泛昔洛韦联合泼尼松治疗老年人带状疱疹的疗效观察

目的探讨泛昔洛韦联合短期小剂量泼尼松口服治疗带状疱疹的疗效及安全性。方法 125例50岁以上相对健康的带状疱疹患者随机分为两组。激素组:口服泛昔洛韦片(0.25g/次,3次/d)10d和泼尼松片(10mg/次,3次/d)7d;对照组:口服泛昔洛韦片(0.25g/次,3次/d)10d。观察疱疹开始结痂和完全愈合时间,并于初诊时、第4周和第12周以数字评价量表(NRS)评估疼痛严重程度。并记录药物治疗的不良反应。结果疱疹结痂和完全愈合时间,激素组均低于对照组(P<0.05);患者疼痛缓解程度,第4周激素组优于对照组(P<0.05);第12周激素组与照组比较差异无统计学意义(P>0.05)。轻度不良反应事件两组相当。结论泛昔洛韦联合短期小剂量泼尼松口服治疗带状疱疹有助于减少带状疱疹急性疼痛的发生率和严重程度,但是对带状疱疹后遗神经痛的发生率和疼痛严重程度无明显影响。     

泛昔洛韦联合甲泼尼龙片治疗中老年带状疱疹疗效观察

目的：观察泛昔洛韦联合甲泼尼龙片治疗中老年带状疱疹的临床疗效。方法：将随机抽取的60例中老年带状疱疹患者分为两组，治疗组口服泛昔洛韦和甲泼尼龙片对照组仅口服泛昔洛韦片，比较两组疗效。结果：通过比较，治疗组止疱、结痂、脱痂、疼痛缓解及疼痛消失的时间均比对照组短且两组比较有统计学差异。结论：泛昔洛韦联合甲泼尼龙片治疗中老年带状疱疹疗效佳可以推广使用。     

喜炎平联合蒲地蓝治疗带状疱疹66例及对细胞免疫功能的影响

目的：探讨喜炎平联合蒲地蓝治疗带状疱疹的效果和对细胞免疫功能的影响。方法选择收治带状疱疹患者66例,随机分为治疗组和对照组,治疗组给予喜炎平注射液50 mg加入250 mL生理盐水中,静滴,1次/d,共滴注7 d;蒲地蓝消炎口服液,10 mL/次,3次/d,共用药7 d。对照组给予膦甲酸钠氯化钠注射液3.0,1次/d,共滴注7 d。伐昔洛韦口服0.3,2次/d,弥可保0.5 mg,3次/d,观察2组治疗效果及止疱、结痂、脱痂、疼痛缓解的时间、睡眠状况、生活质量改善状况等,并采用流式细胞仪检测治疗前,治疗10 d后患者外周血T细胞亚群改变情况。结果治疗组治疗总有效率明显高于对照组;治疗组止疱、结痂、脱痂、疼痛缓解时间明显短于对照组;治疗组睡眠质量评分和生活质量评分高于对照组;治疗组患者治疗后CD3、CD4、CD8、CD4/CD8明显高于对照组。结论该法治疗带状疱疹有效率高、症状缓解快,并且可以有效调节T细胞亚群功能,增强患者免疫防护。     

威伐光联合膦甲酸钠治疗带状疱疹疗效观察

目的：探讨威伐光联合膦甲酸钠治疗带状疱疹的疗效。方法选择68例带状疱疹患者随机分为两组,对照组应用膦甲酸钠、甲钴胺片及喷昔洛韦乳膏,试验组在对照组的基础上加用威伐光照射。结果试验组在止疱时间、止痛时间、结痂时间、皮疹消退时间及总有效率方面均优于对照组,两组之间差异有显著性（P〈0.05）。结论威伐光联合膦甲酸钠治疗带状疱疹疗效更显著。     

草药七色花治疗带状疱疹的疗效观察与护理

目的:比较七色花草药与临床常规用药治疗带状疱疹的疗效。方法:本组带状疱疹86例,随机分为治疗组、对照组各43例。治疗组采用七色花药水淋洗和(或)湿敷,对照组给予常规治疗,即静脉滴注利巴韦林、西米地丁,口服泛昔洛韦,患处外涂阿昔洛韦软膏。结果:治疗组病人止疱收敛、止痛、干燥结痂、脱痂时间均明显短于对照组(P<0.05),治疗组治疗效果明显优于对照组(P<0.05)。结论:七色花治疗带状疱疹安全高效,治疗方法简便,值得推广应用。     

