万乃洛韦治疗带状疱疹疗效观察

目的探讨万乃洛韦治疗带状疱疹的疗效和安全性,并与阿昔洛韦作比较。方法将95例带状疱疹随机分为两组,万乃洛韦组(50例):万乃洛韦每次口服0.3g,每天2次,连服10天;阿昔洛韦组(45例):阿昔洛韦每次口服0.2g,每天5次,连服10天。结果万乃洛韦组总有效率为94.0%,阿昔洛韦组总有效率为86.7%,万乃洛韦治疗带状疱疹的疗效明显优于阿昔洛韦(P<0.05)。结论万乃洛韦治疗带状疱疹疗效确切、治愈率高。     

Costs of herpes zoster complications in older adults: A cohort study of US claims database

Background/Objectives

Herpes zoster (HZ) incidence increases with age, and the burden of HZ is expected to grow with aging of populations worldwide. We aim to determine the incremental healthcare resource utilization and associated costs of patients with common HZ-related complications other than postherpetic neuralgia (cutaneous, neurologic and ophthalmic) compared to uncomplicated HZ.

上海市部分地区健康人群水痘-带状疱疹病毒感染率调查报告

目的了解上海市部份地区健康人群水痘-带状疱疹病毒(VZV)自然感染状况。方法采集0~50岁健康人群血清标本921人份,用酶联免疫吸附试验测定抗体水平。结果人群血清中抗VZV-IgG总阳性率为42.78%,几何平均滴度(GMT)为1∶206.69。以0~2岁最低,阳性率为14.52%~18.33%,GMT为1∶45.36~1∶67.97。以后随年龄增长而逐步升高,3、4、5、6、7、8~9、10~141、5~19、20~29、30~39、40~50岁阳性率分别为21.37%、23.81%、27.91%、45.95%、29.63%、91.18%、88.57%、100.00%、97.14%、96.67%、100.00%。7岁以前感染率为45.9%。结论以上数据对应用水痘疫苗免疫预防策略及接种对象提供了科学依据。     

黄芪对老年带状疱疹患者Th1/Th2失衡调节作用的探讨

目的探讨黄芪对带状疱疹患者血清Th1/Th2细胞因子水平的影响。方法选择60例带状疱疹患者随机分为黄芪治疗组和病毒唑治疗组各30例,治疗前后分别用双抗体夹心法酶联免疫吸附实验(ELISA)监测外周血淋巴细胞介素——2(IL—2)、白细胞介素—4(IL—4)、白细胞介素—10(IL—10)、r—干扰素(r—IFN)水平;并以同样方法检测20例体检正常健康者为对照组。结果带状疱疹患者组血清中IL—4、IL—10水平较缝康对照组显著增高(P<0.01);IL—2、r—IFN水平较健康对照组显著降低(P<0.01)。黄芪治疗组患者治疗后,IL—4、IL—10水平显著降低(P<0.01),而IL—2、r—IFN水平显著增高(P<0.01)。病毒唑治疗组治疗前后上述指标无明显改变(P>0.05)。结论黄芪能调节带状疱疹患者体内Th1/ Th2细胞因子的失衡,改善患者机体免疫功能紊乱状态,对促进病情的好转具有重要意义。     

2例心脏移植患者术后早期感染带状疱疹病毒致延迟撤机的护理

总结2例心脏移植患者术后早期感染带状疱疹病毒致延迟呼吸机撤机的护理。护理要点：成立移植管理团队全程细化管理,针对疱疹发展过程的2个时期,发作期严格落实医院感染防控制度、全身抗病毒治疗、皮肤管理、镇痛;愈合期进行阶梯镇痛及多学科合作进行康复训练。经过积极的治疗和护理,2例均成功撤机、转科,康复出院。     

红外线照射治疗带状疱疹的疗效观察

目的：探讨红外线照射辅助治疗疱疹的疗效。方法：将100例确诊为带状疱疹的患者随机分为两组，即观察组和对照组。观察组应用常规疗法加红外线照射局部，对照组应用常规疗法，观察其疗效。结果：观察组能明显缩短止疼、止疱、结痂所需时间及病程。结论：红外线照射带状疱疹局部，能减轻疼痛，促进疱疹吸收，缩短病程。     

