伐昔洛韦联合中等剂量泼尼松治疗中重度带状疱疹临床观察

Clinical observation of valacyclovir combined with moderate dose of prednisone in treatment of moderate to severe herpes zoster

目的观察伐昔洛韦联合中等剂量泼尼松治疗中重度带状疱疹的临床效果。方法将中重度带状疱疹患者124例采用随机数字表法分为观察组和对照组各62例,对照组给予伐昔洛韦抗病毒及营养神经治疗,观察组在对照组基础上加用中等剂量泼尼松治疗,比较2组的治疗前后疼痛数字评分法(NRS)评分、匹兹堡睡眠质量指数(PSQI)评分、止疱时间、结痂时间、带状疱疹后遗神经痛(PHN)发生率及不良反应。结果治疗前2组NRS评分及PSQI评分比较差异均无统计学意义(P>0.05);治疗后2组患者NRS评分及PSQI评分均较治疗前降低,观察组低于对照组;观察组止疱天数和水泡血泡吸收结痂天数均短于对照组;随访2个月后,观察组PHN发生率低于对照组,差异均有统计学意义(P<0.05),观察组白细胞升高发生率高于对照组,差异有统计学意义(P<0.05),2组血压升高、血糖异常、肝功能异常、尿素氮升高、胃部不适及体质量增加的发生率比较差异均无统计学意义(P>0.05)。结论伐昔洛韦联合中等剂量泼尼松治疗无明显禁忌的中重度带状疱疹有较好疗效,且具有一定安全性,值得临床推广应用。

Objective To study the clinical effect of valaciclovir combined with moderate doses of prednisone in treatment of moderate to severe herpes zoster.Methods 124 patients with moderate to severe herpes zoster were randomly divided into observation group and control group,each of 62 cases.Control group was given valacyclovir for antiviral and nutritional neurotherapy,and observation group was treated with medium dose prednisone on the basis of control group.The pain digital score(NRS)score,pittsburgh sleep quality index(PSQI)score,blistering time,crusting time,incidence of postherpetic neuralgia(PHN)and adverse reactions were compared between two groups.Results There were no significant differences in NRS scores and PSQI scores between two groups before treatment(P>0.05).The NRS scores and PSQI scores of two groups were lower than those before treatment,and observation group was lower than control group;The days of blister stopping and blister absorption in the observation group were shorter than those in the control group;After 2 months of follow-up,the incidence of PHN in observation group was lower than that in control group,and the difference was statistically significant(P<0.05).The incidence of leukocyte elevation in observation group was higher than that in control group,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of elevated blood pressure,abnormal blood glucose,abnormal liver function,elevated urea nitrogen,stomach discomfort and body mass in two groups(P>0.05).Conclusion Valaciclovir combined with moderate dose of prednisone has good curative effect on moderate and severe herpes zoster with no obvious contraindication,and has a certain safety,worthy of clinical application.