膦甲酸钠联合地塞米松治疗带状疱疹疗效观察

目的通过应用膦甲酸钠联合地塞米松治疗带状疱疹,观察期疗效并对其合理性进行探讨。方法选取江西省赣州市皮肤病医院门诊皮肤科2013-09—2014-06确诊为带状疱疹的患者154例为研究对象,按照随机数字表法分为治疗组77例和对照组78例。治疗组用膦甲酸钠3.0 g联合地塞米松10 mg静脉滴注,2次/d,联用7 d;对照组用更昔洛韦250 mg静脉滴注,2次/d,治疗7 d。结果治疗组在结痂、痊愈和止痛时间上均短于对照组,差异有统计学意义(P0.05)。结论膦甲酸钠联合地塞米松治疗带状疱疹,能够有效减少治疗时间,加快患者痊愈,是一种较为安全有效的方法。     

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。     

龙葵外敷辅助治疗带状疱疹的临床观察

目的 探讨龙葵外敷辅助西药治疗带状疱疹的临床疗效及安全性。方法 将76例患者随机分为治疗组38例和对照组38例,对照组予以泛昔洛韦分散片、维生素B₁片、维生素B₁₂注射液治疗,治疗组在对照组基础上予以龙葵外敷,连续治疗14 d。观察2组治疗前后视觉模拟评分法(VAS)评分、睡眠质量(QS)评分和疱疹评价指标(止疱时间、结痂时间、脱痂时间);统计2组用药后不良反应发生情况。结果 治疗后,2组VAS评分均低于治疗前,且治疗组低于对照组,差异有统计学意义(P<0.05或P<0.01);治疗后,2组患者QS评分均低于治疗前,且治疗组低于对照组,差异有统计学意义(P<0.05或P<0.01)。治疗组患者止疱、结痂、脱痂时间均短于对照组,差异有统计学意义(P<0.01)。2组患者不良反应发生情况比较,差异无统计学意义(P>0.05)。结论 龙葵外敷辅助西药治疗带状疱疹患者的疗效优于单纯西药治疗,可有效缓解疼痛,提高患者睡眠质量,显著缩短止疱、结痂、脱痂时间,且安全性高,不良反应少。     

综合疗法治疗带状疱疹56例疹疗效观察论著

目的 观察泛昔洛韦联合白介素肌肉注射配合紫外线光疗治疗带状疱疹的疗效.方法 选择在本院皮肤科就诊的明确诊断为带状疱疹病患者98例,随机分为两组,分别予单独泛昔洛韦口服(对照组)和应用泛昔洛韦口服白介素肌肉注射,紫外线光疗仪联合治疗(治疗组).结果 治疗组联合治疗7 d 56例病人痊愈率(94.6%)高于对照组(73.8%),差异有统计学意义(P<0.01).且治疗组在止痛时间、止疱时间、结痂时间三方面均明显优于对照组(P<0.05).结论 泛昔洛韦加白介素联合紫外线光疗仪治疗带状疱疹能缩短疗程,不留后遗症,效果甚佳.     

老年带状疱疹早期应用糖皮质激素的治疗意义

目的探讨小剂量糖皮质激素预防老年人带状疱疹后遗神经痛的效果。方法选择老年带状疱疹患者80例,随机分为治疗组与对照组各40例,两组均常规口服泛昔洛韦、静点胸腺肽、肌注维生素B1、B12治疗组在此基础上口服小剂量强的松12d,疗程均为14d,疗程结束后评价疗效。结果治疗组的止痛时间明显短于对照组（P〈0．01）,止疱、结痂时间亦短于对照组（P〈0．05）,总有效率及后遗神经痛的发生率与对照组相比差异均有统计学意义（P〈0．05）。结论老年带状疱疹早期、短程应用小剂量糖皮质激素治疗可有效缓解疼痛,预防后遗神经痛。     

综合疗法治疗带状疱疹56例疹疗效观察

目的观察泛昔洛韦联合白介素肌肉注射配合紫外线光疗治疗带状疱疹的疗效。方法选择在本院皮肤科就诊的明确诊断为带状疱疹病患者98例,随机分为两组,分别予单独泛昔洛韦口服（对照组）和应用泛昔洛韦口服白介素肌肉注射,紫外线光疗仪联合治疗（治疗组）。结果治疗组联合治疗7d56例病人痊愈率（94．6％）高于对照组（73．8％）,差异有统计学意义（P〈0．01）。且治疗组在止痛时间、止疱时间、结痂时间三方面均明显优于对照组（P〈0．05）。结论泛昔洛韦加白介素联合紫外线光疗仪治疗带状疱疹能缩短疗程,不留后遗症,效果甚佳。     

