灯盏花素联合神经阻滞治疗带状疱疹的效果观察

Clinical observation of treating zoster with nerve block combined with breviscapine

关键词:  灯盏花素|带状疱疹|神经痛

Key words:  breviscapine|zoster|neuralgia

摘要:

[目的] 观察灯盏花素治疗带状疱疹的疗效。[方法] 70例带状疱疹患者随机分为2组，对照组口服药物治疗：泛昔洛韦0.25g，每日3次，口服治疗周期7d；弥可保0.5mg，每日2次，口服，加巴喷丁300mg，每8h口服1次。神经阻滞治疗：根据患者的疱疹区域，选择相应的受累神经，行椎间孔阻滞。选用0.4%利多卡因混合液（每20mL含有维生素B12（VitB12）0.5mg，神经妥乐平3.6单位），每个椎间孔注射5~7mL进行阻滞，一次阻滞最大量不超过20mL，每周2次，连续3周。治疗组在对照组治疗的基础上给予灯盏花素50mg+生理盐水250mL，静脉输注，每日1次，共14d。[结果] 治疗组治疗7d后各时段视觉模拟评分法（VAS评分）明显低于对照组，差异有统计学意义（p<0.05），两组病例的结痂时间分别为（6.8±3.9）、（4.6±2.8）d，脱痂时间分别为（14.1±4.7）、（8.9±3.1）d，治疗组结痂、脱痂时间明显低于对照组，差异有统计学意义（p<0.05）。治疗30d后，两组的总有效率均为100%，治疗组和对照组的显效率分别为85.7%和82.8%，两组疗效比较差异无统计学意义（p>0.05）。随访至患者皮损恢复后6个月，治疗组3例出现后遗神经痛，后遗神经痛发生率为8.6%。对照组5例出现后遗神经痛，后遗神经痛发生率为14.3%，两组比较，治疗组后遗神经痛发生率低于对照组，但差异无统计学意义（p>0.05）。两组病例治疗期间均无不良反应发生。[结论] 灯盏花素能够改善神经纤维的微循环、促进神经修复，降低患者的疼痛强度，改善带状疱疹的症状，有效预防和减少带状疱疹后遗神经痛的发生，可以安全有效地用于治疗带状疱疹。

Abstract:

[Objective] To investigate the curative effects of breviscapine on the zoster. [Methods] The ents with zoster were divided into observation group and control group at random, then the control group was treated with oral drugs (famciclovir 0.25 g, 3 times a day; mecobalamin 0.5 mg, 2 times a day; gaba martin 300 mg) and nerve block (neurotropin in 3.6 IU, Vitamin B12 0.5 mg, 4%lidocaine diluted to 20 mL with sodium chloride). The observation group was treated with 50 mg of breviscapine injection and NS 250 mL through intravenous drip for 14 days. [Results] The VAS of each group decreased obviusly after treatment for 7 days compared with the VAS before treatment, the difference between two groups was significant (p<0.05). Scab time was (6.8±3.9), (4.6±2.8) days. Decrustation time was (14.1±4.7), (8.9±3.1) days, and observation group was significantly lower than the control group. The difference was statistically significant (p<0.05). After 30 d treatment, the total effective rate between two groups was 100%, and the excellence rate of observation group and control group was 85.7%and 82.8%. After 6 months followed to the patients with lesions after recovery, postherpetic neuralgia occurrence rate of observation group and control group was 8.6% and 14.3%. During the period of treatment, the two groups of patients had no adverse reaction. [Conclusion] Breviscapine injection is a kind of effective drugin treating patients of zoster. It can improve the nerve fibers of the microcirculation, promote nerve repair, reduce the intensity of pain patients, and improve the symptom of zoster, effectively prevent and reduce postherpetic neuralgia.