半导体激光联合伐昔洛韦及甲钴胺治疗老年带状疱疹的临床疗效观察

目的探讨半导体激光联合伐昔洛韦及甲钴胺治疗老年带状疱疹的临床疗效。方法分析我院2012年1月至2014年6月收治的140例老年带状疱疹患者临床资料,将140例老年带状疱疹患者随机分为治疗组和对照组。两组均给予伐昔洛韦以及甲钴胺治疗,治疗组联合半导体激光照射,于治疗结束时判断疗效,并做统计学分析。结论治疗组、对照组的总显效率分别为84．28％和64．28％,两者相比差异有统计学意义（P〈0．05）;治疗组的后遗神经痛发生率低,两组相比差异有统计学意义（P〈0．05）。伐昔洛韦及甲钴胺联合半导体激光治疗老年带状疱疹安全性好、起效快、疗效显著、后遗神经痛的发生率低,值得临床推广。     

观察应用伐昔洛韦、胸腺肽联合治疗带状疱疹的临床价值

目的:分析对带状疱疹患者合用伐昔洛韦及胸腺肽的治疗价值.方法:抽取2018年9月～2020年10月本院70例带状疱疹患者,随机数字表法分组,对照组以伐昔洛韦治疗,观察组合用伐昔洛韦、胸腺肽治疗,对比2组治疗总有效率、疼痛度评分、康复进程、不良反应等.结果:观察组治疗总有效率97.14％,对照组85.71％,P<0.05...     

伐昔洛韦联合白芍总苷治疗带状疱疹后神经痛疗效观察

目的探讨伐昔洛韦联合白芍总苷治疗带状疱疹后神经痛(postherpetic neuralia,PHN)的临床疗效。方法选择2010年6月—2011年8月54例PHN患者随机分为对照组和治疗组,对照组给予口服伐昔洛韦,外用喷昔洛韦乳膏,治疗组在对照组基础上给予口服白芍总苷。结果对照组痊愈率59.3%,总有效率100.0%;治疗组痊愈率85.2%,总有效率100.0%。两组痊愈率比较差异有统计学意义(P<0.05),总有效率比较差异无统计学意义(P>0.05)。结论伐昔洛韦联合白芍总苷治疗PHN可明显改善患者症状和机体的功能状态,值得临床应用。     

更昔洛韦并伐昔洛韦治疗儿童EB病毒感染疗效分析

目的探讨更昔洛韦、伐昔洛韦治疗儿童EB病毒感染的疗效。方法治疗组给与更昔洛韦10mg.kg-1.d-1,分两次,共14天,继以伐昔洛韦10mg.kg-1.d-1,分两次,共14天,改伐昔洛韦5mg.kg-1.d-1,每天一次,共14天。对照组给予利巴韦林10mg.kg-1.d-1,每日一次,共七天,继以抗病毒中药口服35天。结果治疗组临床表现好转时间短于对照组(P0.05),治疗4周时EB病毒转阴率32%,高于对照组的11.7%(P0.05);治疗6周时转阴率为64%,也高于对照组的29.4%(P0.05)。结论更昔洛韦伐昔洛韦序贯使用是治疗儿童EB病毒感染的有效方法。     

卡介苗素联合更昔洛韦治疗带状疱疹的临床观察

带状疱疹是由水痘一带状疱疹病毒所引起的急性炎症性皮肤病,由于病毒具有亲神经性,感染后可长期潜伏于脊髓神经后根神经节的神经元内,当机体抵抗力下降后,病毒活动繁殖而激发带状疱疹,影响患者健康。     

盐酸伐昔洛韦治疗儿童水痘疗效观察

目的 评价盐酸伐昔洛韦用于治疗儿童水痘的疗效及安全性.方法 选择2007年2月至2010年8月收治的220例水痘患儿,按照随机数字表法分为治疗组和对照组,每组110例.治疗组口服盐酸伐昔洛韦,按10mg/(kg·d),分2次空腹口服;对照组口服利巴韦林颗粒,按15mg/(kg·d),分3次服用,比较两组的临床疗效.结果 治疗组痊愈98例,显效10例,有效2例;对照组痊愈68例,显效25例,有效9例,无效8例;两组比较差异有统计学意义X2=16.0257,P＜0.05).结论 口服盐酸伐昔洛韦治疗儿童水痘较利巴韦林效果更好,是目前治疗水痘的理想药物.     

