窄谱中波紫外线照射联合药物治疗预防老年带状疱疹后遗神经痛的临床观察

目的评价窄谱中波紫外线（NB-UVB）照射联合药物治疗在预防老年带状疱疹后遗神经痛（PHN）中的临床疗效。方法将80例老年带状疱疹随机分为常规组和联合组,常规组给予阿昔洛韦缓释片0．2g,3次／d,维生素B1、维生素B12口服,内服泼泥松15～30mg,1次／d,局部外用阿昔洛韦软膏。联合组给予常规药物治疗的同时再联合NB-UVB照射,隔日1次,观察并记录2组的疼痛评分及疗效。结果治疗后3个月常规组和联合组平均积分分别为63．29分和15．43分,2组相比差异有显著性意义（P〈0．05）。联合组神经痛发生率以降低与常规组相比较差异有显著性（P〈0．01）。结论窄谱中波紫外线照射联合药物预防老年带状疱疹后遗神经痛的治疗效果满意,在临床上可广泛应用。     

阿昔洛韦联合小剂量糖皮质激素治疗30例带状疱疹

目的:探讨阿昔洛韦联合小剂量皮质激素治疗带状疱疹的疗效及预防后遗神经痛的效果。方法:采用随机对照分组,以阿昔洛韦联合强的松治疗带状疱疹30例为观察组,单纯使用阿昔洛韦治疗带状疱疹30例为对照组,进行对比观察。结果:观察组在止疱、止痛、结痂、痊愈的时间及预防后遗神经痛上优于对照组。结论:早期应用阿昔洛韦联合皮质激素治疗带状疱疹疗效确切、病程短,同时可降低后遗神经痛的发生率。     

老年带状疱疹早期综合治疗分析

目的观察采用阿昔洛韦联合泼尼松、VitB12等治疗老年带状疱疹的临床疗效。方法对2003年6月至2007年10月,病期4 d内的126例老年带状疱疹患者,随机分两组,综合治疗组以阿昔洛韦联合泼尼松治疗,对照组仅以阿昔洛韦治疗,观察治疗1个疗程（15 d）后带状疱疹的临床转归,并进行3个月以上随诊观察。结果综合治疗组及对照组治疗总有效率分别为93.65%和79.37%（P〈0.05）,后遗神经痛发生率为9.52%和26.98%（P〈0.05）。结论对老年性带状疱疹患者,早期采用阿昔洛韦联合小剂量泼尼松治疗有利于提高疗效,降低后遗症发生率。     

炎琥宁联合阿昔洛韦治疗带状疱疹疗效观察

目的：观察炎琥宁联合阿昔洛韦治疗带状疱疹临床疗效。方法：88例带状疱疹患者随机分为两组,炎琥宁与阿昔洛韦合用为联合组,单用阿昔洛韦为对照组,于治疗后30 d观察记录治疗效果。结果：联合用药组与对照组比较在痊愈率及后遗神经痛发生率均有统计学差异,两组均无发生不良反应。结论：炎琥宁联合阿昔洛韦治疗带状疱疹疗效好,缩短病程并能降低后遗神经痛的发生,值得临床上应用。     

He-Ne激光联合阿昔洛韦治疗带状疱疹疗效观察

目的：观察He-Ne激光联合阿昔洛韦治疗带状疱疹的效果。方法：用He—Ne激光联合阿昔洛韦治疗54例带状疱疹（治疗组）．并与单用阿昔洛韦治疗52例带状疱疹患者（对照组）作疗效比较。结果：两组痊愈率和有效率比较（42．6％vs13．5％，92．6％vs63．5％），差异有显著性（均P〈0．01）；治疗组的皮疹愈合、止痛及结痂时间比对照组明显缩短（P〈0．01）。结论：用He-Ne激光联合阿昔洛韦治疗带状疱疹起效快．疗程短，疗效较好。     

窄谱中波紫外线联合阿昔洛韦治疗带状疱疹疗效观察

目的探讨窄谱中波紫外线(NB-UVB)联合阿昔洛韦治疗带状疱疹的疗效。方法将76例带状疱疹患者按治疗方法不同分为对照组和治疗组各38例,对照组给予阿昔洛韦治疗,治疗组在对照组基础上加用NB-UVB照射治疗,观察两组治疗后疗效。结果对照组和治疗组总有效率分别为71.05%和97.37%,治疗组疗效显著优于对照组;治疗组止疱时间、皮损结痂、痂皮脱落时间均明显短于对照组,后遗神经痛的发生率显著低于对照组(P<0.05)。结论 NB-UVB联合阿昔洛韦可显著提高带状疱疹患者的临床疗效,缩短病程,减少后遗神经痛的发生率,值得推广应用。     

