半导体激光治疗带状疱疹疗效观察

目的观察半导体激光治疗带状疱疹的效果。方法将35例带状疱疹的患者在痛处进行半导体激光照射治疗。结果经过2个疗程的治疗,35例患者痊愈15例,显效17例,好转3例,无效0例,总有效率91.4%。结论半导体激光治疗带状疱疹效果明显且安全,值得临床进行推广。     

半导体激光治疗带状疱疹后遗神经痛

带状疱疹后遗神经痛（PHN）患者103例，均符合PHN后遗神经痛的诊断要点，男54例，女49例；年龄23—89岁；病程3d-5年；受累神经有肋间神经、腰骶神经、三叉神经及臂丛神经。101例患者分为激光组58例和对照组43例，2组一般资料比较差异无显著性意义。2组患者均口服复合VitB 20mg，3次／d，布洛芬胶囊0．3g，1次／也激光组同时配合半导体激光照射，患者取舒适位，     

半导体激光治疗枕大神经痛28例疗效观察

半导体激光治疗枕大神经痛２８例疗效观察韩玉芹郭其莲枕大神经痛是一种常见病，多发于女性，以自发性放射性或电击样痛为主要症状，发作时疼痛难忍，数秒钟或数分钟内可自行缓解，在数日或数月内反复发作。严重者影响工作和休息，临床科室多采用消炎镇痛类药物口服或痛...     

神经阻滞疗法控制带状疱疹疼痛的疗效观察

带状疱疹是一种以皮肤疱疹和局部剧烈疼痛为特征的病毒性疾患,多发生于中老年人及抵抗力低下的人群.皮肤损害一般在一月内康复,而疼痛可以持续数月到数年,形成后遗神经痛.大多数带状疱疹病人的日常生活、睡眠均受到疼痛的严重影响.     

刺络拔罐联合半导体激光治疗带状疱疹90例疗效观察

目的:观察刺络拔罐联合半导体激光治疗带状疱疹的疗效。方法:将150例带状疱疹患者随机分为治疗组与对照组。对照组60例给予口服泛昔洛韦、消炎痛,外用黄连炉甘石洗剂;治疗组90例在对照组治疗基础上,同时加用刺络拔罐联合半导体激光照射,1次/d。5d为1个疗程。结果:治疗组的止痛时间、止疱时间、结痂时间、总病程均短于对照组(P<0.05)。结论:刺络拔罐联合半导体激光治疗带状疱疹能明显提高疗效,降低后遗神经痛的发生率,安全可靠。     

伐昔洛韦联合半导体激光治疗带状疱疹的疗效

目的观察伐昔洛韦联合半导体激光治疗带状疱疹的疗效。方法将70例带状疱疹患者随机分为治疗组和对照组各35例。治疗组给予伐昔洛韦0．3g,bidpo,半导体激光照射受损的神经根部和皮损部位,疗程10d。对照组给予伐昔洛韦片0．3g,bidpo,疗程10d。结果治疗组总有效率显著高于对照组（91．4％VS71．4％,P〈0.01）;治疗组患者临床体征消退时间明显短于对照组（均P〈0．05）。结论伐昔洛韦联合半导体激光治疗带状疱疹优于单纯药物治疗,效果显著。     

氦氖激光治疗带状疱疹的疗效观察

目的：观察氦氖激光治疗带状疱疹的疗效。方法：280例带状疱疹患者随机分为观察组和对照组各140例,2组均给予常规抗病毒治疗,观察组加用氦氖激光治疗。结果：治疗10d后,2组患者简化McGill疼痛量表（SF-MPQ）评分均较治疗前明显下降（P＜0．05）,且观察组更低于对照组（P＜0．05）;观察组总有效率明显高于对照组（98．57％、87．86％,P＜0．05）。结论：氦氖激光结合抗病毒药物治疗带状疱疹,疗效较好,值得临床应用推广。     

半导体激光联合阿昔洛韦治疗带状疱疹疗效观察

目的:观察半导体激光联合阿昔洛韦治疗带状疱疹的临床疗效。方法:120例带状疱疹患者分为对照组60例,采用常规治疗;治疗组60例,采用常规治疗 激光照射治疗,比较两组疗效。结果:治疗组总有效率85%,对照组60%;治疗组疼痛减轻,水疱吸收皮损结痂时间均比对照组短,治愈率高,两组差异有统计学意义。结论:半导体激光治疗带状疱疹疗效较好。     

