疏风解毒汤药对带状疱疹临床疗效、后遗神经痛及炎性细胞因子的影响

摘要

目的 观察疏风解毒汤药对带状疱疹临床疗效、后遗神经痛及炎性细胞因子的影响,并探讨其机制.方法 130例患者随机数字表法分为对照组和观察组,各65例.两组均口服泛昔洛韦片,维生素B1片,甲钴胺片,疼痛剧烈口服布洛芬缓释片,观察组在对照组基础上口服疏风解毒汤药,连续治疗1个月.观察两组止疱时间、结痂时间、疼痛消失时间、治疗前后血清中白细胞介素6(IL-6)、白细胞介素2(IL-2)、白细胞介素10(IL-10)表达水平,随访患者至治疗结束6个月,观察后遗神经痛的发生率及患者疼痛程度,记录不良反应的发生情况.结果 观察组治疗后止疱时间、结痂时间、疼痛消失时间均短于对照组(均P＜ 0.05).治疗前,两组血清中IL-6、IL-2、IL-10水平比较差别均不大(均P＞ 0.05).治疗后,两组IL-6、IL-10与治疗前比较均降低,IL-2则均升高,且观察组改善幅度优于对照组(均P＜ 0.05).观察组治疗后后遗症神经痛发生率为9.23％,低于对照组的23.08％ (P＜ 0.05).观察组治疗后后遗症神经痛VAS评分低于对照组(P＜0.05).结论 疏风解毒汤药针对带状疱疹疗效显著,可明显缩短患者病程,并有可能是通过抑制IL-6、IL-10表达,促进IL-2表达而发挥这一作用,且不良反应较小、安全性高.%Objective:To investigate the effect of Shufeng Jiedu Decoction on clinical efficacy,sequelae of neuralgia and inflammatory cytokines in herpes zoster.Methods:According to the random number table,130 cases of herpes zoster were divided into the control group and the observation group.Two groups of patients took oral famciclovir tablets,vitamin B1 tablets,mecobalamin tablets,and painful oral administration of ibuprofen sustained-release tablets.The observation group were added oral administration of Shufeng Jiedu Decoction,continuous treatment for 1 month.Blister time,scab time,pain loss time and the levels of interleukin-6(IL-6),interleukin-2(IL-2) and interleukin-10 (IL-10) in the serum of the two groups before and after treatment were observed.The patients were followed up for 6 months after the treatment.The incidence of sequelae of neuralgia and the degree of pain were observed,and the incidence of adverse reactions was recorded.Results:Blister time,scab time,pain loss time were significantly shorter in the observation group than those in the control group after treatment (P＜ 0.05).Before treatment,the levels of IL-6,IL-2 and IL-10 in the two groups were not significantly different (P＞ 0.05).After treatment,the levels of IL-6 and IL-10 were decreased in both groups;IL-2 increased,and the improvement rate of the observation group was better than that of the control group (P＜ 0.05).The incidence of sequelae neuralgia in the observation group was 9.23％,lower than that in the control group 23.08％(P＜ 0.05),and VAS score of sequelae neuralgia in the observation group was lower than that of the control group (P ＜ 0.05).Conclusion:Shufeng Jiedu Decoction has an obvious curative effect on herpes zoster,which can significantly shorten the course of the patients and may play a role by inhibiting the expression of IL-6 and IL-10 and promoting the expression of IL-2,and the adverse reaction is small,with high security,worthy of clinical application.