伐昔洛韦和阿昔洛韦治疗小儿水痘疗效比较

本文通过对口服盐酸伐昔洛韦分散片和阿昔洛韦治疗小儿水痘进行疗效比较,结果口服盐酸伐昔洛韦分散片治疗小儿水痘疗效优于口服阿昔洛韦片。     

伐昔洛韦片联合酞丁安软膏治疗多发性寻常疣的疗效观察

目的观察伐昔洛韦治疗多发性寻常疣的疗效。方法将158例多发性寻常疣患者随机分成两组,对照组仅外用酞丁安软膏,治疗组加服伐昔洛韦,6周后判定疗效。结果治疗组的痊愈率及有效率均显著高于对照组,两组痊愈率及有效率差异有统计学意义。结论伐昔洛韦联合外用肽丁胺软膏治疗多发性寻常疣疗效较为确切。     

大剂量伐昔洛韦长期抑制疗法治疗复发性生殖器疱疹疗效分析

生殖器疱疹(GH)主要是由单纯疱疹病毒Ⅱ型(HSVⅡ)通过性接触感染的一种常见的、易复发的、难治愈的性传播疾病,发病率高,迄今尚无预防复发及阻止诱发恶变的有效疗法.原发性生殖器疱疹的疱疹消退后,残留的病毒长期潜存于骶神经节,当机体抵抗力降低或某些诱发因素作用使潜存病毒激活而复发,目前采用的治疗方法为间歇抗病毒治疗和长期抑制抗病毒治疗.伐昔洛韦是治疗复发性生殖疱疹(GH)的一线药物,疗效确切,不良反应轻微,在2009年以前,国内的间歇治疗和长期抑制治疗主要采用300mg[1],而国外学者研究发现,500mg伐昔洛韦长期抑制疗法对生殖器疱疹的治疗具有良好临床疗效[2].为探讨500mg大剂量伐昔洛韦长期抑制治疗GH的疗效和安全性,笔者于2009年12月至2011年11月采用大剂量伐昔洛韦长期抑制疗法治疗GH,并与间歇治疗对照观察,现将结果报告如下.     

匹多莫德联合盐酸伐昔洛韦治疗复发性生殖器疱疹的效果

目的:探讨匹多莫德联合盐酸伐昔洛韦治疗复发性生殖器疱疹的效果.方法:选取2017年9月至2019年9月复发性生殖器疱疹66例患者,按照随机数字表法均分为对照组和观察组,各33例.前者采用盐酸伐昔洛韦治疗,后者在前者的基础上,加用匹多莫德治疗,对比两组患者的临床指标、T淋巴细胞亚群水平以及炎症反应指标.结果:观察组患者的...     

梅花针叩刺放血结合激光照射治疗早期带状疱疹的临床疗效观察

目的　观察梅花针叩刺局部放血结合激光照射皮损部位治疗早期带状疱疹的临床疗效及预后情况。方法　选取2016年12月—2018年10月于我院治疗的68例早期带状疱疹患者作为研究对象,按照随机数字表法分为观察组与对照组,各34例,其中对照组采用西医常规治疗及护理,观察组在对照组治疗基础上另给予梅花针叩刺放血结合激光照射治疗。结果　治疗结束后,观察组总有效率为94.12%,明显高于对照组的79.41%（P＜0.05）。治疗结束后1个月、2个月进行随访时,观察组总有效率也均明显高于对照组（P均＜0.05）。2组患者疼痛视觉模拟评分均较治疗前明显下降（P均＜0.05）,且观察组下降差值大于对照组（P＜0.05）。结论　梅花针叩刺放血结合激光照射治疗早期带状疱疹可缩短病程,减轻患者疼痛,具有较好的临床疗效。     

Predictors of herpes zoster vaccination among Australian adults aged 65 and over

Objective(s)To estimate HZ vaccine coverage in Australia among older Australians and to identify potential barriers to vaccination.DesignAnalysis of data from three cross-sectional surveys administered online between 2019 and 2020.Setting and participantsAdults aged 65 and over residing in Australia.Main outcome measuresSelf-reported herpes zoster vaccination.ResultsAmong the 744 adults aged 65 and over in this sample, 32% reported being vaccinated for HZ, including 23% of participants aged 65–74, 55% of participants aged 75–84, and 0% for participants aged 85 and above. Those who are vaccinated with other immunisations are more likely to have received HZ vaccine, including seasonal influenza (OR = 4.41, 95 % CI: 2.44–7.98) and pneumococcal vaccines (OR = 4.43, 95 % CI: 2.92 – 6.75). Participants with a history of certain conditions, such as stroke (OR = 2.26, 95 % CI: 1.13–4.49), were more likely to be vaccinated against HZ. Participants that reported smoking tobacco daily were less likely to be vaccinated against HZ (OR = 0.48, 95 % CI: 0.26–0.89). Participants were less likely to be vaccinated against HZ if they preferred to develop immunity ‘naturally’ (OR = 0.29, 95 % CI: 0.15 – 0.57) or expressed distrust of vaccines (OR = 0.34, 95 % CI: 0.13–0.91).Conclusion(s)Further research is required to understand the barriers to HZ vaccine uptake. Increasing the funding eligibility for those who are at risk of complications from shingles, or lowering the age of eligibility, may increase vaccine coverage.     

