围针合薄棉灸与西药治疗带状疱疹疗效对照观察

目的:比较围针合薄棉灸法与常规口服西药治疗带状疱疹的临床疗效差异.方法:采用随机对照的方法,将80例患者分为围针合薄棉灸组(42例)和西药组(38例).围针合薄棉灸组给予疱疹周边围针配合疱疹表面薄棉灸法治疗,西药组口服阿昔洛韦片加外用阿昔洛韦乳膏.比较治疗前后两组患者疼痛程度积分、疱疹数量积分、疱疹色泽积分、疱疹糜烂渗出积分变化及愈显率.结果:围针合薄棉灸组的愈显率为78.6%(33/42),优于西药组的39.5%(15/38)0.05).两组治疗后各疱状积分较治疗前均明显改善(均P<0.05),且围针合薄棉灸组优于西药组(均P<0.05).结论:围针合薄棉灸法治疗带状疱疹疗效优于常规西药治疗方法.     

氦-氖激光局部照射对带状疱疹的疗效观察及护理

目的：探讨氦-氖（He—Ne）激光照射治疗带状疱疹对皮损愈合的影响及护理。方法：将96例皮肤科门诊带状疱疹患者随机分成照射组（n：50）和对照组（n=46），照射组采用常规药物治疗及He—Ne激光局部照射并配合专科护理，观察其疗效及患者的疼痛消失时间、疱疹结痂和痂皮脱落时间。结果：照射组的痊愈率（50％）和总有效率（94％）均明显高于对照组（P〈0．05）；照射组止痛时间为（1．7±1．02）天，结痂形成时间为（5．1±1．11）天和结痂脱落时间为（7．9±1．23）天，对照组分别为（3．6±1．41）天，（7．3±1．90）天，（9．8±1．53）天，差别均有统计学意义（P〈0．01）。结论：He—Ne激光辅助治疗带状疱疹有明显缓解疼痛、减少皮损渗出、促进皮损干燥、结痂及愈合的作用。     

创疡贴治疗老年带状疱疹80例疗效分析

目的 探讨创疡贴在带状疱疹治疗中的优势.方法 对80例老年带状疱疹,采取针刺疱疹并涂抹阿昔洛伟膏后,应用创疡贴外敷换药治疗.结果 局部胀痛、跳痛立刻缓解,疼痛大大减轻,1周之内发生的带状疱疹3 d～5 d即愈合;1周以上发生感染的带状疱疹创面,5 d～7 d愈合.结论 创疡贴外敷封闭疗法治疗带状疱疹简便易行,疗效满意,值得推广.     

神经阻滞联合疱疹区皮内注射治疗急性带状疱疹痛

目的 观察神经阻滞联合疱疹区皮内注射治疗急性带状疱疹痛的疗效.方法 带状疱疹合并重度疼痛患者86例,分别采用单纯药物治疗（I组）与合用神经阻滞（II组）治疗,观察疼痛缓解程度（VAS评分）、自觉疼痛缓解程度评分、睡眠改善程度评分与并发症.结果 治疗后I、II组VAS评分均明显低于治疗前;II组治疗后VAS评分明显低于I组;合用神经阻滞治疗后自觉疼痛缓解程度评分、睡眠受影响比例均较治疗前及单纯药物治疗后明显改善.结论 神经阻滞联合疱疹区皮内注射治疗急性带状疱疹痛效果明显.     

恩纳和神经阻滞治疗带状疱疹后遗神经痛

目的将恩纳(eutectic mixture of local anesthetics,EMLA)涂抹在带状疱疹后遗神经痛(postherpetic neuralgia,PHN)患者的疼痛皮肤上同时并用神经阻滞,探讨治疗PHN的新方法。方法选择PHN患者40例,用随机、单盲法分成两组。Ⅰ组为试验组,Ⅱ组为对照组。Ⅰ组在疼痛部位涂抹EMLA软膏;Ⅱ组在疼痛部位涂抹红霉素软膏。两组根据疼痛部位所属的脊神经实施肋间神经阻滞或椎间孔阻滞。结果治疗1 h后VAS评分:Ⅰ组0分18例,1-3分2 例;Ⅱ组0分18例,1～3分2例。两组镇痛结果在第1 h差异无统计学意义P>0．05。治疗6-36h 后VAS评分:Ⅰ组0分9例,1-3分11例;Ⅱ组0分1例,1-3分6例,4-6分13例。两组镇痛效果在治疗6-36 h差异有统计学意义P<0．05。1个疗程后Ⅰ组治愈19例(95％),Ⅱ组治愈14例 (70％),两组治愈率差异有统计学意义P<0．05。3个月后随访Ⅰ组总有效率为100％(20例),Ⅱ组总有效率为90％(18例)。两组相比差异有统计学意义P<0．05。结论 EMLA疼痛部位涂抹加神经阻滞治疗PHN比单用神经阻滞有明显的疗效。     

