联合小剂量糖皮质激素治疗带状疱疹的临床疗效评价  

Clinical efficacy evaluation of combined low-dose glucocorticoid in the treatment of herpes zoster

作　　者：赵文斌[1] 陈淑慧[1] 王哲[1] Zhao Wenbin;Chen Shuhui;Wang Zhe(Department of Dermatology,Beijing Pinggu Hospital,Beijing101200,China)

机构地区：[1]北京市平谷区医院皮肤性病科,101200

出　　处：《中华保健医学杂志》2022年第1期54-56,共3页Chinese Journal of Health Care and Medicine

基　　金：北京市平谷区医院课题(Pgyy2018-29)。

摘　　要：目的评价糖皮质激素对带状疱疹患者疼痛、皮肤损伤和生活质量的影响及预防后遗神经痛的作用。方法选取2019年6月~2021年3月北京市平谷区医院门诊就诊的患者,采用完全随机方法分为试验组与对照组,对照组给予抗病毒营养神经治疗,试验组在对照组基础上加用小剂量甲泼尼龙。在治疗1周、2周评价两组间数字疼痛强度量表(numerical rating scale,NRS)、语言评价量表(Verbal rating scales,VRS)、皮肤病生存质量指数(dermatology life quality Index,DLQI)的差异,评价两组患者皮肤损伤恢复时间、疼痛减轻时间上的差异,在治疗4周、8周评价两组患者后遗神经痛的比例。结果共入组100例,试验组50例,对照组50例,实际完成93例,随访期失访6例。两组患者基线资料比较,差异均无统计学意义(P>0.05)。与治疗前比较,试验组与对照组在治疗1周、治疗2周NRS、VRS与DQLI评分均下降(P<0.05)。试验组在治疗1周、治疗2周后NRS、VRS与DQLI评分均低于对照组(P<0.05)。试验组皮肤损伤结痂时间、疼痛减轻时间短于对照组,差异有统计学意义(P<0.05),皮肤损伤痊愈时间与对照组差异无统计学意义(P>0.05)。两组在治疗4周、8周后遗神经痛的比例差异无统计学意义(P>0.05)。结论小剂量糖皮质激素可以减轻带状疱疼痛程度,缩短疼痛减轻时间,加速皮肤损伤愈合,改善患者患病期间的生活质量,但并不能阻止后遗神经痛的发生。Objective To evaluate the effects of glucocorticoids on pain,skin lesion and life quality in patients with herpes zoster and the prevention of post-herpetic neuralgia(PHN),Methods Patients in our department from June 2019 to March 2021 were randomly divided into treatment group and control group.The control group was given the antiviral and neurotrophic therapy,and the treatment group was given low-dose methylprednisolone in addition to the antiviral and neurotrophic therapy.Numerical Rating Scale(NRS),Verbal Rating Scales(VRS)and Dermatology Life quality Index(DLQI)of between the two groups were evaluated at 1 and 2 week of treatment.The difference of skin lesion recovery time and pain relief time between the two groups were evaluated.The proportion of PHN between the two groups were evaluated at 4 and 8 weeks after treatment.Results 100 cases were enrolled,50 cases were treatment group and 50 cases were control group,93 cases were actually completed,6 cases were lost during the follow-up period.There were no significant difference at baseline between the two groups(P>0.05).Compared with prior treatment,NRS,VRS and DQLI scores of treatment group and control group decreased at 1 and 2 weeks(P<0.05).NRS,VRS and DQLI scores of treatment group were lower than those in control group after 1 and 2 weeks(P<0.05).The crusting time of skin lesions and pain relief time of treatment group were shorter than those of control group(P<0.05),but there was no significant difference in the recovery time of skin lesions between the two group(P>0.05).There was no significant difference in the proportion of PHN between the two groups after 4 and 8 weeks(P>0.05).Conclusions Low dose of glucocorticoid can alleviate the pain degree of herpes zoster,shorten the time of pain relief,accelerate crusting time of skin lesion,and improve the quality of life during the course of disease,but it can not prevent the occurrence of PHN.

关 键 词：糖皮质激素 带状疱疹 疼痛 生活质量 

分 类 号：R752[医药卫生—皮肤病学与性病学]