The cost-effectiveness of prophylaxis with valaciclovir in the management of cytomegalovirus after renal transplantation

Prophylaxis-based antiviral treatment and intensive monitoring followed by pre-emptive antiviral treatment are both commonly used management strategies to reduce risk of cytomegalovirus (CMV) infection following renal transplantation. This study employed a decision-model approach using published efficacy data and information from a recent survey of French clinical practice to consider the relative costs and outcomes associated with CMV prevention strategies for high-risk patient groups. The cost per case of treating tissue invasive and symptomatic CMV disease was estimated at €15,431 and €10,852, respectively. In the highest infection-risk patient group (positive donor with no previous CMV history) prophylactic oral valaciclovir was shown to avoid the greatest number of CMV disease cases (35 cases per 100 transplanted patients) and reduced the overall CMV-related costs per transplanted patient by around 14% over a wait-and-treat baseline strategy. In contrast, intensive monitoring and pre-emptive treatment resulted in a much higher cost per transplanted patient. This analysis suggests that prophylactic treatment remains the most cost-effective approach to the management of CMV in renal-transplanted patients. Further comparative studies between prophylactic and pre-emptive treatment would be a valuable addition to the current evidence based on CMV prevention.     

Cost-effectiveness of vaccination against herpes zoster in adults aged over 60 years in Belgium

Aim

To assess the cost-effectiveness of vaccinating all or subgroups of adults aged 60 to 85 years against herpes zoster.

Methods

A deterministic compartmental static model was developed (in freeware R), in which cohorts can acquire herpes zoster according to their age in years. Surveys and database analyses were conducted to obtain as much as possible Belgian age-specific estimates for input parameters. Direct costs and Quality-Adjusted Life-Year (QALY) losses were estimated as a function of standardised Severity Of Illness (SOI) scores (i.e. as a function of the duration and severity of herpes zoster disease).

Results

Uncertainty about the average SOI score for a person with herpes zoster, the duration of protection from the vaccine, and the population that can benefit from the vaccine, exerts a major impact on the results: under assumptions least in favour of vaccination, vaccination is not cost-effective (i.e. incremental cost per QALY gained >€48,000 for all ages considered) at the expected vaccine price of €90 per dose. At the same price, but under assumptions most in favour of vaccination, vaccination is found to be cost-effective (i.e. incremental cost per QALY gained <€5500 for all ages considered). Vaccination of age cohort 60 seems more cost-effective than vaccination of any older age cohort in Belgium.

Discussion

If the vaccine price per dose drops to €45, HZ vaccination of adults aged 60-64 years is likely to be cost-effective in Belgium, even under assumptions least in favour of vaccination. Unlike previous studies, our analysis acknowledged major methodological and model uncertainties simultaneously and presented outcomes for 26 different target ages at which vaccination can be considered (ages 60-85).     

Early impact of universal varicella vaccination on childhood varicella and herpes zoster hospitalizations in Brazil

IntroductionThe Brazilian childhood National Immunization Program (NIP) introduced live and attenuated varicella vaccination in a single dose, combined as tetraviral vaccine, at 15 months of age in the whole country, during September to December of 2013. The aim of this study was to report trends in incidence of childhood hospital admissions related to varicella and zoster in Brazil from 2003 to 2016, including the first three years after vaccine introduction.MethodsThe number and incidence of hospital admission in patients aged less than 20 years in Brazilian public health system with an admission diagnosis of varicella and zoster from 2003 to 2016 were analyzed and pre (2003–2013) and post-vaccination periods (2014–2016) were compared. The data were obtained from DATASUS, a Brazilian government’s open-access public health database system, and analyzed adjusting for secular trend and seasonality if a statistically significant change was found.ResultsDuring the study period, 69,791 admissions due to varicella and herpes zoster occurred in the children younger than 20 years. After adjusting for seasonality, the incidence of hospitalizations decreased from 27.33 to 14.33 per 100000 per year, which corresponds to a reduction of 47.6% (95% confidence interval 18.19–77.04%, p < 0.001) in the vaccinated age group (1–4 years) in 2014–2016 compared to pre-vaccination period. The changes were not significant in the unvaccinated age groups.ConclusionThe hospitalizations due to varicella and herpes zoster were decreased by half early after the introduction of a single dose of tetraviral vaccine in NIP in the vaccinated children. Further studies may assess duration and intensity of this effect, as well as the indirect effect in the unvaccinated age groups.     

