Metformin use and the risks of herpes zoster and postherpetic neuralgia in patients with type 2 diabetes

Herpes zoster and postherpetic neuralgia cause substantial pain in patients. Persons with type 2 diabetes (T2D) are prone to zoster infection and postherpetic neuralgia due to compromised immunity. We conducted this study to evaluate the risks of herpes zoster and postherpetic neuralgia between metformin users and nonusers. Propensity score matching was utilized to select 47 472 pairs of metformin users and nonusers from Taiwan's National Health Insurance Research Database between January 1, 2000, and December 31, 2017. The Cox proportional hazards models were used for comparing the risks of herpes zoster and postherpetic neuralgia between metformin users and nonusers in patients with T2D. Compared with no-use of metformin, the adjusted hazard ratios (95% confidence interval) for metformin use in herpes zoster and postherpetic neuralgia were 0.70 (0.66, 0.75) and 0.510 (0.39, 0.68), respectively. A higher cumulative dose of metformin had further lower risks of herpes zoster and postherpetic neuralgia than metformin no-use. This nationwide cohort study demonstrated that metformin use was associated with a significantly lower risk of herpes zoster and postherpetic neuralgia than metformin no-use. Moreover, a higher cumulative dose of metformin was associated with further lower risks of these outcomes.     

不良妊娠TORCH感染分析

目的　为了了解不良妊娠中TORCH感染的影响。方法　应用酶联免疫吸附试验 (ELISA)对 31例不良妊娠及 43例正常妊娠的孕妇进行TORCH感染监测。结果　两组感染率最高均为CMV ,其次为HSVⅠ 。两组相比CMV有极显著性差异 (P <0 .0 0 5 ) ;HSVⅠ 有显著差异 (P <0 .0 5 )。两组IgG检出率最高均为CMV ,分别为 96 .77%及 6 9.77% ,最低均为TOXO ,分别为 2 .9%、9.3% ;两组的IgM检出率最高均为CMV ,分别为 35 .48%、16 .2 8%。两组易感染率最高均为TOXO。结论　CMV、HSVⅠ 是本地区TORCH感染中对妊娠影响最大的病原体 ,二者均为性传播疾病 ,对其危害不容忽视     

Acyclovir treatment of relapsing-remitting multiple sclerosis

Acyclovir treatment was used in a randomized, double-blind, placebo-controlled clinical trial with parallel groups to test the hypothesis that herpes virus infections are involved in the pathogenesis of multiple sclerosis (MS). Sixty patients with the relapsing-remitting form of MS were randomized to either oral treatment with 800 mg acyclovir or placebo tablets three times daily for 2 years. The clinical effect was investigated by an extensive test battery consisting of neurological examinations, neuro-ophthalmological and neuropsychological tests, and evoked potentials. Results were based on intent-to-treat data and the primary outcome measure was the exacerbation rate. In the acyclovir group (n = 30), 62 exacerbations were recorded during the treatment period, yielding an annual exacerbation rate of 1.03. The placebo group (n = 30) had 94 exacerbations and an annual exacerbation rate of 1.57. Thus, 34% fewer exacerbations were encountered during acyclovir treatment. This difference in exacerbation rate between the treatment groups was not significant (P = 0.083). However, this trend to a lower disease activity in acyclovir-treated patients was supported in subsequent data analysis. If the patients were grouped according to exacerbation frequencies, i.e. into low (0–2), medium (3–5) and high (6–8) rate groups, the difference between acyclovir and placebo treatment was significant (P = 0.017). Moreover, in a subgroup of the population with a duration of the disease of at least 2 years providing an exacerbation rate base-line before entry, individual differences in exacerbation rates were compared between the 2-year pre-study period and the study period in acyclovir-treated (n = 19) and placebo (n = 20) patients and acyclovir-treated patients showed a significant reduction of exacerbations (P = 0.024). Otherwise, neurological parameters were essentially unaffected by acyclovir treatment and there were no convincing signs of reduced neurological deterioration in the acyclovir group. This study indicates that acyclovir treatment might inhibit the triggering of MS exacerbations and thus suggests that acyclovir-susceptible viruses might be involved in the pathogenesis of MS. This possibility warrants further investigation.     

