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.     

更昔洛韦治疗中老年带状疱疹疗效观察

目的:评价更昔洛韦治疗中老年带状疱疹的疗效及安全性。方法:156例中老年带状疱疹患者分为两组,更昔洛韦组静脉滴注更昔洛韦0.25g,每日1次;阿昔洛韦组静脉滴注阿昔洛韦0.5g,每日2次。两组疗程均为7d。结果:更昔洛韦组有效率为93.4%,阿昔洛韦组有效率为78.8%,两组比较差异有显著性(P<0.01);患者各项症状、体征消退时间,更昔洛韦组明显较阿昔洛韦组缩短(P<0.01);更昔洛韦组不良反应发生率为6.6%,阿昔洛韦组为13.8%,两组比较差异无显著性(P>0.05)。结论:更昔洛韦治疗中老年带状疱疹安全、速效。     

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。     

病毒性皮肤病

20101774伐昔洛韦治疗带状疱疹临床疗效观察/龚宪军(山东枣庄矿业中心医院皮科)∥中国性科学.-2010,19(6).-37~40140例患者,随机分为两组各70例。试验组予伐昔洛韦0.3g2次/d,对照组阿昔洛韦0.2g5次/d口服,疗程均为10天。结果:止痛、止疱、结痂时间试验组明显快于对照组,痊愈、显效、有效率前者亦明显优于后者。认为伐昔洛韦治疗带状疱疹疗效好,不良反应少,服用方便,安全有效。表2参2(张锦章)20101775窄谱中波紫外线联合伐昔洛韦口服治疗老年性带状疱疹临床观察/李梅(上海奉贤镇塘外卫生院)∥中国中西医结合皮肤性病学杂志.-2010,9(2).-120将患者随机分     

两种剂量的伐昔洛韦分散片治疗带状疱疹临床疗效对照

目的比较两种剂量的伐昔洛韦分散片治疗带状疱疹的疗效。方法选择在本院门诊就诊符合诊断标准的带状疱疹患者为研究对象,采用随机、开放、对照的临床试验。治疗组患者采用伐昔洛韦分散片0.15g,2次/d口服,共服10天;对照组患者采用伐昔洛韦分散片0.3g2次/d口服,共服10天。用药后第3,6和10天观察疗效。结果共入组77例,治疗后第3,6和10天,治疗组的有效率分别是32.5%,42.5%,87.5%,对照组的有效率分别是35.1%,62.2%,89.2%,两组患者治疗指数比较差异无统计学意义(P>0.05);疼痛改变(VAS法分值)比较两组间差异无统计学意义(P>0.05)。结论伐昔洛韦分散片治疗带状疱疹0.15g2次/d口服疗效不低于0.3g2次/d口服。     

伐昔洛韦联合小牛脾提取物治疗带状疱疹48例疗效评价

目的:评价伐昔洛韦联合小牛脾提取物治疗带状疱疹的疗效和安全性。方法:将95例带状疱疹患者随机分为2组,治疗组(48例)给予伐昔洛韦片和小牛脾提取物注射液;对照组(47例)仅给予伐昔洛韦片,10天后观察疗效。结果:治疗组总有效率为85.42%,对照组总有效率68.09%,治疗组的止疱、结痂、止痛时间和总病程明显缩短。结论:伐昔洛韦联合小牛脾提取物治疗带状疱疹疗效优于单用伐昔洛韦。     

盐酸伐昔洛韦治疗复发性生殖器疱疹的临床疗效观察

目的:观察盐酸伐昔洛韦治疗复发性生殖器疱疹的临床疗效。方法:将我院2011年1月至2013年1月收治的120例复发性生殖器疱疹随机分为观察组与对照组两组,每组60例,观察组患者接受盐酸伐昔洛韦口服治疗,对照组患者接受阿昔洛韦片口服治疗,比较两组患者疗效后疗效以及患者治疗1年后复发率。结果:观察组患者治疗总有效率(91.67%)显著高于对照组(71.67%),(P<0.05)差异有统计学意义;观察组患者治疗1年内复发率(31.67%)显著低于对照组(63.33%),(P<0.05)差异有统计学意义,观察组患者复发面积率以及皮损愈合时间显著低于对照组(P<0.05),两组患者治疗过程中均未出现不良反应。结论:盐酸伐昔洛韦治疗复发性生殖器疱疹的临床疗效显著,能够显著降低复发性生殖器疱疹复发率,且安全性高,值得临床进一步推广应用。     

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.     

