mNGF联合腺苷钴胺治疗带状疱疹急性期神经痛的疗效观察

目的观察鼠神经生长因子（mNGF）及腺苷钴胺联合用药对带状疱疹急性期神经痛的治疗效果。方法将90例发病5 d内的带状疱疹患者随机分为3组,每组30例,除予以抗病毒等基础治疗外,腺苷钴胺组肌肉注射腺苷钴胺1.0 mg,1次/d；mNGF组肌肉注射鼠神经生长因子30μg,1次/d；联合组肌肉注射腺苷钴胺1.0 mg＋鼠神经生长因子30μg,1次/d,治疗持续14 d。观察50%疱疹结痂的时间,治疗前、治疗7 d、14 d后疼痛程度[视觉模拟评分（VAS）评分]以及疼痛缓解的总有效率。结果 3组50%疱疹结痂时间是：腺苷钴胺组（9.68±2.20）d,mNGF组（9.40±1.95）d,联合组（9.17±2.30）d,均无明显差异（P〉0.05）；3组VAS评分在治疗后较治疗前均降低,其中腺苷钴胺组与mNGF组治疗后VAS评分无显著差异,但联合组治疗后VAS评分明显低于其他两组（P〈0.05）；治疗总有效率腺苷钴胺组、mNGF组和联合组分别是63.33%、66.67%、90.00%,联合组更优（P〈0.05）。结论mNGF联合腺苷钴胺治疗带状疱疹急性期神经痛效果显著,优于单独应用一种药物。

Curative effects of mouse nerve growth factor combined with cobamamide on neuralgia of acute herpes zoster

Objective To observe the effects of mouse nerve growth factor（ mNGF） combined with cobamamide on neuralgia of acute herpes zoster. Methods 90 cases of herpes zoster patients with onset time 5 days were randomly divided into 3 groups：cobamamide group,mNGF group and combined group,30 cases in each; antiviral therapy was performed on all the patients in the 3groups,while injection of cobamaide（ 1. 0 mg）,once a day,was added to patients in cobamamide group,injection of mNGF（ 30 μg）,once a day,to patients in mNGF group and combined injection of cobamamide（ 1. 0 mg） and mNGF（ 30 μg）,once a day,to patients in combined group,the courses in the 3 groups all lasted for 14 days; an observation was made to the crusting time of 50% lesion,visual analog scales（ VAS） at the time point of before treatment,the 7th day and the 14 th day after treatment,and the total effective rate of pain relief. Results The crusting time of 50% lesion was（ 9. 68 ± 2. 20） days in cobamamide group,（ 9. 40 ± 1. 95） days in mNGF group and（ 9. 17 ± 2. 30） days in combined group,the difference among the 3 groups was not obvious（ P 〉0. 05）; VAS in the 3 groups all decreased after treatment,no significant difference was found between cobamamide group and mNGF group after treatment,while VAS in combined group after treatment was much lower than those in the other 2 groups（ P〈 0. 05）; the total effective rate was 63. 33% in cobamamide group,66. 67% in mNGF group and 90. 00% in combined group,and the total effective rate in combined group was the most superior（ P 〈 0. 05）. Conclusions The effect of combined application of mNGF and cobamamide on neuralgia of acute herpes zoster is much better than that of sole application of mNGF or cobamamide.