【摘要】 目的探讨泛昔洛韦对带状疱疹患者T细胞亚群、细胞因子和疼痛物质P的影响及近远期效果,为临床治疗带状疱疹提供可靠数据依据。方法选取医院2013年1月至2015年12月疼痛专科收治带状疱疹患者96例,随机单盲取法分为观察组与对照组各48例,两组均给予镇痛、营养神经药物,局部应用阿昔洛韦膏外涂等对症、局部治疗,对照组在以上治疗基础上给予阿昔洛韦口服治疗,观察组在以上治疗基础上给予泛昔洛韦治疗,观察两组治疗期间患者P物质含量、T淋巴细胞亚群、相关细胞因子、免疫蛋白变化、不良反应、视觉模拟评分(VAS)及随访1月后遗神经痛发生情况。T淋巴细胞亚群指标包括:CD3~+、CD4~+、CD8~+、CD4~+/CD8~+;免疫蛋白包括:Ig A、Ig E、Ig G、Ig M;相关细胞因子包括:白细胞介素-2(IL-2)、白细胞介素-4(IL-4)、白细胞介素-10(IL-10)、白细胞介素-17(IL-17)及干扰素-γ(IFN-γ)。结果两组治疗前VAS评、P物质含量T淋巴细胞亚群、相关细胞因子及免疫细胞对比,差异均无统计学意义,观察组治疗后VAS评分、P物质含量、相关细胞因子IL-4、IL-10、IL-17免疫蛋白Ig A、Ig E均低于治疗前及对照组治疗后(P<0.05),T淋巴细胞亚群CD3~+、CD4~+、CD4~+/CD8~+,相关细胞因子IL-2、IFN-γ,免疫蛋白Ig G、Ig M均高于同组治疗前及对照组治疗后(P<0.05),两组治疗期间不良反应发生率对比,差异无统计学意义,观察组总有效率(95.83%)高于对照组(75.00%)(P<0.05),后遗神经痛发生率(2.83%)低于对照组(18.75%)(P<0.05)。结论泛昔洛韦治疗带状疱疹,可改善血清Th1/Th2/Th17水平,降低P物质含量,提高近远期治疗效果。更多还原

【Abstract】 Objective To explore the effect of famciclovir on T cell subgroups,cytokines and pain material P in patients with herpes zoster and short and long terms effect,in order to provide reliable basis for clinical treatment of herpes zoster.Methods A total of 96 patients with herpes zoster in Pain Special Departemtn of this hospital during January 2013 to December 2015 were chosen for this study,and they were divided into observation group and control group according to randomized single blind extraction method,each group with 48 cases.Patients in these 2 groups were given with analgesia,drugs for nerve nutrition,topical application of acyclovir cream for symptomatic and local treatment,patients in control group were additionally administrated with acyclovir for treatment,and patients in observation group were additionally given with famciclovir on the basis of the above treatment.The changes in contents of pain material P,T lymphocyte subsets related cytokines,immune proteins,adverse reactions and visual simulation scores( VAS) were observed during the treatment course and the follow-up period of 1 month for the situation of post herpetic analgesia.The indexes of T lymphocyte subsets CD3~+,CD4~+,CD8~+,CD4~+/ CD8~+;immune proteins including:Ig A,Ig E,Ig G,Ig M and related cytokines including interleukin-2( IL-2),leukocyte mediated interleukin-4( IL-4),interleukin-10( IL-10) and interleukin-17( IL-17) and interferon gamma( IFN-γ) were observed in patients of these 2 groups.Results There was no difference in VAS assessment,contents of substance P,T lymphocyte subsets,cytokines and immune cells between these 2 groups before treatment.After treatment,VAS scores,material P contents,related cytokines IL-4,IL-10,IL-17 and immune proteins ig A and Ig E in observation group were lower than those before treatment and control group after treatment( P < 0.05),T lymphocyte subsets CD3~+,CD4~+,CD4~+/ CD8~+and related cytokines IL-2,IFN-gamma and immune proteins Ig G and Ig M were higher than those of the same group before treatment and control group( P < 0.05).In comparison with the rates of adverse reactions in these two groups during treatment,the difference was not statistically significant.The total efficacy in observation group( 95.83%)was higher than that( 75.00%) of control group( P < 0.05),the incidence of post-herpetic neuralgia in observation group( 2.83%) was lower than that( 18.75%) of control group( P < 0.05).Conclusion The application of famciclovir in treatment of patients with herpes zoster can raise the serum levels of Th1 / Th2 / Th17,reduce the content of material P and improve the therapeutic effect.更多还原