四物汤化裁治疗带状疱疹后遗神经痛疗效观察

目的:观察四物汤化裁治疗带状疱疹后遗神经痛临床疗效。方法:将100例患者随机分成2组各50例,治疗组运用四物汤化裁治疗;对照组运用维生素B1、维生素B12、芬必得口服治疗。2组治疗时间均为1周,3周后判定疗效。结果:2组治疗后与治疗前、治疗后不同阶段疼痛视觉模拟评分(VAS)平均积分比较均有显著性差异(P<0.01);治疗后1周和治疗后3周VAS平均积分组间比较均有显著性差异(P<0.01)。结论:四物汤化裁治疗带状疱疹后遗神经痛临床疗效优于单纯西医治疗。     

射频温控热凝术治疗带状疱疹后肋间神经痛的疗效观察

带状疱疹后肋间神经痛是有明显的带状疱疹病史后出现的肋间神经支配区疼痛综合征,临床特点为一个或几个肋间持续性疼痛,阵发性加重,呼吸、咳嗽可加剧,相应肋间出现皮肤感觉过敏和肋骨边缘压痛。1998—2011年我们采用     

七叶皂苷钠联合伐昔洛韦治疗中老年带状疱疹疗效观察

目的：探讨七叶皂苷钠联合伐昔洛韦治疗中老年带状疱疹的疗效。方法120例患者均为门诊或住院部中老年带状疱疹患者,将其随机分为A、B、C三组,每组40例。其中,A组采用基础治疗方案,即口服伐昔洛韦（每次0．3 g,每日2次）和甲钴胺（每次0．5 mg,每日3次）,外加莫匹罗星软膏每日2次外搽;B组和C组采用与A组相同治疗方案的同时,分别加用地塞米松（5 mg／d）或七叶皂苷钠（20 mg／d）静脉滴注治疗,3组疗程均为9 d。结果治疗后B组和C组疗效显著高于A组,比较差异有统计学意义（qA-B ＝3．72,P＜0．05和qA-C ＝3．51,P＜0．05）,而B组和C组间疗效比较差异无统计学意义（qB-C ＝1．29,P＞0．05）。治疗后B组和C组患者的疼痛缓解时间、止痛时间、结痂时间、VAS评分明显低于A组（P均＜0．01）,C组疼痛缓解时间低于B组,而B、C两组的止痛时间、结痂时间比较差异无统计学意义（P＞0．05）。C组患者疱疹后遗神经痛（PHN ）发生率显著低于A组,比较差异有统计学意义（χ2＝4．30,P＜0．017）。结论对中老年带状疱疹患者早期给予七叶皂苷钠治疗,不但可收到较好的疗效,而且可以减少PHN的发生,同时又能避免应用糖皮质激素可能产生的不良反应。     

神经阻滞治疗带状疱疹神经痛临床疗效观察

目的 探讨神经阻滞在治疗带状疱疹神经痛及带状疱疹后神经痛(PNH)中的临床疗效.方法 总结我院麻醉科疼痛病房2003年3月至2007年10月所收治的167例带状疱疹神经痛及PNH患者,比较单纯药物治疗与合用神经阻滞治疗后疼痛缓解程度(VAS评分),自觉疼痛缓解程度评分、睡眠受影响率、并发症发生情况.结果 167例患者中,带状疱疹神经痛组(85例)中,单纯药物治疗后,VAS评分降低(1.61±1.8)分,72%患者仍存在中～重度疼痛;合用神经阻滞治疗后,VAS评分降低(4.14±2.17)分,63%患者睡眠改善.PNH组(82例)中,单纯药物治疗后,VAS评分降低(1.21±0.96)分,85%患者仍存在中～重度疼痛;合用神经阻滞治疗后,VAS评分降低(4.21±1.77)分,55%患者睡眠改善.结论 神经阻滞治疗对带状疱疹神经痛及PNH均有疗效.     

影响皮神经阻滞技术治疗带状疱疹疗效的相关因素的分析研究

目的探讨影响皮神经阻滞技术治疗带状疱疹及预防远期后遗神经痛(PHN)效果的相关因素,为皮神经阻滞技术应用于社区医疗提供理论依据。方法对150例于疼痛科就诊的带状疱疹急性期患者应用皮神经阻滞技术进行治疗,采用前瞻性队列观察研究的方法,评价不同因素下的治疗效果。结果经治疗的150例带状疱疹患者中,PHN发生率为8%;疼痛的缓解程度与年龄、皮疹出现后治疗介入时间、皮损面积相关(P0.05),与性别无明显相关性(P0.05)。即:中青年、介入治疗时间早、皮损面积小的患者疼痛缓解程度更明显。结论皮神经阻滞技术对带状疱疹的治疗效果明确,针对特定人群的治疗效果更佳。应针对相关影响因素,对社区易感人群进行健康教育,促使患者提早就医;在治疗中,评估就诊患者的一般情况,在适宜的基础上早期应用皮神经阻滞技术治疗。     