伐昔洛韦联合紫外线治疗带状疱疹60例疗效观察及护理

目的:观察伐昔洛韦联合UVA和UVB治疗带状疱疹的疗效,并报告护理体会。方法:120例带状疱疹患者随机分为2组:治疗组60例口服伐昔洛韦片0.3 g/次,每日2次,同时联合UVA、UVB治疗,每日1次;对照组60例单用伐昔洛韦治疗,剂量、方法同治疗组。共治疗10天,治疗结束后比较两组有效率、症状与体征消退时间,1月后比较两组后遗神经痛的发生率。治疗中对患者采取积极的护理干预,注重眼部、皮肤以及心理方面的护理。统计方法采用2检验及t检验。结果:治疗组有效率98.33%,明显高于对照组的85.00%(2=6.21,P0.05);治疗组带状疱疹后遗神经痛发生率(8.33%)比对照组(21.67%)明显降低(2=5.39,P0.05);治疗组的止痛时间、结痂时间、疼痛消失时间均短于对照组(t值分别为3.17、5.86、11.32,P值均0.05),差异均有统计学意义。结论:伐昔洛韦联合UVA和UVB治疗带状疱疹并配合良好的护理可取得较好的疗效,且起效快,并能有效防止后遗神经痛的发生。     

伐昔洛韦联合紫外线治疗带状疱疹60例疗效观察及护理

目的:观察伐昔洛韦联合UVA和UVB治疗带状疱疹的疗效,并报告护理体会。方法:120例带状疱疹患者随机分为2组:治疗组60例口服伐昔洛韦片0.3 g/次,每日2次,同时联合UVA、UVB治疗,每日1次;对照组60例单用伐昔洛韦治疗,剂量、方法同治疗组。共治疗10天,治疗结束后比较两组有效率、症状与体征消退时间,1月后比较两组后遗神经痛的发生率。治疗中对患者采取积极的护理干预,注重眼部、皮肤以及心理方面的护理。统计方法采用2检验及t检验。结果:治疗组有效率98.33%,明显高于对照组的85.00%(2=6.21,P<0.05);治疗组带状疱疹后遗神经痛发生率(8.33%)比对照组(21.67%)明显降低(2=5.39,P<0.05);治疗组的止痛时间、结痂时间、疼痛消失时间均短于对照组(t值分别为3.17、5.86、11.32,P值均<0.05),差异均有统计学意义。结论:伐昔洛韦联合UVA和UVB治疗带状疱疹并配合良好的护理可取得较好的疗效,且起效快,并能有效防止后遗神经痛的发生。     

万乃洛韦联合小剂量泼尼松治疗老年人带状疱疹的临床疗效观察

目的:了解盐酸万乃洛韦与小剂量泼尼松联合用药治疗老年人带状疱疹的临床疗效.方法:84例老年带状疱疹患者随机分为两组,研究组联用盐酸万乃洛韦与小剂量泼尼松,对照组单纯用盐酸万乃洛韦,用药后第3、7、14、30天观察记录治疗效果.结果:研究组发疹停止时间、疼痛缓解时间、痊愈时间及后遗神经痛发生率与对照组比较均有显著性差异,两组均无不良反应发生.结论:万乃洛韦联合小剂量泼尼松治疗老年人带状疱疹起效快、病程短并能减少后遗症神经痛的发生率.     