维生素B12、曲安奈德穴位注射治疗带状疱疹后遗神经痛

目的观察维生素B12、曲安奈德穴位注射治疗带状疱疹后遗神经痛的疗效。方法将261例带状疱疹后遗神经痛患者随机分成3组,治疗组128例患者按疱疹分布区的经络辩证循经取穴,将维生素B12、曲安奈德及利多卡因的混合液进行穴位注射,1次／d,10次为1疗程,其余2组分别为维生素B12组和曲安奈德组。结果治疗组128例患者,痊愈100例,显效14例,有效率89．06％,维生素B12组52例患者,痊愈21例,显效5例,有效率50．00％,曲安奈德组81例患者,痊愈36例,显效8例,有效率54．32％,治疗组与两组对照组比较有效率的差异有统计学意义(P<0．01), 3个月随访患者症状无反复。结论维生素B12与曲安奈德穴位注射疗法效高、价廉、安全,适用于无禁忌证的带状疱疹后遗神经痛患者。     

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。     

Real-world evidence on adherence and completion of the two-dose recombinant zoster vaccine and associated factors in U.S. adults, 2017–2021

IntroductionPoor compliance with adult vaccination recommendations contributes to substantial disease burden. Evidence on adherence, completion, and completion timeliness for the 2-dose recombinant herpes zoster vaccine (RZV) and factors associated with these outcomes is limited and not readily generalizable for the entire U.S.MethodsThis retrospective, observational study examined adherence, completion, and the impact of sociodemographic, clinical and geographical factors among U.S. adults ≥ 50 years receiving RZV (4/20/2017 to 3/31/2021), using a large, geographically representative administrative claims database. Continuous enrollment in a medical benefit plan for six months prior to and following the index date (first observed vaccine dose) was required. Adherence was defined as receipt of the 2nd dose within 2–6 months, per label recommendation. Completion (receipt of all doses) was assessed at 6, 12, 18, and 24 months.ResultsAmong 726,352 adults included, the adherence rate was 71.8%. Among 208,311 adults with 24–month follow-up, the completion rate was 72.3% after 6 months and 86.2% after 24 months. Logistic regression showed low adherence/completion was associated with younger age, Black or Hispanic race/ethnicity, lower income, lower educational attainment, and possessing commercial rather than Medicare healthcare insurance. Recipients identified using pharmacy claims had much higher adherence (74.0%) than those identified using medical claims (48.0%).ConclusionsAdherence and completion rates for RZV are suboptimal, especially for adults aged 50–64, racial/ethnic minorities, individuals with lower socio-economic status and those without Medicare insurance. More research and public health efforts are needed to understand and address potential barriers to RZV uptake, adherence and completion.     

Assessing the effectiveness of zoster vaccine live: A retrospective cohort study using primary care data in the United Kingdom

BackgroundHerpes zoster (shingles) is a common viral disease increasing in risk and severity with age. Post-herpetic neuralgia (PHN), a complication of shingles, causes severe pain impacting quality of life (QoL). Zoster Vaccine Live (ZVL), a licensed vaccine for the prevention of shingles in the United Kingdom (UK), is part of the national immunisation programme (NIP) for adults aged 70–79. Public Health England (PHE) reports show shingles vaccine coverage varies, but is typically 50–60% across eligible cohorts.Materials/methodsThis retrospective, matched cohort study was conducted using The Health Improvement Network (THIN) UK primary care database. Individuals aged 70–79 were classified based on their vaccination status between September 2013 and May 2016. Risk and incidence rates for shingles were calculated for both groups over the duration of the study (mean 1.2 years). Vaccine effectiveness (VE) was calculated using the equation 1-relative risk (RR) for shingles and PHN.ResultsWithin the total cohort (n = 295,135), 70,867 (24%) were vaccinated and 224,268 (76%) were unvaccinated. 2435 (0.83%) patients developed shingles: 241 (0.34%) among the vaccinated and 2194 (0.98%) among the unvaccinated. The VE for preventing shingles was 65.3% (95% CI: 60.3–69.6%). The incidence rate in the vaccinated group was 2.95 (95% CI: 2.59–3.34) vs 8.02 (95% CI: 7.68–8.36) per 1000 person years in the unvaccinated group. Risk of PHN was 0.02% and 0.06% in the respective vaccinated and unvaccinated groups. The VE for preventing PHN was 72% (95% CI: 50.0–83.9%). PHN incidence rates were 0.16 (95% CI: 0.08–0.27) and 0.53 (95% CI: 0.44–0.62) per 1000 person years in the vaccinated and unvaccinated groups, respectively.ConclusionsZVL reduced the risk of shingles among an elderly population. Given the negative impact of shingles and PHN on QoL, the benefits of vaccination are clear. Improving uptake in the UK is needed in this population.     

Contralateral facial palsy in a case of cervical zoster

Zusammenfassung Die Facialisparese beim Ramsay Hunt Syndrome und seinen Untergruppen wurde bisher stets ipsilateral zur Hauteruption beschrieben.Kelly berichtet von einer kontralateralen Facialisparese bei einem Zoster Oticus. Hier wird ein Fall von kontralateraler Facialisparese bei einem zervikalen Zoster dargestellt. Es handelt sich um eine 78jährige Patientin, die 2 Wochen nach linksseitigem Auftreten des Herpes Zoster im oberen Zervikalbereich eine periphere Facialisparese rechts entwickelte.Die möglichen pathogenetischen Zusammenhänge werden diskutiert.

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Research Fellow of the Alexander von Humboldt Foundation