伐昔洛韦片治疗带状疱疹临床疗效观察

目的:评价伐昔洛韦片(维德思)治疗带状疱疹的临床疗效.方法:将入选患者随机分为两组,实验组患者给予伐昔洛韦片口服,1 g/d,每日3次;对照组患者给予阿昔洛韦片口服,0.2 g/d,每日5次.疗程均为7 d,并于用药后观察记录临床症状和体征改善情况.结果:实验组的平均止痛、止疱、结痂时间均比对照组短,实验组有效率为93.4%,对照组有效率为49.2%,两组有效率比较,差异有显著性意义(P<0.01).实验组1例,对照组4例在治疗过程中出现轻度不良反应.结论:伐昔洛韦片治疗带状疱疹疗效好,不良反应少,是治疗带状疱疹安全有效的药物.     

威伐光联合伐昔洛韦治疗带状疱疹的疗效观察

目的 观察带状疱疹患者采取威伐光联合伐昔洛韦治疗的疗效.方法 抽取某医院2018年1月至2019年3月就诊的90例带状疱疹患者纳入研究,将其随机分组分为对照组及观察组,对照组采取常规治疗措施(盐酸伐昔洛韦分散片),观察组在对照组的基础上加用威伐光照射治疗,观察治疗后两组患者的疗效、止痛时间等指标.结果 观察组患者有效率...     

海特光联合伐昔洛韦治疗带状疱疹疗效观察

目的观察海特光联合伐昔洛韦治疗带状疱疹的临床疗效。方法对照组52例,口服伐昔洛韦0.3,2次/d共7天。治疗组52例,口服药物同对照组,同时予海特光局部照射,1次/d,每次30min,5天为一疗程,用药后第1、3、5、7、14天观察疗效和不良反应。结果治疗组有效率94.23%,对照组有效率70.12%,治疗组在止痛、止疱、结痂时间均明显优于对照组,两组有效率差异有统计学意义(P0.05)。结论海特光联合伐昔洛韦治疗带状疱疹有较好的疗效。     

伐昔洛韦治疗严重带状疱疹

1998年1月至2001年12月,我们应用四川明欣药业有限公司生产的盐酸伐昔洛韦治疗严重带状疱疹。取得较好疗效,现报道如下。     

盐酸伐昔洛韦治疗带状疱疹临床疗效观察

目的:评价盐酸伐昔洛韦治疗带状疱疹的临床疗效。方法:将入选患者随机分为两组,治疗组患者给予盐酸伐昔洛韦0.3g,每日2次口服;对照组患者给予阿昔洛韦0.2g,每日5次口服。疗程均为10d,并于用药后观察记录临床症状和体征改善情况。结果:盐酸伐昔洛韦的平均止痛、止疱、结痂时间均比阿昔洛韦短,治疗组有效率为91.4%,对照组有效率为54.3%,两组有效率比较,差异有显著性意义(P0.01)。结论:盐酸伐昔洛韦治疗带状疱疹疗效好,不良反应少,是一个安全有效的药物。     

微波联合伐昔洛韦治疗带状疱疹疗效观察

我科自2004年5月开始用微波照射联合伐昔洛韦（商品名：丽珠威，丽珠集团丽珠制药厂生产）治疗带状疱疹，并取得了满意的效果，现将结果报道如下。     

伐昔洛韦联合加巴喷丁治疗带状疱疹急性期神经痛的疗效观察

目的观察伐昔洛韦联合加巴喷丁治疗带状疱疹急性期神经痛的临床疗效。方法65例急性期带状疱疹患者随机分为治疗组（33例）及对照组（32例）。所有患者均给予伐昔洛韦、甲钴胺胶囊及维生素B1治疗,治疗组同时加用加巴喷丁。采用视觉模拟评分法（VAS）评价患者治疗前、治疗后1、2、4周疼痛程度及治疗效果,同时观察患者的不良反应。治疗结束后,随访4个月。结果治疗组VAS评分及带状疱疹后遗神经痛（PHN）发生率明显低于对照组（P〈0.01,P〈0.05）。治疗期间的不良反应主要有嗜睡2例、头昏乏力5例、眩晕2例、恶心3例。结论伐昔洛韦联合加巴喷丁治疗带状疱疹急性期神经痛疗效满意,可防止PHN的发生。     