中西医结合治疗老年带状疱疹的疗效观察及护理

目的观察中西医结合综合疗法对老年带状疱疹患者的临床疗效。方法对87例老年带状疱疹患者随机分为治疗组44例和对照组43例。对照组采用口服更昔洛韦胶囊，每次0．5g（0．25g／片），每日3次。同时配合局部皮肤氦氖激光照射治疗，每日1次，每次20min。治疗组在对照组治疗的基础上加服中药方自拟清血汤。两组均以7d为1疗程，2个疗程后进行疗效评定。结果清血汤联合阿昔洛韦、氦一氖激光照射以及良好的护理治疗带状疱疹，其疗效明显优于对照组，可以达到缩短病程、减轻痛苦、减少不良反应和后遗神经痛之目的。结论中西医结合治疗老年带状疱疹疗效满意。     

2型糖尿病合并带状疱疹神经痛患者红光照射联合药物治疗的效果观察

目的：探讨红光照射联合药物治疗2型糖尿病合并带状疱疹神经痛患者的临床效果。方法将100例糖尿病合并带状疱疹神经痛患者按入院时间先后顺序随机分为观察组和对照组各50例。对照组遵医嘱采用阿昔洛韦治疗及专科护理干预,观察组在对照组治疗的基础上加用红光照射,7 d为1个疗程,2个疗程结束时比较两组的平均止疱时间、结痂时间、疼痛缓解时间、疼痛基本消失时间和临床疗效。结果观察组的平均止疱时间、结痂时间、疼痛缓解时间、疼痛基本消失时间均较对照组缩短（P<0.05）;观察组临床疗效明显好于对照组（P<0.05）。结论2型糖尿病合并带状疱疹神经痛患者在药物治疗及护理干预的基础上,增加红光照射,疗效显著。     

激光点灼治疗带状疱疹的效果

目的探讨激光点灼治疗带状疱疹的效果。方法急性带状疱疹病人62例，随机分为2组。A组32例，给予激光点灼＋阿昔洛韦治疗；B组30例，给予阿昔洛韦＋可由软膏治疗。比较两组疼痛减轻时间、皮疹结痂时间、痊愈时间及有无遗留带状疱疹后神经痛。结果A组疼痛减轻时间、结痂时间及痊愈时间较B组明显缩短（t＇=284．0、265．2、165．4．P〈0．01）．无遗留神经痛。结论激光点灼治疗带状疱疹安全，操作简单，无副作用，可明显缩短疗程。     

紫外线联合中频电治疗带状疱疹神经痛的疗效观察

目的观察紫外线联合中频电治疗带状疱疹的疗效.方法带状疱疹得42例,分为治疗组和对照组,治疗组用紫外线联合中频电治疗;对照组用抗病毒口服液和阿昔洛韦.结果两组疗效相比,治愈率有显著性差异(P<0.05),治疗组疗效明显优于对照组.结论紫外线联合中频电治疗带状疱疹,能够迅速地消除神经痛,明显缩短了病程.     

Treatment of herpes zoster and postherpetic neuralgia.

Herpes zoster results from reactivation of latent varicella-zoster virus. It is most common in elderly patients and immunosuppressed patients, especially those with human immunodeficiency virus (HIV) infection. Zoster is often the earliest indicator of HIV infection. The acute course of herpes zoster is generally benign, but systemic complications may be fatal. Postherpetic neuralgia is the major chronic complication and is a difficult management problem. High-dose acyclovir (800 mg orally five times daily) has recently been approved for treatment of herpes zoster and, if started early, decreases the duration and severity of symptoms. In the prevention of postherpetic neuralgia, acyclovir does not appear to be effective, and the efficacy of steroids is questionable. The best therapy currently available for postherpetic neuralgia is amitriptyline, topical capsaicin and transcutaneous electrical stimulation.     

Management of herpes zoster (shingles) and postherpetic neuralgia

Herpes zoster (commonly referred to as "shingles") and postherpetic neuralgia result from reactivation of the varicella-zoster virus acquired during the primary varicella infection, or chickenpox. Whereas varicella is generally a disease of childhood, herpes zoster and post-herpetic neuralgia become more common with increasing age. Factors that decrease immune function, such as human immunodeficiency virus infection, chemotherapy, malignancies and chronic corticosteroid use, may also increase the risk of developing herpes zoster. Reactivation of latent varicella-zoster virus from dorsal root ganglia is responsible for the classic dermatomal rash and pain that occur with herpes zoster. Burning pain typically precedes the rash by several days and can persist for several months after the rash resolves. With postherpetic neuralgia, a complication of herpes zoster, pain may persist well after resolution of the rash and can be highly debilitating. Herpes zoster is usually treated with orally administered acyclovir. Other antiviral medications include famciclovir and valacyclovir. The antiviral medications are most effective when started within 72 hours after the onset of the rash. The addition of an orally administered corticosteroid can provide modest benefits in reducing the pain of herpes zoster and the incidence of postherpetic neuralgia. Ocular involvement in herpes zoster can lead to rare but serious complications and generally merits referral to an ophthalmologist. Patients with postherpetic neuralgia may require narcotics for adequate pain control. Tricyclic antidepressants or anticonvulsants, often given in low dosages, may help to control neuropathic pain. Capsaicin, lidocaine patches and nerve blocks can also be used in selected patients.     