Valacyclovir in the Treatment of Herpes Simplex,Herpes Zoster,and Other Viral Infections

BACKGROUND: Genital herpes and herpes labialis are prevalent, physically and psychologically painful, and often disabling. Herpes zoster is often very painful and may result in months or years of postherpetic neuralgia (PHN). Over the past two decades, the treatment of these conditions has been transformed by guanosine nucleoside antivirals such as valacyclovir (Valtrex, a highly bioavailable prodrug of acyclovir (Zovirax, and famciclovir (Famvir), a highly bioavailable prodrug of penciclovir (Denavir). OBJECTIVE: We describe the pharmacology, pharmacokinetics, and clinical efficacy of valacyclovir for the treatment of herpes simplex, herpes zoster, and other viral infections. Valacyclovir is also compared with acyclovir and famciclovir. METHODS: All published literature containing the word "valacyclovir" was reviewed and summarized. RESULTS: Valacyclovir is the only oral antiviral agent approved for therapy of herpes labialis, the only antiviral drug approved for a 3-day course in the episodic treatment of recurrent genital herpes, as well as the only antiviral drug approved for once daily dosing for suppressive therapy. In herpes zoster, valacyclovir is more effective than acyclovir and equally effective as famciclovir at hastening the healing of zoster-associated pain and PHN. CONCLUSION: Valacyclovir is safe and effective in the therapy of patients with herpes simplex and herpes zoster and may be useful in other viral infections.     

Comparison between famciclovir and valacyclovir for acute pain in adult Japanese immunocompetent patients with herpes zoster

Famciclovir is a guanine analog antiviral drug used commonly for herpes zoster. Efficacy of famciclovir treatment has been reported to be comparable to valacyclovir treatment. Both of these medications reduce the time to complete cessation of zoster‐associated pain including post‐herpetic neuralgia, as compared to acyclovir. We conducted a multicenter, randomized, open clinical trial in order to evaluate the extent of pain relief afforded by these two antiviral drugs during the acute disease phase of herpes zoster. The study group comprised 86 immunocompetent adult patients suffering from herpes zoster, who were treated with either famciclovir or valacyclovir for 7 days. Of these, 55 patients enrolled in this study within 72 h of the onset of the rash and 31 patients after 72 h of the onset. There was a significant reduction in acute herpes zoster pain with famciclovir on day 7 and at 2–3 weeks in both of these patient groups, while with valacyclovir, there was not significant reduction in pain on day 7. Of patients aged 50 years or older, there was a significantly earlier reduction in pain with famciclovir than with valacyclovir. In addition, a significant reduction in the number of patients with pain was observed as early as days 3–4 with famciclovir treatment as compared with valacyclovir treatment. We conclude that famciclovir was superior to valacyclovir in the relief of acute pain of herpes zoster. Accordingly, famciclovir is recommended for herpes zoster patients with moderate symptoms and a visual analog scale score of under 50 mm.     

Open-label study of valacyclovir 1.5 g twice daily for the treatment of uncomplicated herpes zoster in immunocompetent patients 18 years of age or older

BACKGROUND: Herpes zoster (shingles) is a common disease caused by a reactivation of the latent varicella-zoster virus (chickenpox), which resides in the dorsal root ganglia. Valacyclovir HCl, the L-valyl ester of acyclovir, is an antiviral drug that is used to accelerate the resolution of the herpes zoster rash and associated pain and reduce the duration of postherpetic neuralgia. OBJECTIVE: To demonstrate the safety and efficacy of oral valacyclovir 1.5 g twice daily (bid) for the treatment of uncomplicated herpes zoster in immunocompetent patients over 18 years of age. The dosing schedule of bid versus three times daily is desirable for enhancing patient compliance and to subsequently reduce the incidence of viral resistance. METHODS: One treatment group of 125 patients was administered oral valacyclovir 1.5 g bid for 7 days. Administration of the first dose occurred within 72 hours after onset of rash. Patients were seen and assessed for cutaneous healing, zoster-associated pain (ZAP), and/or zoster-associated abnormal sensations (ZAAS). Patients under 50 years of age were followed for 4 weeks and patients 50 years of age and older were followed for a total of 24 weeks. Patients >or= 50 years were also asked to record a daily diary on pain and abnormal sensations throughout the 24-week study period. Responses to resource use and quality of life questions were also collected. Safety was monitored by means of routine hematologic and biochemical assessments and reporting of adverse experiences. RESULTS: Data from this study were compared with historical control groups both for three times daily antiviral therapy and for placebo. The results showed that twice-daily dosing was as safe and effective as three times daily dosing for the reduction of ZAP and ZAAS. Adverse-effect profiles were similar between the two different regimens, and both treatment groups showed better outcomes than the historical placebo group. Because it is standard of care to administer antivirals for the treatment of acute herpes zoster, a placebo-controlled trial is not possible, necessitating the use of historical controls. CONCLUSION: Oral valacyclovir 1.5 g bid is safe and effective for the treatment of uncomplicated herpes zoster in immunocompetent patients over 18 years of age. Twice-daily dosing may help increase patient compliance and therefore increase the effectiveness of treatment of the acute herpes zoster rash and the prevention of ZAP.     