大剂量口服伐昔洛韦片治疗带状疱疹的疗效观察

目的:观察大剂量伐昔洛韦片治疗带状疱疹的临床疗效。方法:将66例带状疱疹患者随机分为治疗组和对照组:治疗组31例,给予伐昔洛韦片1 000 mg口服,每日3次,共7天;对照组35例,给予伐昔洛韦片300 mg口服,每日2次,共10天。用药后第3、5、8、11天观察疗效,皮疹消退后1个月随访后遗神经痛的发生情况。结果:治疗组的止痛时间、止疱时间、皮疹结痂时间均明显短于对照组,后遗神经痛的发生率(6.45%)低于对照组(28.57%),两组比较有明显差异(P<0.05),而不良反应的发生率无统计学差异(分别为19.35%、20.00%,P>0.05)。结论:在带状疱疹早期应用伐昔洛韦1 000 mg口服、每日3次、共7天疗法较伐昔洛韦300 mg口服、每日2次、共10天疗法起效快、疗效好,并能明显减少后遗神经痛的发生率,值得临床推广。     

伐昔洛韦联合复方甘草酸苷治疗带状疱疹60例疗效观察

目的：探讨伐昔洛韦联合复方甘草酸苷治疗带状疱疹的疗效及安全性.方法：将120例患者随机分为治疗组和对照组各60例,对照组口服伐昔洛韦片0.3 g,每日2次,甲钴胺胶囊500 μg,每日3次,连用10日,治疗组在对照组治疗的基础上加用复方甘草酸苷40 mL静脉滴注,每日1次,疗程同对照组.结果：治疗组和对照组的有效率分别为86.67%和66.67%,差异有统计学意义（P〈0.05）.结论：伐昔洛韦联合复方甘草酸苷治疗带状疱疹安全有效.     

半导体激光联合伐昔洛韦治疗带状疱疹疗效观察

目的观察半导体激光、He—Ne激光联合伐昔洛韦治疗带状疱疹的临床疗效。方法将118例带状疱疹患者分为3组,试验组、对照组1及对照组2。所有患者均给予伐昔洛韦以及维生素B1、维生素B12治疗。试验组和对照组1再分别使用半导体激光和He—Ne激光照射。结果试验组在痊愈率、总有效率及止痛、止疱、结痂时间、后遗神经痛发生率等方面均明显优于对照组。结论半导体激光联合伐昔洛韦治疗带状疱疹疗程短,疗效快,安全性好。     

不同剂量和疗程伐昔洛韦治疗带状疱疹的多中心随机双盲对照研究

目的：比较不同剂量和疗程伐昔洛韦治疗带状疱疹的疗效和安全性。方法：选择带状疱疹患者为研究对象，采用多中心、随机、双盲、对照的临床试验。试验组患者采用伐昔洛韦1000mg每日3次口服，共服7d；对照组患者采用伐昔洛韦300mg每日2次口服，共服10d。用药后第3、6和10天观察疗效和不良反应。结果：共入组128例，全分析集（FAS）分析128例，符合方案集（PPS）分析118例。治疗后第3、6和10天，试验组和对照组患者的症状、体征积分下降值及有效率比较差异无统计学意义（P〉0．05）；疼痛视觉模拟评分法（visnal analogue scale，VAS）值比较，两组间差异无统计学意义（P〉0．05），但入组时疼痛VAS值≥8的患者，FAS集分析显示，在治疗后第6、10天VAS值下降两组均存在统计学差异（P〈0．05）；PPS集分析显示治疗后第10天VAS值下降，两组间存在统计学差异俨〈0．05）。试验组和对照组不良反应发生率分别为17．18％和12．50％．主要为嗜睡和恶心。结论：增加伐昔洛韦用量治疗带状疱疹安全、有效，与较低剂量伐昔洛韦组相比，对疼痛程度较严重的患者能更显著地减轻疼痛。     