老年带状疱疹后遗神经痛病人多维度协同护理效果观察

[目的]观察多维度协同护理在老年带状疱疹后遗神经痛病人中的应用效果。[方法]将84例带状疱疹后遗神经痛老年病人按照住院尾号单双号分为对照组(40例)和观察组(44例),对照组接受常规护理,观察组接受多维度协同护理干预,干预后对两组病人的焦虑、抑郁、疼痛情况及护理效果进行比较。[结果]干预后观察组病人焦虑与抑郁评分、疼痛评分均低于对照组,临床护理总有效率高于对照组,经比较差异均有统计学意义(P均0.05)。[结论]对带状疱疹后遗神经痛老年病人实施多维度协同护理,有利于改善病人的负性情绪,降低疼痛程度,提高临床护理疗效。     

Acyclovir and postherpetic neuralgia

Studies have demonstrated the benefit of acyclovir, given intravenously or orally, on the acute illness in herpes zoster (HZ). Whether or not such treatment influences the subsequent development of postherpetic neuralgia (PHN) has been the subject of recent controversy. Intravenous acyclovir has not been shown to influence PHN significantly in prospective studies. Oral acyclovir in large doses may reduce PHN during the 3 months after acute HZ, but this effect has not been observed consistently in well-designed studies. From 3 months onwards, no trial has demonstrated a significant effect of oral acyclovir in reducing PHN. The way forward is discussed.     

Herpes zoster: medical and nursing management

Herpes zoster, the latent descendent of the varicella zoster virus, commonly is seen in clinical practice. Healthcare providers must recognize and treat the virus to decrease the incidence of postherpetic neuralgic pain syndrome. Treatment with an antiviral medication regimen should be initiated rapidly for patients who have had lesions for up to 72 hours. Acyclovir has been the treatment of choice for herpes zoster in the past, but newer drugs, such as valacyclovir, a prodrug of acyclovir, and famciclovir, are as effective for treating the virus and have more convenient dosing regimens and decreased incidence of postherpetic neuralgia.     

Herpes zoster and postherpetic neuralgia: prevention and management

Herpes zoster (shingles) is diagnosed clinically by recognition of the distinctive, painful vesicular rash appearing in a unilateral, dermatomal distribution. An estimated 1 million cases occur in the United States each year, and increasing age is the primary risk factor. Laboratory testing, including polymerase chain reaction, can confirm atypical cases. Treatment with acyclovir, famciclovir, or valacyclovir decreases the duration of the rash. Adjunct medications, including opioid analgesics, tricyclic antidepressants, or corticosteroids, may relieve the pain associated with acute herpes zoster. There is conflicting evidence that antiviral therapy during the acute phase prevents postherpetic neuralgia. Postherpetic neuralgia in the cutaneous nerve distribution may last from 30 days to more than six months after the lesions have healed. Evidence supports treating postherpetic neuralgia with tricyclic antidepressants, gabapentin, pregabalin, long-acting opioids, or tramadol; moderate evidence supports the use of capsaicin cream or a lidocaine patch as a second-line agent. Immunization to prevent herpes zoster and postherpetic neuralgia is recommended for most adults 60 years and older.     

神经妥乐平治疗带状疱疹后遗神经痛的临床研究

目的:研究神经妥乐平治疗带状疱疹后遗神经疼痛的疗效、方法和安全性.方法:将患者随机分为对照组和神经妥乐平不同剂量组(3.8u/日,10.8u/日),疗程14天.结果:神经妥乐平使带状疱疹后遗神经痛明显改善,并具有快速起效、长时间止痛作用.尤其神经妥乐平10.8u/日组,疗效显著.结论:神经妥乐平是治疗带状疱疹后遗神经痛有效和安全药物.     

阿片类药物在慢性非癌性疼痛中的应用

目的:回顾性分析卡马西平和加巴喷丁治疗原发性三叉神经痛、带状疱疹以及带状疱疹后遗神经痛的疗效、安全性和不良反应。方法:102位患者进入本研究,比较卡马西平或加巴喷丁治疗前后患者疼痛强度的改变和对睡眠影响的改善;依据药物分类,比较两种药物的副作用和不良反应。结果:卡马西平治疗原发性三叉神经痛起效较加巴喷丁快,二者长期疗效相当;加巴喷丁治疗带状疱疹和带状疱疹后神经痛的疗效优于卡马西平;疗效随治疗时间的延长而增加。卡马西平的副作用和不良反应事件发生率较加巴喷丁高。结论:抗癫痫药物卡马西平和加巴喷丁是治疗神经病理性疼痛的有效药物,可以改善患者的睡眠,但副作用和不良反应发生率高。