泛昔洛韦治疗带状疱疹临床疗效观察

抗病毒药泛昔洛韦(FCV)因其服药次数少、用药量小、疗效高、安全可靠而被广泛用于临床。为进一步探讨该药的临床最小用量．我们应用不同剂量的泛昔洛韦治疗86例带状疱疹患者．以探讨该药的临床最小用量．现将结果报告如下。     

穿琥宁辅助治疗带状疱疹50例疗效观察

2004年9月-2005年12月,我科采用穿琥宁辅助治疗带状疱疹50例,疗效较好。现报告如下。     

中西药联用治疗老年寻常型带状疱疹疗效观察

带状疱疹是一种常见病毒性皮肤病 ,老年人患病局部疼痛明显 ,病程较长 ,易后遗神经痛 ,治疗甚为棘手。1999～ 2 0 0 1年 ,我们采用中西药联用治疗老年寻常型带状疱疹患者 46例 ,效果满意 ,现报告如下 :临床资料 :本组年龄 6 0～ 78岁 ,平均 6 9岁 ;发病时间 1～ 5天 38例 ,5～ 10天 8例。 46例均为寻常型 ,受累神经为颅神经 8例 ,颈神经 5例 ,胸神经 2 3例 ,腰神经 6例 ,骶神经 4例。主要临床表现为不同程度的全身不适、食欲不振、局部皮肤疼痛 ,疱疹发生后疼痛加剧 ,甚至影响睡眠。患者既往身体健康 ,无过敏史。治疗方法 :将地塞米松 10 mg…     

针灸拔罐治疗寒湿痹证152例疗效观察

2000-2005年，我采用针灸拔罐治疗寒湿痹证152例，效果较好。现报告如下。     

中医针灸治疗糖尿病周围神经病变患者的疗效观察

目的探讨研究中医治疗糖尿病周围神经病变患者的治疗效果。方法案例分析法。选取该院2011年6月—2013年9月收治的100例糖尿病周围神经病患者临床资料进行回顾性分析,将患者随机分为治疗组和对照组,每组各50例患者,观察患者治疗效果并进行统计分析。结果治疗组50例患者中在治疗之前出现四肢麻木症状者有40例,通过治疗之后症状改善者38例,总体有效率95%,对照组50例患者中治疗之前出现四肢麻木症状者有45例,治疗后症状改善者32例,有效率71.1%,两者之间差异有统计学意义(P<0.05);治疗组患者治疗之前出现感觉减退患者26例,治疗后症状改善者25例,有效率96.1%,对照组治疗前出现感觉减退患者23例,治疗后症状改善者13例,有效率56.5%,两者之间差异有统计学意义(P<0.05);治疗组治疗之前出现自发性疼痛患者42例,治疗后症状改善者40例,有效率95.2%,对照组治疗之前出现自发性疼痛患者41例,治疗后症状改善者26例,有效率63.4%,两者之间差异有统计学意义(P<0.05)。结论采用中医针灸治疗糖尿病周围神经病变有更好的疗效,可以显著改善患者临床症状,提升患者的生存质量,故值得在临床治疗当中进一步推广使用。     

紫外线负离子喷雾与创灼膏治疗带状疱疹122例疗效观察

1999年 1月～ 2 0 0 0年 7月 ,我院运用紫外线负离子喷雾联合普生创灼膏治疗带状疱疹 12 2例 ,并与用阿昔洛韦治疗患者进行对比。现报告如下。临床资料 :本组 (治疗组 ) 12 2例中 ,男 6 8例 ,女 5 4例 ;年龄 19～ 6 6岁 ;病程 1～ 9天 ,平均 4.1天。皮损分布于胸背部45例 ,腰腹部 37例 ,头颈部 12例 ,四肢 2 8例。另选取对照组78例 ,男 42例 ,女 36例 ;年龄 15～ 6 3岁 ,平均 2 9.5岁 ;病程1～ 10天 ,平均 4.7天。皮损分布于胸背部 2 9例 ,腰腹部 30例 ,头颈部 8例 ,四肢 11例。所有病例均有沿周围神经单侧分布的集簇疱疹和神经疼痛。两组的…     