Factors influencing pain outcome in herpes zoster: an observational study with valaciclovir

AIM OF THE STUDY: An observational study with valaciclovir was conducted to assess clinical outcome in herpes zoster, especially pain and associated neurological signs and symptoms in relation to a series of demographic and disease characteristics discernible at presentation. The safety and acceptability of valaciclovir for treatment of zoster was assessed in a wide variety of primary care and clinic referral settings. METHODS: In total, 1897 immunocompetent adults with clinically diagnosed, localized acute herpes zoster were enrolled in this international, open-label study of valaciclovir. All subjects received treatment with oral valaciclovir (1000 mg three times daily) for 7 days from entry to the study and were asked to record the presence of zoster-associated pain and abnormal sensations throughout treatment and 6 months' follow-up. They were seen frequently in clinic to verify subjective assessments and for evaluation of rash healing. Safety and tolerability were assessed by adverse event monitoring. RESULTS: Overall, 1191 subjects (63%) were aged > or = 50 years, and 203 (11%) had ophthalmic zoster. Cessation of zoster-associated pain was significantly faster in the younger age group; median times to loss of zoster-associated pain were 23 days and 9 days in the > or = 50 and < 50 years age groups, respectively. Similarly, abnormal sensations resolved significantly more rapidly in the younger subjects; the median duration of abnormal sensations was 31 days in the > or = 50 year olds and 16 days in those aged < 50 years. In cases of ophthalmic zoster, the rate of pain resolution was not different from those with zoster in other dermatomes (median duration of pain 18 vs. 16 days). However, abnormal sensations persisted significantly longer in subjects with ophthalmic zoster than in those with zoster at other sites (47 vs. 22 days). In addition to advancing age, subjects suffering moderate to severe prodromal pain or acute pain during the rash phase were at significantly greater risk of zoster-associated pain and abnormal sensations persisting for longer. Subjects with concomitant neurological disorders were also more likely to develop prolonged abnormal sensations. Valaciclovir treatment was well tolerated, and adverse events were rare and generally mild. CONCLUSION: This study confirmed the prognostic importance of advancing age and the intensity of prodromal or acute pain as risk factors for prolonged zoster-associated pain and persisting abnormal sensations in the affected dermatome. Ophthalmic zoster and pre-existing neurological disorders are also identified as highly significant risk factors for prolonged abnormal sensations in herpes zoster.     

地塞米松防治带状疱疹所致神经痛疗效评价

目的:评价地塞米松在治疗带状疱疹神经痛以及预防带状疱疹后遗神经痛中的有效性和安全性。方法:将60例带状疱疹患者随机分为治疗组和对照组,两组患者均静滴更昔洛韦,口服甲钴胺、维生素B_1、氨芬曲马多。治疗组同时给予地塞米松5 mg静滴,每日1次。结果:治疗4天后,治疗组VAS评分低于对照组,有显著统计学意义(P0.05)。治疗组和对照组的后遗神经痛的发病率分别为9.67%和27.59%(P0.05)。结论:早期使用地塞米松可有效缓解带状疱疹神经痛,并能有效预防后遗神经痛。     

无环鸟苷及干扰素治疗单纯疱疹和带状疱疹的疗效观察

47例单纯疱疹及带状疱疹病人随机分为无环鸟苷治疗组(12例),干扰素治疗组(21例)及对照治疗组(14例)。三组在年龄及发病时间上经统计学处理无显著性差异(P>0.05)。结果表明:每日肌注5万单位干扰素比外用3％无环鸟苷软膏(或0.1％无环鸟苷药水)和对照治疗组,能明显缩短病程,减轻症状(P<0.001)。     

