小柴胡汤加减治疗急性带状疱疹的有效性及对疱疹后神经痛的预防作用

李田芳; 谢蔚; 张淑红; 姚亚君; 祝琳; 吴瑜煜; 叶红

doi:10.16766/j.cnki.issn.1674-4152.003512

小柴胡汤加减治疗急性带状疱疹的有效性及对疱疹后神经痛的预防作用

doi: 10.16766/j.cnki.issn.1674-4152.003512

李田芳¹,
谢蔚²,
张淑红³,
姚亚君⁴,
祝琳¹,
吴瑜煜⁵,
叶红^6, ,

1.
龙游县人民医院康复医学科，浙江衢州 324400
2.
衢州市中医医院针灸科，浙江衢州 324000
3.
龙游县人民医院神经内科
4.
龙游县人民医院皮肤科
5.
象山县中医医院医疗健康集团针灸推拿科，浙江宁波 315700
6.
象山县中医医院医疗健康集团神经内科

基金项目:

浙江省中医药科技计划项目 2024ZL986

详细信息

通讯作者:
叶红，E-mail：694372753@qq.com

中图分类号: R752.12 R289.51
计量
- 文章访问数: 35
- HTML全文浏览量: 17
- PDF下载量: 2
- 被引次数: 0
出版历程
- 收稿日期: 2024-01-23
- 网络出版日期: 2024-07-20

The effectiveness of modified Xiaochaihu Decoction in the treatment of acute herpes zoster and its preventive effect on postherpetic neuralgia

1.
Rehabilitation Department of Longyou County People ' s Hospital, Quzhou, Zhejiang 324400, China

摘要

摘要: 目的探讨小柴胡汤加减治疗急性带状疱疹(AHZ)的疗效及对疱疹后神经痛(PHN)的预防作用，旨在寻找一种有效、安全的治疗方案。方法将2019年1月—2023年6月龙游县人民医院收治的186例AHZ患者按照随机数字表法分成A组与B组，A组93例予以常规西药治疗，B组93例给予小柴胡汤加减治疗。观察2组患者疼痛程度与睡眠质量、T细胞亚群、细胞因子、病情控制时间、临床疗效、盐酸羟考酮缓释片使用率、复发率以及PHN发生率。结果治疗后，B组患者数字评分量表(NRS)、匹兹堡睡眠质量指数量表(PSQI)得分[(3.43±0.52)分、(7.78±0.97)分]均低于A组[(4.15±0.67)分、(10.06±1.22)分, P＜0.05]。治疗后，B组患者CD3⁺、CD4⁺、CD4⁺/CD8⁺高于A组，CD8⁺低于A组；B组TNF-α、IL-1β低于A组，IL-2、IL-10高于A组，差异均有统计学意义(P＜0.05)。B组止疱、结痂、脱痂、止痛的时间均短于A组。B组总有效率(96.77%，90/93)高于A组(83.87%, 78/93), 差异有统计学意义(P＜0.05)。B组盐酸羟考酮缓释片使用率、复发率与PHN发生率均低于A组(P＜0.05)。结论小柴胡汤加减治疗AHZ的有效性较好，可减轻患者疼痛，改善睡眠质量，增强免疫功能，减轻炎症反应，患者病情控制时间短，且盐酸羟考酮缓释片使用率、复发率及PHN发生率较低。
- 小柴胡汤加减治疗 /
- 抗病毒 /
- 急性带状疱疹 /
- 神经痛
Abstract: Objective To explore the therapeutic effect of modified Xiaochaihu Decoction on acute herpes zoster (AHZ) and its preventive effect on postherpetic neuralgia (PHN), aiming to find an effective and safe treatment. Methods A total of 186 AHZ patients admitted to Longyou County People ' s Hospital from January 2019 to June 2023 were divided into Group A and Group B according to random number table method. Group A (93 cases) were treated with conventional Western medicine, while Group B (93 cases) were treated with modified Xiaochaihu Decoction. Two groups of the degree of pain and sleep quality, T cell subsets, cytokines, disease control time, clinical efficacy, utilization rate of oxycodone hydrochloride sustained-release tablets, recurrence rate, and incidence of PHN were observed. Results After treatment, the numerical rating scale (NRS) and Pittsburgh sleep quality index (PSQI) scores of patients in group B (3.43±0.52, 7.78±0.97) were lower than those in group A (4.15±0.67, 10.06±1.22), P < 0.05. The levels of CD3⁺, CD4⁺, CD4⁺/CD8⁺in Group B were higher than those in Group A, while CD8⁺ was lower than that in Group A. TNF-α and IL-1β in Group B were lower than those in Group A, while IL-2 and IL-10 were higher than those in Group A, with statistical differences (P < 0.05). The time for preventing blisters, scabbing, scabbing, and pain relief in Group B were shorter than those in Group A. The total effective rate of group B (96.77%, 90/93) was higher than that of group A (83.87%, 78/93), with statistical difference (P < 0.05). The utilization rate of roxycodone hydrochloride sustained-release tablets, recurrence rate, and PHN incidence rate in Group B were lower than those in Group A (P < 0.05). Conclusion The modified Xiaochaihu Decoction is effective in treating AHZ, It can relieve pain, improve sleep quality, enhance immune function, and reduce inflammatory reactions. The time of disease control is relatively shorter, and the utilization rate of oxycodone hydrochloride, recurrence rate and the incidence of PHN are lower.
- Treatment with modified Xiaochaihu Decoction /
- Antivirus /
- Acute herpes zoster /
- Neuralgia