Patient perspective on herpes zoster and its complications: an observational prospective study in patients aged over 50 years in general practice

Understanding the effect of herpes zoster and zoster-related pain should inform care to improve health-related quality of life in elderly patients. A 12-month, longitudinal, prospective, multicenter observational study conducted in primary care in France enrolled patients aged ?50 years with acute eruptive herpes zoster. Patient-reported zoster-related pain was assessed by validated questionnaires (Douleur Neuropathique en 4 Questions [DN4], Zoster Brief Pain Inventory [ZBPI], and Neuropathic Pain Symptom Inventory [NPSI]) on days 0 and 15, and at months 1, 3, 6, 9, and 12. Health-related quality of life was assessed by the 12-item short-form health survey (SF-12) and the Hospital Anxiety and Depression scale on day 0 and at months 3, 6, and 12. Of 1358 patients included, 1032 completed follow-up. Mean ± standard deviation age was 67.7 ± 10.7 (range, 50-95) years; 62.2% were women. Most patients (94.1%) were prescribed antiviral drugs. The prevalence of zoster-related pain on day 0 and at months 3, 6, 9, and 12 was 79.6%, 11.6%, 8.5%, 7.4%, and 6.0%, respectively. Patients with persistent pain had lower scores on the physical and mental component summaries of the SF-12 and the ZBPI interference score than those without pain. By logistic regression analysis, main predictive factors on day 0 for postherpetic neuralgia at month 3 were age, male sex, ZBPI interference score, Physical Component Summary score of the SF-12, and neuropathic quality of pain (DN4 score ?4). Despite early diagnosis and treatment with antiviral agents, many patients with herpes zoster experience persistent pain and marked long-term reduction in health-related quality of life.     

A randomized,placebo-controlled trial of oxycodone and of gabapentin for acute pain in herpes zoster

Although acute pain in patients with herpes zoster can be severe and has a substantial impact on health-related quality of life, there have been no randomized clinical trials of oral medications specifically for its ongoing treatment. A randomized clinical trial was conducted in which 87 subjects ?50 years of age with herpes zoster within 6 calendar days of rash onset and with worst pain in the past 24 h ? 3 on a 0–10 rating scale initiated 7 days of treatment with famciclovir in combination with 28 days of treatment with either controlled-release (CR) oxycodone, gabapentin, or placebo. Subjects were evaluated for adverse effects of treatment, acute pain, and health-related quality of life. The results showed that CR-oxycodone and gabapentin were generally safe and were associated with adverse events that reflect well-known effects of these medications. Discontinuing participation in the trial, primarily associated with constipation, occurred more frequently in subjects randomized to CR-oxycodone (27.6%) compared with placebo (6.9%). Treatment with CR-oxycodone reduced the mean worst pain over days 1–8 (p = 0.01) and days 1–14 (p = 0.02) relative to placebo but not throughout the entire 28-day treatment period as pain resolved in most subjects. Gabapentin did not provide significantly greater pain relief than placebo, although the data for the first week were consistent with a modest benefit. By demonstrating that CR-oxycodone is safe, generally adequately tolerated, and appears to have efficacy for relieving acute pain, the results of this clinical trial provide a foundation for evidence-based treatment for acute pain in herpes zoster.     

浮针埋线疗法对带状疱疹后遗神经痛疗效观察

目的观察浮针埋线治疗带状疱疹后遗神经痛的疗效和安全性。方法选择60例带状疱疹后遗神经痛患者,随机分为两组:浮针埋线组(n=32,以18G套管针在皮下运针并埋线治疗)和对照治疗组(n=28,将18G套管针置入皮下后,仅以采用相同运针手法进行治疗而不做皮下埋线)。分别在治疗前、治疗后3 d、7 d以及14 d对患者进行疼痛视觉模拟评分(VAS)、身体机能状态(PS)和患者满意度(PPS)评分及不良反应发生率等指标进行评价。结果与治疗前相比,浮针埋线组患者在接受治疗后各时点疼痛强度、身体机能状态和患者满意度评分呈明显下降(P<0.05);与对照治疗组相比,浮针埋线组患者治疗后各时点疼痛强度、身体机能状态和患者满意度评分亦呈明显下降(P<0.05~0.01)。不良反应:浮针埋线组及对照治疗组分别出现5例和1例皮下出血。结论浮针埋线疗法对患者疼痛程度和生活质量均有显著改善作用。     