喷昔洛韦治疗带状疱疹后遗神经痛40例疗效观察

带状疱疹是由水痘—带状疱疹病毒感染所致,神经痛是其主要特征之一。带状疱疹后遗神经痛多发于中、老年人,神经痛症状在皮肤病变愈合后可持续数周或数月。2008年10月～2010年10月,我们采用喷昔洛韦治疗带状疱疹后遗神经痛患者40例,取得满意疗效。现报告如下。     

梅花针叩刺配合局部拔火罐治疗带状疱疹132例疗效观察

2006年5月～2008年3月,我们用梅花针叩刺配合局部拔火罐治疗带状疱疹132例取得较满意的疗效。现报告如下。     

阿昔洛韦联合UVN-3型光疗机治疗带状疱疹疗效观察

1997年 12月至 2 0 0 0年 12月 ,我科采用阿昔洛韦联合UVN- 3型光疗机治疗带状疱疹 ,取得满意疗效 ,现报告如下。临床资料 :观察患者 3 2 4例 ,均有典型的带状疱疹症状和体征。随机分为两组 ,观察组 2 3 8例 ,男 12 8例 ,女 110例 ;年龄 9～ 80岁 ;病程 2～ 11天。皮疹位于三叉神经区 5 7例 ,肋间神经区 10 8例 ,腰骶神经区 63例 ,臂丛神经区 10例。对照组86例 ,男 46例 ,女 40例 ;年龄 12～ 77岁 ;病程 2～ 12天。皮疹位于三叉神经区 19例 ,肋间神经区 3 3例 ,腰骶神经区 2 2例 ,臂丛神经区 12例。两组资料无显著性差异。治疗方法 :观察…     

紫草油外敷结合TDP治疗带状疱疹的疗效观察

目的：探讨紫草油外敷结合TDP照射治疗带状疱疹的临床效果.方法：评估患者皮肤受损情况,外敷紫草油后结合TDP照射治疗,每日1~3次,7d为1疗程.结果：通过采取一系列的护理措施,经过1个疗程的治疗后,患者的疱疹创面愈合,疼痛减轻.结论：紫草油外敷结合TDP治疗带状疱疹效果较好,值得推广应用.     

微波联合七叶皂苷钠治疗中老年带状疱疹的临床疗效观察

目的 观察微波联合七叶皂苷钠对中老年带状疱疹的治疗效果。方法 选择2018年9月至2022年3月中国人民解放军63750部队医院收治的带状疱疹患者120例,采用随机数字表法将其分为观察组和对照组,每组60例。对照组接受抗病毒、营养神经治疗。观察组在对照组治疗方案基础上给予微波联合七叶皂苷钠治疗。于治疗前和治疗后第1、2周对两组进行皮肤病生活质量指数(DLQI)、数字评定量表(NRS)和语言描述分级量表(VRS)评分,比较两组疼痛缓解时间、结痂时间、皮损消退时间以及后遗神经痛(PHN)发生率。结果 经治疗后,两组DLQI、NRS、VRS评分均较治疗前下降,且观察组评分下降幅度更大(P<0.05)。在治疗后第1、2周,观察组DLQI、NRS、VRS评分均低于对照组,差异有统计学意义(P<0.05)。观察组疼痛缓解时间、疱疹结痂时间、皮损消退时间均短于对照组,差异有统计学意义(P<0.05)。在皮损消退后4周,对照组有6例(10.00%)发生PHN,观察组有2例(3.33%)发生PHN,两组PHN发生率比较差异无统计学意义(χ²=1.205,P=0.2...     

