中西医结合防治三叉神经痛微创术后带状疱疹病毒激活再感染的效果观察  

Effect of Integrated Traditional Chinese and Western Medicine in the Prevention and Treatment of Herpes Zoster Virus Reinfection Patients after Minimally Invasive Surgery for Trigeminal Neuralgia

作　　者：黄锦益[1] 文志谦 韦克[2] 邓军[2] 兰剑 HUANG Jing-yi;WEN Zhi-qian;WEI Ke;DENG Jun;LAN Jian(Department of Pain,Affiliated Hospital,Youjiang Medical University for Nationalities,Guangxi,533000;Department of Anesthesiology,Affiliated Hospital,Youjiang Medical University for Nationalities,Guangxi,533000)

机构地区：[1]右江民族医学院附属医院疼痛科,广西百色533000 [2]右江民族医学院附属医院麻醉科,广西百色533000

出　　处：《中国中西医结合杂志》2021年第12期1450-1455,共6页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：广西百色市科学研究与技术开发计划项目(No.百科20201711)。

摘　　要：目的观察抗病毒口服液联合伐昔洛韦对三叉神经痛微创术后带状疱疹病毒激活再感染的防治效果。方法80例均为右江民族医学院附属医院疼痛科2014年12月—2019年6月期间收治的拟行经皮微球囊压迫术治疗的三叉神经痛患者,按随机数字表法分为观察组和对照组,每组40例,观察组患者在术前给予伐昔洛韦(每次0.3 g,口服,每天2次)联合抗病毒口服液(每次10 mL,口服,每天2次)预防治疗,连续用药7天;对照组不予抗病毒药物预防用药;观察两组术后带状疱疹发生率;对于术后发生带状疱疹的患者,观察组继续给予伐昔洛韦联合抗病毒口服液治疗,对照组给予伐昔洛韦治疗;比较两组带状疱疹治疗有效率,观察疱疹止疱、结痂、脱痂时间;观察模拟疼痛评分(VAS)、血清IL-2、IL-10、CXC趋化因子配体10(CXCL 10)变化情况,并记录治疗过程中不良反应。结果观察组患者术后带状疱疹发生率为32.50%(13/40),低于对照组[57.50%(23/40)],差异有统计学意义(χ^(2)=5.051,P<0.05);观察组治疗有效率92.31%(12/13),高于对照组[60.87%(14/23)],差异有统计学意义(χ^(2)=4.092,P<0.05);观察组止疱、结痂、脱痂时间均短于对照组(P<0.01);治疗前观察组患者VAS、IL-10、CXCL 10低于对照组,IL-2高于对照组(P<0.01),治疗后两组患者VAS、IL-10、CXCL 10均降低,IL-2升高(P<0.01),且观察组上述指标变化更显著(P<0.05);两组治疗过程中均无明显不良反应发生。结论预防性使用抗病毒口服液联合伐昔洛韦可降低三叉神经痛微创术后带状疱疹发生率,且联合使用治疗带状疱疹的疗效优于单用伐昔洛韦,值得临床推广。Objective To observe the efficacy of Antiviral Oral Liquid(AOL)combined with valaciclovir in the treatment of herpes zoster virus reinfection patients after minimally invasive surgery for trigeminal neuralgia.Methods Totally 80 trigeminal neuralgia patients undergoing micro-balloon compression at Department of Pain,Affiliated Hospital,Youjiang Medical University of Nationalities from Dec.2014 to June 2019 were assigned to an observation group and a control group according to random digit table,40 in each group.Patients in the observation group took valaciclovir(0.3 g each time,twice per day)combined with AOL(10 mL per time,twice per day)for 7 consecutive days.Those in the control group received no antiviral prophylaxis.The incidence of postoperative herpes zoster was observed in the two groups.Patients with herpes zoster after operation were given valaciclovir combined AOL in the observation group and valaciclovir in the control group.The effective rate of herpes zoster treatment was compared between the two groups.The herpes indicators(anti-blister,crusting,desquamate time),visual analogue pain score(VAS),serum IL-2,IL-10,CXC chemokine ligand 10(CXCL 10)were observed.And adverse reactions during the treatment were recorded.Results The incidence of shingles in the observation group was 32.50%(13/40),lower than that in the control group[57.50%(23/40)].The difference between the two groups was statistically significant(χ^(2)=5.051,P<0.05).The effective rate in the observation group was 92.31%(12/13),higher than that in the control group[60.87%(14/23);χ^(2)=4.092,P<0.05].The time of stopping blisters,crusting and removing crusts in the observation group was shorter than that in the control group(P<0.01).Before treatment VAS scores,IL-10,and CXCL 10 of the observation group were lower than those of the control group,and IL-2 was higher than that of the control group(P<0.01).After treatment VAS scores,IL-10,and CXCL 10 in both groups all decreased,while IL-2 increased(P<0.01).And the changes of the above indicators

关 键 词：三叉神经痛 带状疱疹病毒 伐昔洛韦 抗病毒口服液 中西医结合 

分 类 号：R651.3[医药卫生—外科学]