B超引导下胸椎旁神经阻滞治疗急性带状疱疹肋间神经痛的研究

目的:探讨B超引导下胸椎旁神经阻滞在治疗急性带状疱疹肋间神经痛中的临床疗效。方法:80例胸背部急性带状疱疹伴肋间神经痛患者随机分为两组,每组各40例。A组(对照组)予常规抗病毒及按需口服镇痛药物治疗,B组(试验组)同时接受在B超引导下选择性胸椎旁神经阻滞治疗。观察治疗后7、14及30天两组患者疼痛视觉模拟评分(VAS)、辅助镇痛药用量、不良反应及后遗神经痛(PHN)发生率。结果:治疗后各观察时间点两组VAS评分均较治疗前降低(P0.009),组间比较差异显著,B组明显低于A组(P0.05)。辅助镇痛药物用量、PHN发生率B组亦显著低于A组(P0.05)。两组均无明显不良反应发生。结论:B超引导下胸椎旁神经阻滞联合抗毒治疗急性带状疱疹肋间神经痛安全有效,明显优于单纯药物治疗,并可减少后遗神经痛的发生率,值得临床推广应用。     

半导体激光联合更昔洛韦治疗带状疱疹对疼痛评分的影响

目的 探讨半导体激光联合更昔洛韦治疗带状疱疹对疼痛评分的影响.方法 58例带状疱疹患者分别采用半导体激光联合更昔洛韦及单纯更昔洛韦治疗,统计学分析比较治疗前后视觉模拟评分法(VAS)评分.结果 两组治疗后VAS评分较治疗前明显降低(P<0.05),其中半导体激光联合更昔洛韦治疗后VAS评分明显低于单纯阿昔洛韦治疗(P<...     

A prospective randomized comparison of the efficacy of standard antiviral therapy versus ultrasound-guided thoracic paravertebral block for acute herpes zoster

ObjectivesTo evaluate the effectiveness of repetitive thoracic paravertebral block (TPVB) under ultrasound (US) guidance for acute pain associated to herpes zoster (HZ) and its prophylactic effects on post-herpetic neuralgia (PHN).MethodsPatients who suffered from acute pain associated to HZ within 1 week of rash onset were randomized in a ratio of 1:1 to receive a seven-day course antiviral therapy, antiviral therapy with additional US-guided repetitive TPVB using transverse short axial (TSA) approach every 48 h for a week after antiviral therapy. All patients were allowed to receive rescue analgesics. The primary endpoint was HZ burden of illness (HZ-BOI) measured by a severity-by-duration composite pain assessment conducted 1-month post inclusion. Adverse events were also recorded.ResultsA total of 96 patients completed the entire 6-month follow-up. The BOI-30_AUC was 112.5 (95%CI: 105.2, 119.9) in control group, and 82.7 (95%CI: 75.4, 90.1) in TPVB group (F = 32.252, p<.001) at D30 after inclusion. Compared with control group, significant reductions of BOI-30–90_AUC, and BOI-90–180_AUC were observed in TPVB group (F = 11.392, p=.001 at D90; F = 7.467, p=.007 at D180, respectively). At 3 and 6 months after inclusion, the incidence of PHN in TPVB group was significantly lower than control group. Quality of life (QoL) in TPVB group also showed greater improvements at all the time points in all domains of EQ-5D-3L (p<.05). No serious adverse events were observed.ConclusionsUS-guided repetitive TPVB significantly reduced the HZ-BOI and the PHN incidence compared to antiviral therapy alone. It might be considered as an early intervention and preventive strategy to the development of PHN after acute HZ.

KEY MESSAGE

• This is a prospective randomized comparative study. We made a hypothesis that US-guided repetitive thoracic paravertebral block (TPVB) using a transverse short axial (TSA) approach to treat thoracic herpes zoster (HZ) in acute phase could reduce the burden of illness associated to acute pain. Moreover, this therapy might be a feasible preventive strategy to reduce the incidence of post-herpetic neuralgia.

     

系统性红斑狼疮合并带状疱疹病人的临床观察及护理

[目的]探讨系统性红斑狼疮（SLE）合并带状疱疹病人的临床表现,总结其护理措施。[方法]回顾性分析141例SLE合并带状疱疹病人的临床资料。[结果]本组SLE病人并发带状疱疹的发生率为18.6%,皮疹类型多为寻常型,其次为大疱型、出血型以及坏死型;皮损部位以腰腹部最常见,其次为胸背部、头面部、四肢以及会阴部;本组病人基本痊愈135例,遗留神经痛4例,由于SLE死亡2例。[结论]SLE病人易并发带状疱疹,以寻常型为主,并在腰腹部感染发生率较高;应了解病人的临床表现,采取针对性的护理措施。