刺络拔罐放血疗法配合药物治疗带状疱疹46例疗效观察

目的:观察刺络拔罐放血疗法配合药物治疗带状疱疹的疗效。方法:将符合临床诊断的90例带状疱疹患者随机分为两组,治疗组46例采用刺络拔罐放血疗法配合口服泛昔洛韦、甲钴胺治疗,对照组44例采用口服泛昔洛韦、甲钴胺治疗。结果:治疗组总有效率为82.6%,对照组总有效率为52.3%,两组比较差异有统计学意义(P<0.05)。结论:采用刺络拔罐放血疗法配合口服泛昔洛韦、甲钴胺治疗带状疱疹较口服泛昔洛韦、甲钴胺治疗带状疱疹疗效更好。     

电针夹脊穴配合刺络拔罐治疗带状疱疹

目的:观察电针夹脊穴配合刺络拔罐治疗带状疱疹的临床疗效。方法:80例带状疱疹患者随机分为A、B2组各40例,均采用电针夹脊穴治疗,A组加用患处刺络拔罐治疗。结果:治疗10d后,A组平均止痛和结痂时间均较B组短(P0.01);临床疗效比较,A组痊愈率及总有效率均明显高于B组(52.5%、97.5%与27.5%、87.5%,P0.01)。结论:电针夹脊穴配合刺络拔罐治疗带状疱疹可明显缩短治疗时间,提高疗效。     

泛昔洛韦联合外用重组人干扰素α-2b治疗带状疱疹的临床效果

目的探讨泛昔洛韦联合外用重组人干扰素α-2b治疗带状疱疹的临床效果。方法将120例带状疱疹患者根据单双号随机化分组法分为对照组(60例,泛昔洛韦)与观察组(60例,泛昔洛韦联合外用重组人干扰素α-2b)。比较两组的临床效果。结果治疗后7 d,两组的P物质水平、临床症状评分、VAS评分、IgM、IgG、IgE、IgA水平均降低,且观察组低于对照组(P<0.05)。观察组的止疱时间、水疱完全消失时间、开始结痂时间及痊愈时间均短于对照组(P<0.05)。观察组的治疗总有效率高于对照组,随访3、5个月的复发率均低于对照组(P<0.05)。结论泛昔洛韦联合外用重组人干扰素α-2b治疗带状疱疹的临床效果显著。     

更昔洛韦治疗眼部带状疱疹临床效果观察

目的探讨更昔洛韦治疗眼部带状疱疹的临床效果。方法将眼部带状疱疹患者52例分为两组,治疗组28例用更昔洛韦针剂0.25 g/d,静脉滴注,对照组24例用阿昔洛韦0.5 g/d,静脉滴注,均连续使用10天,比较两组临床疗效,主要观察项目及不良反应。结果治疗组有效率(92.9%)明显高于对照组(58.3%),带状疱疹的止痛时间、止疱时间及结痂时间均明显短于对照组,差异均有统计学意义(P<0.05)。两组均无任何眼部后遗症,不良反应均轻微。结论更昔洛韦治疗眼部带状疱疹具有疗效好、见效快、症状改善显著,值得临床推广应用。     

Clinical Science (43)