When zoster hits close to home: Impact of personal zoster awareness on zoster vaccine uptake in the U.S.

U.S. zoster vaccine uptake has been sluggish. Most adults are aware of zoster but unaware of its distressing manifestations. We found that vaccine uptake is markedly increased immediately following occurrence of zoster in a spouse. Thus, personal zoster awareness can prompt vaccination. Our findings have implications in terms of both vaccine promotion and interpretations of vaccine performance.     

Factors associated with herpes zoster vaccination status and acceptance of vaccine recommendation in community pharmacies

Objectives

1. Identify patient characteristics, awareness and knowledge associated with herpes zoster (HZ) vaccination status. 2. Identify self-reported reasons for not receiving Zostavax^®. 3. Assess the impact of a patient education program by measuring post-intervention interest in obtaining the Zostavax^® vaccine across reasons for being unvaccinated.

Methods

A cross-sectional design with patients aged 60 years or older in 51 community pharmacies in Alabama and Florida was utilized. During the Introductory Pharmacy Practice Experience in summer 2013, 137 immunization-certified student pharmacists provided patient education on HZ and Zostavax^® to unvaccinated patients using the Shingles Vaccine Information Statement. An interviewer-administered questionnaire assessed patient awareness of HZ, receipt of recommendations to receive Zostavax^®, and patient characteristics as well as vaccination status, reasons for being unvaccinated and interest in obtaining Zostavax^® after the educational session.

Results

A total of 681 patients participated in a conversation with a student pharmacist regarding their HZ vaccination status. The majority were female (57.6%), white (84.6%), and unvaccinated (73.6%). Results from logistic regression suggest that participants were more likely to be vaccinated if they received a recommendation from a healthcare provider (OR = 5.15), received the influenza vaccine during the previous year (OR = 3.56), or knew that Zostavax^® was recommended for individuals over 60 years of age (OR = 3.55). The most frequently provided reasons for being unvaccinated were “haven’t gotten around to it/forgot” (27.2%) and “didn’t know it was needed” (27.1%). After the educational session, the majority (72.5%) of unvaccinated patients were interested in speaking with their pharmacist or physician about receiving Zostavax^®. Analysis suggests that interest differed across initial reason for being unvaccinated (χ² = 64.44; p < 0.01).

Implications/conclusions

Recommendations from healthcare providers are valued by patients and can improve vaccination rates. The patient education program increased interest in receiving Zostavax^® and this interest differed depending on the reason provided for being unvaccinated.     

带状疱疹初期疗法与神经痛疗效的相关性研究

目的 探讨带状疱疹初期治疗方法与神经痛疗效的关系.方法 将120例带状疱疹患者随机分为3组,A组给予泛昔洛韦,B组给予泛昔洛韦联合复方甘草酸苷,C组给予阿昔洛韦联合复方甘草酸苷,疗程均为7 d,随访1个月.结果 疼痛缓解和消失时间B组最短,与A、C两组比较差异均有统计学意义(P＜0.05),A、C两组相近(P＞0.05).A、B、C三组痊愈率1周时分别为40.0%、65.0%和37.5%,2周时分别为62.5%、90.0%和70.0%,4周时分别为90.0%、100.0%和97.5%,B组与A、C组差异有统计学意义(P＜0.05).结论 本研究中,泛昔洛韦联合复方甘草酸苷治疗初期带状疱疹疼痛疗效最好.     

理疗配合外用药物治疗带状疱疹的临床体会

目的观察理疗配合外用药物治疗带状疱疹的临床疗效。方法把来笔者所在医院皮肤科就诊的72例带状疱疹患者随机分为治疗组和对照组。对照组36例,采用常规药物治疗,口服病毒灵、维生素B1、消炎痛,外涂阿昔洛韦软膏,10d为1个疗程;治疗组36例采用理疗配合云南白药软膏,用棉签涂抹于患处,比较两组的临床疗效。结果治疗组总有效率94．44％,对照组总有效率75％,治疗组与对照组的治愈情况、总有效率比较差异有统计学意义。结论采用物理疗法配合外用药物治疗带状疱疹治愈率高,值得临床推广。