氦氖激光联合治疗带状疱疹疗效的观察及护理

目的观察氦氖激光联合治疗带状疮疹对减轻带状疱疹患者疼痛和促进皮疹痊愈的效果。方法将97例带状疱疹患者随机分为治疗组50例和对照组47例。两组患者均接受抗病毒药、神经营养药治疗和局部护理等,治疗组在此基础上采用氦氖激光治疗仪对局部皮疹进行照射。结果采用氦氖激光治疗第5d和第10d后治疗组疼痛缓解率分别为72.0%,94.0%,对照组疼痛缓解率分别为34.0%,44.7%,治疗组疼痛减轻程度较对照组明显(均P0.01);水疱结痂率治疗组分别为64.0%,86.0%,对照组分别为25.5%,59.6%,水疱结痂率治疗组较对照组提高(均P0.01)。结论氦氖激光联合治疗带状疱疹对减轻带状疱疹患者疼痛和促进皮疹痊愈有较好的效果。     

黄芪对感染VZV小鼠T、MФ细胞功能的影响

目的　观察黄芪对感染VZV小鼠T、MФ细胞功能的影响 ,探讨黄芪在病毒感染治疗方面的作用及机理。方法　制备感染VZV小鼠模型 ,检测血液淋巴细胞转化功能、腹腔巨噬细胞吞噬功能和血清溶血素。结果　感染服药组与对照组比较 ,淋巴细胞转化率、巨噬细胞吞噬率和吞噬指数及血清溶血素均有明显回升 (P <0 .0 1和P <0 .0 5 )。结论　黄芪具有改善VZV感染小鼠体液免疫和细胞免疫功能的作用。     

皮内注射治疗带状疱疹后神经痛的进一步探讨

目的探讨皮内注射治疗带状疱疹后神经痛的效果。方法疱疹消退后3～6个月，病变局部仍有烧灼样刺痛或跳痛，局部皮损面积较小者，采用皮内注射镇痛液，内含0.5％布比卡因5ml，弥可保(Methycobal)针剂500μg，0．9％生理盐水10ml，共16ml，行点状包围法或片状包围法注射。每点注入镇痛液0．2-0．4ml，每日注射1次，连续3d，3次为1疗程，一般需要4-6次，最少3次，最多10次。结果100例患者治疗后，97例痛感完全消失，夜间睡眠改善，生活质量显著提高，随访1年未发现特殊不适。3例患者左上肢病变侵及左腋下，治疗后疼痛消失，但在阴天或劳累后偶有局部跳痛感。结论皮内注射是一种治疗带状疱疹后神经痛的有效、安全且简便的方法。     

Predicting and preventing post-herpetic neuralgia: Are current risk factors useful in clinical practice?

Post-herpetic neuralgia (PHN) following acute herpes zoster remains a significant cause of neuropathic pain especially in the elderly. Early treatment of the zoster rash with antiviral agents, such as aciclovir remains one of the few measures proven to reduce the incidence and duration of PHN albeit only in a subset of patients. It is therefore crucial that the physician who first sees a case of zoster identifies those patients who are most likely to develop long-term pain and treats them accordingly. In particular, prodrugs such as famciclovir and valaciclvoir may be more beneficial in reducing PHN than the shorter acting aciclovir, but can be more expensive. Measures that could be used to predict patients likely to develop PHN would also facilitate the evaluation of early use of antiepileptic, anti-inflammatory and analgesic agents in the prevention of PHN. In a prospective study of 280 herpes zoster (HZ) cases seen by the general practitioner (GP) we evaluated the predictive value of five clinical factors identified in clinical trials as associated with a higher likelihood of PHN. A visual analogue score (VAS) over 5 and/or age over 50 correctly identified all subjects with PHN at 3 and 6 months, respectively. However, the specificity of this prediction was low because as many as 81% and 85% of those aged over 50 recovered within 3 and 6 months, respectively. Better methods are needed to identify patients over 50 at most risk of PHN that enable GPs to better allocate their resources with respect to HZ treatment.