Valaciclovir: a review of its use in the management of herpes zoster. (Adis International Limited, Auckland, New Zealand) Drugs 2000;59:1317–1340. This study compared the effectiveness of valaciclovir (1000 mg 3 times daily for 7 days) and aciclovir (800 mg 5 times daily for 7 days) in controlling the symptoms of acute herpes zoster. Valaciclovir was found to alleviate zoster‐associated pain and postherpetic neuralgia significantly faster than aciclovir. A 14‐day regimen of valaciclovir showed no significant advantage over the 7‐day regimen. A smaller trial in Japanese patients focusing primarily on the cutaneous (rash) signs of herpes zoster confirmed the similar efficacy of valaciclovir and aciclovir in the 7‐day regime. Valaciclovir and aciclovir demonstrated similar efficacy for the control of cutaneous lesions and ocular complications in patients with zoster ophthalmicus. Starting treatment later than 72 h after rash onset did not significantly reduce the beneficial effect of valaciclovir on the duration of zoster‐associated pain, suggesting that valaciclovir might be effective when given later than previously thought. However, valaciclovir should ideally be given as soon as possible after symptoms appear. Valaciclovir was well tolerated with nausea and headache as being the most commonly reported adverse events. The adverse events profile of the agent was similar to that seen with aciclovir or famciclovir. Conclude that the efficacy of valaciclovir for the treatment of herpes zoster has been confirmed and extended by follow‐up studies in herpes zoster ophthalmicus, in Japanese patients, and in the wider primary care setting. Valaciclovir is at least equivalent to, and better in certain parameters than, aciclovir and appears to have similar efficacy to famciclovir 500 mg 3 times daily. Comment by Susan Anderson, MD. This is a review article on the antiviral drug valaciclovir. The varicella zoster virus (VZV) is commonly treated with the antiviral drug aciclovir. However, aciclovir has a low oral bioavailability that limits its efficacy in the treatment of herpes zoster. Valaciclovir was developed in order to have a more readily absorbed oral antiviral drug. When valaciclovir was compared to aciclovir in a large study, it was noted that valaciclovir was as effective in controlling the symptoms of acute herpes zoster. It was also noted valaciclovir alleviated zoster associated pain and postherpetic neuralgia significantly faster than aciclovir. Also, there was no significant advantage of treating valaciclovir 14 days versus 7 days; therefore, a 7‐day regimen is recommended. In a smaller trial from Japan that focused primarily on the cutaneous (rash) signs of herpes zoster, there was also confirmation of similar efficacy of aciclovir and valaciclovir in a 7‐day regimen. The similarity in efficacy was not only for cutaneous lesions but also for ocular complications in patients with zoster ophthalmicus. In a large controlled trial, they compared valaciclovir and famciclovir. This showed similar efficacy in resolution of acute herpes zoster rashes shortening the duration of postherpetic neuralgia. It was purposed in the article that the therapeutic window for beneficial treatment with valaciclovir and zoster associated pain may be wider that previously though. It is still recommended that valaciclovir be ideally given as soon as possible after symptoms appear. However, starting treatment after 72 hours after rash onset did not significantly reduce the beneficial effect of the valaciclovir on duration of zoster associated pain. Valaciclovir is known to be well tolerated with nausea and headache being the most commonly reported adverse events. The adverse events profile of valaciclovir is similar to aciclovir or famciclovir. The purpose of this review was to present an overview of the pharmacodynamic/pharmacokinetic properties and therapeutic efficacy in the assessment of pain in herpes zoster in comparison with known agents of aciclovir, famciclovir, and/or placebo. It is concluded that valaciclovir is an efficacious agent in the treatment of herpes zoster and herpes zoster ophthalmicus. It's at least as efficacious as aciclovir and has similar efficacy to famciclovir. It is well tolerated with a similar side effect profile as aciclovir and famciclovir.     

膦甲酸钠联合阿德福韦酯治疗慢性乙型重型病毒性肝炎62例

目的探讨膦甲酸钠联合阿德福韦酯治疗慢性重型乙型肝炎的疗效。方法将123例慢性乙型重型肝炎患者随机分为对照组61例，给予治疗常规治疗加拉米夫定100mg，1次／d；治疗组62例，在常规治疗基础上加用膦甲酸钠和阿德福韦酯，膦甲酸钠注射液3．0g250ml，静脉滴注，2次／d，阿德福韦酯胶囊10mg，1次／d，疗程28d。结果肝功能复常率、HBV-DNA的阴转率治疗组优于对照组（P〈0．001）。治疗组肝性脑病、感染、肝肾综合征发生率分别为20．9％（13／62）、19．4％（12／62）、17．7％（11／62）明显低于对照组41．0％（25／61）、39．3％（24／61）、37．7％（23／61）差异有统计学意义（P〈0．05）。病死率：治疗组22．6％（14／62），显著低于对照组54．1％（33／61）（P〈0．01）。结论在基础保肝支持治疗同时，及时应用膦甲酸钠联合阿德福韦酯胶囊能显著提高慢性乙型重型肝炎的抢救成功率。     

Review of antiviral therapy for herpes labialis, genital herpes and herpes zoster

Acyclovir (Zovirax) was approved for the treatment of herpesvirus infections almost two decades ago. It was the first agent in a novel group of antiviral medications that now include valacyclovir (Valtrex), penciclovir (Denavir and famciclovir (Famvir). These agents have made a dramatic impact on the morbidity associated with herpes simplex virus infections and herpes zoster. Topical and oral antiviral use have shown modest but statistically significant efficacy in treating herpes labialis with most studies demonstrating a significant reduction in episode length and/or healing time. Oral acyclovir, valacyclovir and famciclovir are efficacious and safe for the treatment of the first episode and recurrent genital herpes and are useful as suppressive therapy for individuals with frequent genital herpes recurrences. In addition, high doses of oral acyclovir, valacyclovir and famciclovir have been shown to speed the healing of herpes zoster, and data suggests that these agents also decrease associated acute and chronic pain in people of 50 years of age or older. Further research is required to clarify the safety of these agents in pregnant women with genital herpes, the role of antiviral therapy in decreasing the sexual transmission of genital herpes, and the efficacy and cost-effectiveness of these agents in treating herpes zoster in people below the age of 50 years.     

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。