联用糖皮质激素治疗老年头面部带状疱疹的疗效

doi:10.3760/cma.j.issn.0412-4030.2018.09.008

摘要/Abstract

摘要： 目的观察联用糖皮质激素（简称激素）治疗 ≥ 60岁老年人头面部带状疱疹的疗效。方法 2013年6月至2017年6月就诊于常熟市第一人民医院皮肤科头面部带状疱疹患者76例，抽签法随机分为激素组与常规治疗组，对比两组患者皮损改善时间、疼痛缓解时间、后遗神经痛及不良反应发生情况。结果激素组皮损改善时间低于常规治疗组，两组相比差异均有统计学意义（P < 0.01）。两组治疗前疼痛数字评分（NRS）差异无统计学意义（P > 0.05），治疗后第7天激素组低于同期常规治疗组（P < 0.05）；治疗后第30、90天，两组差异均无统计学意义（P > 0.05）。两组带状疱疹后遗神经痛发生率均低，且差异无统计学意义（χ2 = 0.347，P > 0.05）。两组不良反应发生率低且程度较轻。结论联用糖皮质激素治疗老年人头面部带状疱疹疗效显著，安全性好。

关键词: 带状疱疹, 糖皮质激素类, 治疗结果, 抗病毒药, 疗效比较研究

Abstract: Zhang Jing, Xue Qiao, Fan Wen′ge, Wei Mei, Wang Ling, Zhao Jun, Ding Hao, Tao Xiaoyu Department of Dermatology, Changshu No.1 People′s Hospital, Changshu Hospital Affiliated to Soochow University, Changshu 215500, Jiangsu, China Corresponding author: Fan Wen′ge, Email: fwgqh@sina.com 【Abstract】 Objective To evaluate the therapeutic effect of combined glucocorticoids on herpes zoster of the head and face in the elderly aged ≥ 60 years. Methods From June 2013 to June 2017, 76 patients with herpes zoster of the head and face were enrolled from the Department of Dermatology of Changshu No.1 People′s Hospital, and randomly and equally divided into glucocorticoid group and conventional treatment group by drawing lots. The patients in the 2 groups were all treated with intravenous penciclovir （0.25 g, twice a day） for 7 days, intravenous mecobalamine （1 ml, once a day） for 7 days, and topical penciclovir cream four times every day, and the patients in the glucocorticoid group were additionally treated with intravenous methylprednisolone sodium succinate （40 mg, once a day） for 5 days. The time to skin lesion improvement and pain relief, incidence of postherpetic neuralgia and adverse reactions were compared between the two groups. Results The time to skin lesion improvement was shorter in the glucocorticoid group than in the conventional treatment group（P < 0.01）. Before the treatment, no significant difference in the numerical rating scale （NRS） score for pain was observed between the 2 groups （P > 0.05）. Seven days after the treatment, the NRS score was significantly lower in the glucocorticoid group than in the conventional treatment group （P < 0.05）, while there was no significant difference between the 2 groups after 30-and 90-day treatment （both P > 0.05）. The incidence rate of postherpetic neuralgia was very low in the 2 groups with no significant difference between them （χ2 = 0.347, P > 0.05）. The 2 groups both showed infrequent and mild adverse reactions. Conclusion Combined glucocorticoids showed marked therapeutic effect and good safety for herpes zoster of the head and face in the elderly.

Key words: Herpes zoster, Glucocorticoids, Treatment outcome, Antiviral agents, Comparative effectiveness research

张静薛峤范文葛魏梅王玲赵军丁浩陶晓瑜. 联用糖皮质激素治疗老年头面部带状疱疹的疗效[J]. 中华皮肤科杂志, 2018, 51(9): 670-672.

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