The effect of daily valacyclovir suppression on herpes simplex virus type 2 viral shedding in HSV-2 seropositive subjects without a history of genital herpes

BACKGROUND: A substantial number of HSV-2 seropositive individuals lack a history of clinically recognized genital herpes. These individuals can transmit disease during periods of asymptomatic viral shedding. The frequency of asymptomatic shedding and the efficacy of antiviral therapy in reducing shedding has not been assessed in this population. OBJECTIVE: To compare the effect of valacyclovir 1 g once daily for 60 days versus placebo on asymptomatic viral shedding in immunocompetent, HSV-2 seropositive subjects without a history of symptomatic genital herpes infection. STUDY DESIGN: Seventy-three subjects were randomized to receive valacyclovir 1 g daily or placebo for 60 days each in a 2-way crossover design. A daily swab of the genital area was self-collected for HSV-2 detection by polymerase chain reaction. RESULTS: Fifty-six subjects with at least 1 polymerase chain reaction measurement in both treatment periods comprised the primary efficacy population. Valacyclovir significantly reduced shedding during subclinical days compared to placebo [mean, 1.5% vs. 5.1% of subclinical days (P <0.001), a 71% reduction]. Eighty-four percent of subjects had no shedding while receiving valacyclovir versus 54% of subjects on placebo (P <0.001). Eighty-eight percent of patients receiving valacyclovir had no recognized signs or symptoms versus 77% for placebo (P = 0.033). Valacyclovir was not associated with any safety risk compared with placebo. CONCLUSIONS: In this study, asymptomatic viral shedding occurred in a substantial number of HSV-2 seropositive subjects without a history of genital herpes. Valacyclovir 1 g daily significantly reduced asymptomatic shedding compared with placebo in this population.     

An international, randomized, double-blind, placebo-controlled, study of valacyclovir for the suppression of herpes simplex virus type 2 genital herpes in newly diagnosed patients.

BACKGROUND: Antiviral suppressive therapy of genital herpes is often initiated based on the established pattern of recurrences in an individual. Because most persons with first episode herpes simplex virus type 2 (HSV-2) infection experience recurrences and because viral shedding occurs frequently in the first year after infection, we examined the strategy of initiating suppressive therapy shortly after diagnosis of genital HSV-2 infection. SUBJECTS AND METHODS: From June 16, 2004 to July 26, 2006, 384 subjects from 74 sites in the United States, Canada, Argentina, Brazil, and Chile who were newly diagnosed with a first recognized episode of genital herpes at the time of the screening visit or within 3 months before the screening visit were randomized (2:1) to receive valacyclovir 1 g once daily or placebo for 24 weeks. Subjects were instructed to return to clinic during suspected genital herpes outbreaks for clinician confirmation of recurrences. RESULTS: Valacyclovir significantly prolonged the time to first recurrence of HSV-2 genital herpes in newly diagnosed subjects compared with placebo, with approximately 43% of subjects on placebo and 71% of subjects on valacyclovir recurrence-free at 24 weeks (P <0.001). Valacyclovir significantly reduced the mean number of genital HSV-2 recurrences per month occurring during the 24-week study period (0.11 for valacyclovir, 0.48 for placebo, P <0.001). Adverse events were comparable in the valacyclovir and placebo arms. CONCLUSION: Valacyclovir 1 g once daily administered for 24 weeks was well-tolerated and effective in suppressing genital herpes recurrences in immunocompetent newly diagnosed persons without an established recurrence pattern.     