10例带状疱疹性角膜炎、虹膜睫状体炎的治疗体会

目的 评价静滴氢化可的松、0．5％阿托品眼液与0．5％托吡酰胺眼液点眼在治疗带状疱疹性角膜炎、虹膜睫状体炎中的疗效。方法 在带状疱疹性角膜凝、虹膜睫状体炎的早期应用静滴氢化可的松、0．5％阿托品眼液与0．5％托吡酰忮眼液点眼。结果 虹膜睫状体炎症缓解，角膜炎症被控制。结论 在带状疱疹性角膜炎、虹膜睫状体炎早期应用静滴氢化可的松。0．5％阿托品眼液与0．5％托吡酰忮眼液点眼疗效确切，可降低虹膜睫状体炎的并发症。     

刺络拔罐为主治疗头颈部带状疱疹疗效观察

目的:对比刺络拔罐配合艾灸与西药治疗头颈部带状疱疹的临床疗效.方法:治疗组35例在大椎等穴以及出疱疹处运用梅花针刺络拔罐并配合艾灸等治疗;对照组35例采取静脉滴注阿昔洛韦及外用阿昔洛韦霜治疗.结果:7天后治疗组愈显率为85.7%,优于对照组的51.4%(P＜0.01),且治疗组治疗3天后重、中度疼痛缓解率也明显优于对照组(P＜0.01).结论:刺络拔罐疗法配合艾灸等治疗头颈部带状疱疹,止痛明显,疗效显著,见效快.     

腺病毒介导HSV-TK/GCV系统联合放射治疗口腔鳞癌的研究

目的 探讨单纯疱疹病毒胸苷激酶基因（HSV－TK）／丙氧鸟苷（GCV）自杀基因系统对放射治疗的增敏作用。方法 口腔鳞癌细胞（Tca8113细胞系）经HSV－TK／GCV系统治疗后给予放射治疗，采用LQ和单击多靶（SHMT）模型分析细胞存活曲线参数。结果 细胞存活曲线分析显示：单纯放射治疗组其α为0.1074,β为0.0158,D0为2.2576,Dq为3.5413；与单纯放射治疗组比较，HSV－TK／GCV治疗组α（0.2127)和α：β（9.496)值大，D0（1.4526)和Dq(2.2257)值小，其放射增敏率（SER）为1.55。结论 HSV－TK／GCV系统具有放射增敏作用，可提高放射治疗对口腔鳞癌的治疗疗效。     

黄振民老中医治疗带状疱疹经验介绍

介绍黄振民老中医治疗带状疱疹经验，提出从肝经辨证论治，主张发作期以泻肝火为主，后遗症期以养肝活血为主，并根据皮损发生的部位，加入不同的引经药，取得明显的疗效。     

复方甘草酸苷联合无环鸟苷治疗带状疱疹疗效观察

目的:观察复方甘草酸苷联合无环鸟苷治疗带状疱疹的疗效。方法:将98例带状疱疹患者随机分为治疗组(复方甘草酸苷+无环鸟苷)和对照组(无环鸟苷)。结果:治疗后症状、体征消退时间治疗组明显短于对照组(P<0.01);治疗组和对照组后遗神经痛发生率分别为6.10%、18.37%(P<0.01)。结论:复方甘草酸苷联合无环鸟苷治疗带状疱疹的疗效优于单用无环鸟苷。     

新型抗生素S632A对单纯疱疹病毒Ⅰ型感染小鼠的治疗作用

目的研究新型抗生素S632A对单纯疱疹病毒Ⅰ型感染小鼠的治疗作用。方法建立小鼠单纯疱疹病毒性脑炎(HSE)模型，观察给药后小鼠存活率和平均存活时间，并检测给药后不同时间小鼠脑组织病毒滴度，以及HE染色观察给药组小鼠脑组织病变程度。结果实验结果显示28mg／kg治疗剂量的S632A能够明显降低小鼠死亡率，延长其平均存活时间，降低脑组织病毒滴度，减轻脑组织病变程度，且与阳性对照药物阿昔洛韦(ACV)治疗效果类似，统计学上无显著差异。结论一定剂量的S632A在小鼠体内具有类似于ACV的治疗作用，值得进一步研究和开发。