、皮损恢复快、后遗神经痛发生率低及安全性好的优点。

Objective:To evaluate the therapeutic efficacy of valacyclovir combined with foscarnet sodium in the treatment of elderly facial herpes zoster.Methods:The clinical data of 74 herpes zoster patients aged≥65 years from the ward of Dermatology,Zhongshan Hospital in Hubei province were collected.Among them,40 patients received valacyclovir and foscarnet sodium(combined treatment group),and34 patients only received foscarnet sodium alone(control group).All the patients were treated for 10 days.Clinical efficacy and the time of clinical symptoms improvement were observed in both groups as well as VAS score before and after treatment.The occurrence of postherpetic neuralgia(PHN)and adverse reaction(ADR)were also observed in both groups.Results:The analgesic time,stopping herpes time,lesion scabby time,50%lesion scabby time,lesion disappeared time of combined treatment group were significantly shorter than those of control group(all P<0.05).VAS scores of both groups decreased significantly after treatment,while the combined treatment group had lower VAS scores than the control group did(P<0.05).The occurrence of PHN in combined treatment group was higher than in control group(P<0.05).There was no statistical significance in the incidence of ADR between the two groups(P>0.05).Conclusion:The valacyclovir and foscarnet sodium combination therapy can effectively treat elderly facial herpes zoster patients,with advantages of analgesic effect,rapid lesions recovery,low rate of PHN,and good safety.