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表 1 2组AHZ患者疼痛程度与睡眠质量比较(x±s，分)

Table 1. Comparison of pain levels and sleep quality between two groups of AHZ patients (x±s, points)

组别	例数	NRS得分		PSQI得分
组别	例数	治疗前	治疗后	治疗前	治疗后
A组	93	7.46±1.04	4.15±0.67^b	15.16±1.47	10.06±1.22^b
B组	93	7.51±1.02	3.43±0.52^b	15.20±1.45	7.78±0.97^b
统计量		0.331^a	10.252^c	0.187^a	16.214^c
P值		0.741	＜0.001	0.852	＜0.001
注：与同组治疗前比较，^bP＜0.05。^a为t值，^c为F值。

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表 2 2组AHZ患者T细胞亚群比较(x±s)

Table 2. Comparison of T-cell subpopulations in two groups of patients with AHZ (x±s)

组别	例数	CD3⁺(%)		CD4⁺(%)		CD8⁺(%)		CD4⁺/CD8⁺
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
A组	93	44.61±5.54	48.73±7.16^b	38.03±4.75	42.33±4.96^b	29.98±4.21	26.35±4.94^b	1.19±0.40	1.45±0.57^b
B组	93	44.58±5.57	52.57±6.49^b	37.96±4.79	47.61±5.89^b	30.03±4.17	23.16±4.22^b	1.22±0.37	1.70±0.51^b
统计量		0.037^a	4.135^c	0.100^a	7.020^c	0.081^a	5.262^c	0.531^a	4.682^c
P值		0.971	＜0.001	0.920	＜0.001	0.935	＜0.001	0.596	＜0.001
注：与同组治疗前比较，^bP＜0.05。^a为t值，^c为F值。

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表 3 2组AHZ患者细胞因子比较(x±s)

Table 3. Comparison of cytokines in two groups of AHZ patients (x±s)

组别	例数	TNF-α(ng/L)		IL-1β(ng/L)		IL-2(pg/mL)		IL-10(pg/mL)
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
A组	93	18.63±3.68	10.94±2.20^b	10.38±2.15	6.15±1.62^b	11.62±3.15	17.23±3.77^b	13.63±2.72	23.62±2.73^b
B组	93	18.67±3.71	6.33±1.56^b	10.42±2.10	3.45±1.12^b	11.58±3.19	28.14±4.50^b	13.29±2.76	30.17±3.84^b
统计量		0.074^a	18.732^c	0.128^a	15.014^c	0.086^a	18.936^c	0.846^a	14.958^c
P值		0.941	＜0.001	0.898	＜0.001	0.932	＜0.001	0.399	＜0.001
注：与同组治疗前比较，^bP＜0.05。^a为t值，^c为F值。

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表 4 2组AHZ患者病情控制时间比较(x±s，d)

Table 4. Comparison of disease control duration between two groups of ahz patients (x±s, d)

组别	例数	止疱	结痂	脱痂	止痛
A组	93	5.15±1.30	10.53±1.76	13.11±1.97	18.35±2.77
B组	93	4.49±1.13	8.49±1.30	11.83±1.55	14.26±2.10
t值		3.695	8.991	4.924	11.347
P值		＜0.001	＜0.001	＜0.001	＜0.001

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表 5 2组AHZ患者临床总有效率比较

Table 5. Comparison of overall clinical efficacy between two groups of AHZ patients

组别	例数	痊愈(例)	显效(例)	有效(例)	无效(例)	总有效[例(%)]
A组	93	20	27	31	15	78(83.87)
B组	93	28	42	20	3	90(96.77)
注：2组总有效率比较，χ²=8.857，P=0.003。

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表 6 盐酸羟考酮缓释片使用率、复发率与PHN发生率比较[例(%)]

Table 6. Comparison of Usage rate, recurrence rate, and incidence of PHN in extended-release oxycodone hydrochloride tablets [cases (%)]

组别	例数	盐酸羟考酮缓释片使用	复发	PHN发生
A组	93	9(9.68)	8(8.60)	6(6.45)
B组	93	2(2.15)	1(1.08)	0
χ²值		4.735	4.203	4.306
P值		0.030	0.040	0.038

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