Epidemiology and clinical characteristics of herpes zoster in a tertiary care hospital in Brazil

BackgroundThere is little information on herpes zoster from hospital registries in South America. The aim of this study was to describe the epidemiological and clinical aspects of herpes zoster (HZ) in hospitalized patients.’MethodsWe searched for hospital-based records during the period from March 2000 to January 2017 in a 700-bed tertiary-care hospital located in southern Brazil. The medical records of all eligible patients were reviewed, and data regarding demographics, medical history, clinical and laboratory characteristics, treatment regimens, and clinical outcomes were collected. Patients were also evaluated for mortality.ResultsThere were 801 records of herpes zoster according to the proposed criteria. Most patients with HZ presented a cutaneous clinical form of the disease with involvement of a single dermatome (n = 589, 73.5%). Additional clinical characteristics included postherpetic neuralgia (22.1%), ophthalmic HZ (7.6%) and meningoencephalitis (2.7%). Most patients presented immunocompromised conditions (64.9%) including HIV, administration of immunosuppressive agents, and malignant neoplasms. During this period, there were 105 (13.1%) deaths, which were mostly unrelated to HZ. Five deaths were related to HZ meningoencephalitis.ConclusionThe results of this study demonstrate a high burden of HZ disease in a Brazilian tertiary care hospital in the HZ vaccination era. Awareness of the incidence and comorbidity factors associated with HZ in Latin American countries such as Brazil contribute for adoption and implementation of strategies for immunization in this area.     

老年患者带状疱疹神经痛的临床治疗研究

目的通过评估刺血拔罐对不同年龄段急性期带状疱疹治疗的临床效果,为老年患者带状疱疹神经痛的治疗提供有效的治疗方案。方法按照不同年龄段,将67例患者分为两组：老年组37例,60～90岁;中青年组30例,28-59岁。每组再随机分为两个亚组,老年治疗组（n=19,A组）和老年对照组（n=18,B组）;中青年治疗组（n=15,C组）和中青年对照组（n=15,D组）。治疗组采用药物、刺血拔罐治疗,对照组采用药物、神经阻滞治疗。采用VAS评分对疼痛程度进行评估。结果治疗前A组、B组、C组、D组的VAS分别为：7．66±1．13、7．94±1．11、8．00±1．16和7．97±1．12;治疗5W后,4组的VAS分别为：1．53±0．81、2．50±0．73、1．30±0．82和1．63±0．83。老年带状疱疹患者采用刺血拔罐配合药物的综合治疗疗效与中青年患者相比,差异无统计学意义;治疗3W后,中青年患者神经阻滞治疗疗效优于老年患者。结论临床上可根据患者的年龄和病情,选用不同的方法进行治疗,对老年带状疱疹神经痛患者来说,刺血拔罐治疗疗效更好。     

单倍型相合骨髓移植后带状疱疹并发症的临床观察

目的:观察单倍型相合骨髓移植后带状疱疹发病情况、诊治及预后.方法:对单倍型相合骨髓移植后带状疱疹的发生时间、临床表现、治疗及预后进行总结分析.结果:可评估的120例接受单倍型相合骨髓移植患者中有17例并发带状疱疹,发病率14.1%,其中14例发生在移植后6个月内.10例发生过急性移植物抗宿主病(aGVHD),临床主要表现为区域性皮肤疱疹.15例接受阿昔洛韦静脉滴注治疗,2例阿昔洛韦片口服治疗.平均治疗时间为18.5 d,全部治愈.5例出现严重疱疹后神经痛,需强效止痛,无泛发性疱疹及内脏受累病例,无疱疹相关死亡.结论:带状疱疹是单倍型相合骨髓移植后常见的病毒感染性疾病,主要发生在骨髓移植术后6个月内免疫功能低下阶段,阿昔洛韦治疗有较好疗效,预后良好.     

A case report of abdominal distention caused by herpes zoster

Gastrointestinal complications caused by herpes zoster are extremely rare. Here, we described a case of abdominal distention caused by herpes zoster. The patient was a 59-year-old female who suffered from unexplained paroxysmal and a burning pain on the right part of her waist and abdomen, accompanied by abdominal distention. Intestinal pseudo-obstruction was diagnosed by abdominal radiography. Distention of the right abdominal wall was still apparent after one month. In this report, we found that recovery from abdominal distention caused by herpes zoster is difficult and may require surgical intervention.     

Facial herpes zoster complicated by varicella zoster virus (VZV) encephalitis: The diagnostic significance of atypical lymphocytes in cerebrospinal fluid (CSF)

Background

In general, viral infections of the central nervous system (CNS) manifest as encephalitis and, less commonly, as meningoencephalitis or aseptic meningitis. Varicella zoster virus (VZV) is an uncommon cause of encephalitis.