伐昔洛韦不同药物使用方案在女性复发性生殖疱疹中的疗效对比及安全性研究

目的:分析伐昔洛韦不同药物使用方案在女性复发性生殖疱疹中的疗效以及安全性,为提高女性复发性生殖疱疹的临床疗效及安全性提供科学依据。方法:选取2014年1月至2015年6月100例复发性生殖器疱疹女性患者,随机分为观察组与对照组,每组50例。所有患者均使用单药伐昔洛韦治疗,采用不同的用药方案。对照组连续用药7d,2次/d,300mg/次;观察组连续用药5d,2次/d,500mg/次。在治疗第1d(D1)、第3d(D3)、第5d(D5)以及第7d(D7),比较两组患者的临床疗效,观察两组治疗前、D1、D3的HSV检出率以及并发症发生率。结果:观察组与对照组在D1、D3、D5、D7的治疗有效率差异无统计学意义(P0.05);观察组与对照组在D1的HSV阳性率显著低于对照组(P0.05),两组在治疗前和D3的HSV阳性率无统计学意义(P0.05);两组治疗过程中的并发症发生率无统计学意义(P0.05)。结论:单次伐昔洛韦用药量增大能够提高复发性生殖器疱疹的临床疗效,能够缩短单纯疱疹病毒在皮损部位的存在时间,并且对用药安全性无任何影响。     

Patients' preference of valacyclovir once-daily suppressive therapy versus twice-daily episodic therapy for recurrent genital herpes: a randomized study

BACKGROUND: Valacyclovir is effective for suppressive and episodic treatment of recurrent genital herpes. Few data on patients' treatment strategy preferences are available. GOAL: The goal was to assess patients' preference, satisfaction, and quality of life with suppressive versus episodic treatment of recurrent genital herpes. STUDY DESIGN: This was a multicenter, open-label, randomized, two-arm, crossover 48-week study involving 225 patients with genital herpes. RESULTS: Suppressive valacyclovir therapy was preferred to episodic valacyclovir treatment by 72% of patients (P < 0.001). Overall treatment satisfaction and quality of life were significantly greater during suppressive therapy (P < 0.001 and P = 0.002, respectively). The risk of recurrence during the first 24 weeks was reduced by 78% with suppressive therapy (P < 0.001). Significantly fewer patients experienced recurrences during suppressive treatment than with episodic treatment (P < 0.001). Valacyclovir was well tolerated. CONCLUSIONS: Suppressive valacyclovir was preferred to episodic therapy by most patients. Suppressive therapy was associated with increased treatment satisfaction, and decreased risk and lower frequency of recurrences.     

Efficacy of low dose gabapentin in acute herpes zoster for preventing postherpetic neuralgia: a prospective controlled study

Postherpetic neuralgia (PHN) is a sequela of herpes zoster that adversely affects quality of life seriously. The risk factors for PHN are well known but the effective interventions that reduce the incidence of PHN are less studied. The objective of this study is to evaluate the efficacy of treatment with gabapentin in patients with acute herpes zoster for preventing PHN. We performed a prospective randomized controlled study of 120 participants diagnosed with acute herpes zoster, aged 50 and over and complaining moderate to severe pain. All patients were treated with valacyclovir and acetaminophen. Half of the participants were assigned to the gabapentin group and received gabapentin 300 mg three times a day additionally. The intensity of pain at every visit and the incidence of PHN in both groups were measured. Total 52 and 49 patients in the gabapentin group and the control group, respectively, had completed 12 weeks of follow‐up period. Although the incidence of PHN was higher in the control group, the difference was not statistically significant (6.1% vs. 3.8%, p = 0.67). Our results indicate that the use of low‐dose gabapentin in acute herpes zoster seems not effective in the prevention of PHN.