围针皮下注射治疗带状疱疹后遗神经痛25例

目的 观察围针皮下注射治疗带状疱疹后遗神经痛的疗效。方法 治疗组采用2％利多卡因5～10ml,维生素B12注射液500μg,曲安奈德注射剂20～40mg,根据不同的发病部位分别作围针皮下注射,对照组口服对乙酰氨基酚片,口服1周后观察疗效。结果 治疗组疼痛完成消失12例,明显缓解10例,轻度缓解3例。对照组分别为2、11、9、疼痛无缓解3例。结论 围针皮下注射治疗带状疱疹后遗神经痛显效快,且长期趋向稳定。     

Relationship between prior knowledge about herpes zoster and the period from onset of the eruption to consultation in patients with herpes zoster

Herpes zoster (HZ) is a common internal infection caused by latent varicella zoster virus. Emergence of antiviral chemotherapy has changed the treatment of HZ dramatically, but the effects of such therapy are documented only in patients who started treatment within 72 h of HZ onset of the eruption. There have been few studies addressing the question of factors that determine early attendance of patients at a clinic. We questioned 256 patients with acute HZ about: (i) date from onset of the eruption to first clinic visit; and (ii) their prior knowledge of HZ. We found a tendency that patients who already knew about HZ had consulted dermatology clinics earlier (P < 0.05). People most commonly obtained information about the disease from friends and family members who had previously had HZ, but not from the Internet or other mass media. Our results indicate that patient education is important for early attendance at dermatology clinics, which in turn, should result in the improved outcome of antiviral chemotherapy and prevention of postherpetic neuralgia.     

Atypical herpes zoster in a patient with AIDS

Objective To report a case of persistent infection by varicella-zoster virus (VZV) in an HIV-infected patient who presented with atypical, hyperkeratotic viral lesions and a partial response to acyclovir. Methods Viral changes found on histopathological examination; definitive diagnosis of VZV infection was established by viral culture. Results Lesions of chronic hyperkeratotic herpes zoster responded partially to acyclovir therapy, and complete resolution was achieved with intravenous foscarnet. Absence of visceral involvement. Conclusion Prolonged acyclovir therapy for herpes virus infections in HIV-seropositive patients may represent an important pathogenic factor for the appearance of atypical clinical forms associated with drug-resistant viral strains.     

万乃洛韦结合膦甲酸钠注射液治疗复发性生殖器疱疹的临床效果观察

目的：研究万乃洛韦结合膦甲酸钠注射液治疗复发性生殖器疱疹的临床效果。方法：本组抽取我院于2011年4月至2013年4月收治的复发性生殖器疱疹患者58例,将患者随机均分为两组,观察组患者采用万乃洛韦结合膦甲酸钠注射液治疗,对照组患者采用阿昔洛韦治疗,观察两组患者的临床疗效以及病情复发情况。结果：观察组患者的治疗有效率和1年内病情未复发率分别为100％、62．07％;对照组组患者的治疗有效率和1年内病情未复发率分别为79．31％、24．14％,差异具有统计学意义（P〈0．05）。结论：复发性生殖器疱疹患者入院后,取万乃洛韦结合膦甲酸钠注射液治疗,能够降低疾病的复发率,值得推广使用。     

45例带状疱疹并脑膜脑炎的回顾性研究

目的：探讨带状疱疹并发脑膜脑炎的相关因素及发病机制。方法：汇集了山东省12家省市级大医院皮肤科及神经内科住院患者的资料，共有45例，从临床及实验室等方面进行了总结分析。结果：认为年龄不是主要因素，各种原因导致的免疫抑制是重要因素，颅神经尤其是三叉神经眼支受累引起脑炎占首位，其次是肋间神经。结论：带状疱疹并发脑膜脑炎的机制是由于VZV直接侵入脑组织，也存在免疫机制，因此在治疗中要合理的运用抗疱疹病毒药物、糖皮质激素及对症治疗，一般预后还是好的。