Methods

Herpes zoster (shingles) is a cutaneous reactivation of previous chickenpox infection due to VZV. Herpes zoster may be dermatomal (ie, <3 dermatomes) or disseminated (ie, >3 dermatomes). Decreased cell-mediated immunity from stress, steroids, or immunosuppressive drugs often precede dermatomal/disseminated herpes zoster. With herpes zoster, the closer the dermatomal involvement is to the CNS (ie, head/neck shingles), the more likely a patient will have symptomatic CNS involvement (eg, encephalitis). Except for the association of the herpes zoster rash and the simultaneous/subsequent encephalitis, there are few clinical features that distinguish VZV encephalitis from that due to other viruses. The cerebrospinal fluid (CSF) profile of VZV encephalitis is usually clinically indistinguishable from that due to of other causes of viral encephalitis. In VZV meningoencephalitis or encephalitis, the CSF typically shows a modest lymphocytic pleocytosis with normal CSF glucose levels, variably elevated CSF protein levels, and normal CSF lactic acid levels. Atypical lymphocytes are rare in the CSF with VZV encephalitis.

Results

We present the case of a 75-year-old woman who developed VZV encephalitis after having herpes zoster on her forehead. Except for facial herpes zoster, there were no clinically distinguishing features to determine the cause of her encephalitis. Her CSF had 800 white blood cells/high power field with 26% lymphocytes (17% atypical lymphocytes). The patient’s CSF glucose and CSF lactate dehydrogenase levels were normal, and her CSF protein was elevated. The CSF lactic acid was minimally elevated secondary to red blood cells in the CSF. Electroencephalogram showed general background slowing bilaterally, typical of viral encephalitis. The absence of unilateral focal frontotemporal/parietal lobe focus on electroencephalogram argued against the diagnosis of herpes simplex encephalitis. CSF atypical lymphocytes provided the key clue to the etiology of her encephalitis. CSF atypical lymphocytes are not uncommon in Epstein-Barr virus or cytomegalovirus encephalitis. Less commonly, atypical lymphocytes may be present in the CSF with enteroviruses, West Nile encephalitis, and Japanese encephalitis. VZV is a rare cause of atypical lymphocytes in the CSF but was the clue to the diagnosis before CSF polymerase chain reaction results for VZV were available. Her CSF polymerase chain reaction was negative for Mycobacterium tuberculosis, herpes simplex virus, human herpesvirus-6, cytomegalovirus, enteroviruses, and West Nile virus, but was positive for VZV. She made an uneventful recovery with acyclovir.

Conclusion

CSF atypical lymphocytes, if present, are an important diagnostic clue in some causes of viral encephalitis. The most common cause of nonseasonal viral encephalitis is herpes simplex virus, which is not associated with CSF atypical lymphocytes. Patients with Epstein-Barr virus, cytomegalovirus, West Nile encephalitis, and enteroviruses usually have extra-CNS signs and symptoms which should suggest the cause of the patient’s encephalitis. CSF atypical lymphocytes limit the differential diagnostic possibilities in patients with viral encephalitis and may be the key clue to the diagnosis, as in the case presented.     

