伐昔洛韦联合神经阻滞对急性期带状疱疹性神经痛临床疗效的影响  

The Effect of Valacyclovir Combined with Nerve Block on the Clinical Efficacy of Acute Herpes Zoster Neuralgia

作　　者：杨秀环[1] 梁华杰[1] 李泉[1] 林宗航[1] 苏适夷 李恒[1] YANG Xiuhuan;LIANG Huajie;LI Quan;LIN Zonghang;SU Shiyi;LI Heng(Department of Pain,the Sixth Affiliated Hospital of Guangzhou Medical University,Qingyuan 511518,China;不详)

机构地区：[1]广州医科大学附属第六医院(清远市人民医院)疼痛科,广东清远511518

出　　处：《中国医学创新》2024年第9期64-69,共6页Medical Innovation of China

基　　金：广东省清远市科技计划项目(190912104569116)。

摘　　要：目的:探讨伐昔洛韦联合神经阻滞对急性期带状疱疹性神经痛患者睡眠质量及血清疼痛介质指标、炎症因子表达的影响。方法:前瞻性选取2020年5月—2023年5月广州医科大学附属第六医院收治的60例急性期带状疱疹性神经痛患者作为本次研究对象,按照随机数字表法分为治疗A组和治疗B组,各30例。治疗A组予以伐昔洛韦治疗,治疗B组则在治疗A组基础上加用神经阻滞治疗。评估两组临床疗效、匹兹堡睡眠质量指数(PSQI)评分、血清疼痛介质指标、炎症因子表达水平及不良反应发生情况。结果:治疗B组临床治疗总有效率为93.33%,显著高于治疗A组的63.33%,差异有统计学意义(P<0.05)。干预后,两组PSQI评分较干预前均显著改善,且治疗B组PSQI评分显著优于治疗A组,差异均有统计学意义(P<0.05)。干预后,治疗B组血清疼痛介质指标较干预前均明显改善,且治疗B组β-内啡肽(β-EP)指标明显高于治疗A组,血浆P物质(SP)及一氧化氮(NO)指标则明显低于治疗A组,差异均有统计学意义(P<0.05)。干预后,治疗B组炎症因子表达水平较干预前均明显改善,且治疗B组γ干扰素(IFN-γ)水平明显高于治疗A组,而白细胞介素-6(IL-6)及肿瘤坏死因子-α(TNF-α)水平则明显低于治疗A组,差异均有统计学意义(P<0.05)。治疗B组发生的头晕、胃肠不适及皮肤瘙痒总发生率显著低于治疗A组,差异有统计学意义(P<0.05)。结论:伐昔洛韦联合神经阻滞治疗急性期带状疱疹性神经痛患者,其临床疗效更为显著,可有效改善患者的睡眠质量、血清疼痛介质指标及炎症因子表达水平,减少不良反应的发生率。Objective:To investigate the effect of Valacyclovir combined with nerve block on sleep quality and serum pain mediators and inflammatory factors in patients with acute herpes zoster neuralgia.Method:A total of sixty patients with acute herpes zoster neuralgia admitted to the Sixth Affiliated Hospital of Guangzhou Medical University from May 2020 to May 2023 were prospectively selected as the subjects of this study,they were divided into treatment group A and treatment group B by the random number table method,with 30 cases in each group.The treatment group A was treated with Valacyclovir,and the treatment group B was treated with nerve block on the basis of the treatment group A.The clinical efficacy,Pittsburgh sleep quality index(PSQI),serum pain mediator indexes,inflammatory factor expression level and adverse reactions of the two groups were evaluated.Result:The total effective rate of clinical treatment in the treatment group B was 93.33%,which was significantly higher than 63.33%in the treatment group A,the difference was statistically significant(P<0.05).After the intervention,the PSQI scores in the two groups were significantly improved compared with those before the intervention,and the PSQI scores in the treatment group B were significantly better than those in the treatment group A,the differences were statistically significant(P<0.05).After the intervention,the serum pain mediator indexes of the patients in the treatment group B were significantly improved compared with those before the intervention,and theβ-endorphin(β-EP)index in the treatment group B was significantly higher than that in the treatment group A,while the plasma substance P(SP)and calcitonin gene-related peptide(NO)indexes were significantly lower than those in the treatment group A,the differences were statistically significant(P<0.05).After intervention,the expression levels of inflammatory factors in the treatment group B were significantly improved compared with those before intervention,and the level of interferon-γ(IFN-γ)in t

关 键 词：伐昔洛韦 神经阻滞 急性期带状疱疹性神经痛 睡眠质量 疼痛介质指标 炎症因子 

分 类 号：R752.12[医药卫生—皮肤病学与性病学]