老年带状疱疹患者急性期T细胞亚群变化及其与疱疹相关性疼痛的关系

目的 检测老年带状疱疹患者急性期外周血T细胞亚群水平,观察患者急性期机体细胞免疫状态与带状疱疹急性期疼痛(AHP)和后遗神经痛(PHN)的关系。 方法 选择急性期老年带状疱疹患者60例,根据AHP视觉模拟评分(visual analogue scales,VAS)分为轻中度AHP组：VAS评分≤6分,重度AHP组：VAS评分＞6分;再根据随访结果是否发生带状疱疹后PHN分为非PHN组和PHN组。选取年龄、性别相匹配的门诊健康体检者25例作为对照组。记录患者AHP最严重时VAS评分,采用流式细胞测定技术测定急性期外周血T细胞亚群CD3+、CD4+和CD8+百分比及计算CD4 +/CD8+比值。 结果 各组年龄、性别差异无统计学意义(P＞0.05);轻中度AHP组、重度AHP组、非PHN组和PHN组CD3+、CD4+、CD8+表达与对照组比较均降低(P＜0.05),重度AHP组CD4+表达低于轻中度AHP组(P＜0.05) ;CD4 +/CD8+比值轻中度AHP组、非PHN组均高于对照组(P＜0.05),重度AHP组低于轻中度AHP组(P＜0.05),PHN组低于非PHN组(P＜0.05);PHN组AHP VAS评分高于非PHN组(P＜0.05)。 结论 老年带状疱疹患者急性期普遍存在细胞免疫功能低下,表现为T细胞亚群百分比降低;重度AHP患者细胞免疫状态更低。PHN患者在疱疹急性期存在更严重的局部损害和更低下免疫应答。     

Incidence of herpes zoster in Japanese patients with rheumatoid arthritis from 2005 to 2010

Abstract

Objective. To clarify the incidence and the risks of herpes zoster infection in Japanese patients with rheumatoid arthritis (RA).

Methods. By using a self-report of occurrence of herpes zoster in patients with RA in a large observational cohort study from 2005 to 2010, the standardized incidence rate was calculated. A Cox model was used to analyze risk factors for occurrence of herpes zoster.

Results. A total of 7,986 patients (female 83.1%) accumulated 30,140 patient-years of observation, and 366 events were confirmed. The standardized incidence rate per 1,000 patient-years was 9.1 (95% confidence interval (CI) 6.2–12.9) in total, 7.8 (3.6–14.8) in men, and 10.3 (6.8–15.0) in women. The risk factors for herpes zoster were age [/10 years: Hazard ratio (HR) 1.268, 95% CI 1.153–1.393, p < 0.0001), high disease activity compared with remission (HR 1.642, 95% CI 1.067–2.528, p < 0.05), prednisolone (< 5 mg/day compared with 0 mg/day: HR 1.531, 95% CI 1.211–1.936, p < 0.001; ≥ 5 mg/day compared with 0 mg/day: HR 1.471, 95% CI 1.034–2.093, p < 0.05), and methotrexate (HR 1.382, 95% CI 1.076–1.774, p < 0.05).

Conclusion. This study quantified the historical incidence and risk for herpes zoster in Japanese RA patients, and is a benchmark for future studies.     

更改交谈方式在原发性肝癌合并带状疱疹患者中的应用效果*

目的 探讨采用更改交谈方式对原发性肝癌（PLC）合并带状疱疹患者生活质量、个人独立性及对护理满意度的影响。方法 2014年1月~2016年12月在我院接受治疗的144例PLC合并带状疱疹患者,采用随机数字表法分为对照组72例和观察组72例,分别给予常规交谈干预方案或更改交谈方式护理干预。采用改良生活质量测定量表行生活质量评分。采用ADL个人生活能力指数评价量表行个人生活能力评价,采用改良的护理满意度评价量表行护理满意度调查。结果 干预4周后,观察组患者生活质量总分为（93.7±3.9）分,显著高于对照组的（67.9±3.3）分（P<0.05）;观察组个人生活能力指数为90.3%,显著高于对照组的76.4%（P<0.05）;观察组护理满意度总分为（55.5±2.8）分,明显高于对照组的（37.5±2.5）分（P<0.05）。结论 采用更改交谈方式进行护理干预能够有效提高PLC合并带状疱疹患者生活质量和个人生活能力,较大程度地提高其对护理的满意度。     

慢性阻塞性肺疾病急性加重期住院患者继发带状疱疹22例临床分析

目的 探讨慢性阻塞性肺疾病急性加重(AECOPD)患者住院期间继发带状疱疹(HZ)的临床特征、诊断、治疗及转归.方法 回顾2008年8月至2011年7月AECOPD患者住院期间继发HZ的住院病历.结果 AECOPD住院患者中HZ发病率为0.44％(22/4276患者),男19例,年龄(69.5±7.79)岁,FEV1...