【摘要】 目的探讨加巴喷丁联合伐昔洛韦对带状疱疹神经痛的治疗效果及对视觉模拟评分法(visual analogue scale,VAS)疼痛评分的影响。方法选取2015年6月至2017年8月本院收治的带状疱疹神经痛患者94例,根据治疗方法不同分为伐昔洛韦组47例和联合用药组47例。伐昔洛韦组采用伐昔洛韦治疗,联合用药组在伐昔洛韦组的基础上联合加巴喷丁治疗。采用VAS量表对两组患者治疗前后的疼痛情况进行评估,采用放射免疫分析法测定两组治疗前后血清β-内啡肽水平,采用酶联免疫吸附试验测定两组治疗前后肿瘤坏死因子-α(tumor necrosis factorα,TNF-α)和白细胞介素1β(interleukin 1β,IL-1β)水平,采用流式细胞仪测定两组治疗前后CD3~+、CD4~+、CD8~+T细胞水平及CD4~+/CD8~+比值,比较两组的临床疗效及评分。结果联合用药组治疗后1、2、3、4周VAS评分均低于伐昔洛韦组(P<0.05);联合用药组治疗后2周血清β-内啡肽,CD3~+、CD4~+T淋巴细胞水平,CD4~+/CD8~+比值均高于伐昔洛韦组,差异有显著性(P<0.05),而TNF-α、IL-1β和CD8~+T淋巴细胞水平均低于伐昔洛韦组,差异有显著性(P<0.05)。两组治疗2周后药物不良反应发生率差异无显著性(P>0.05)。结论加巴喷丁联合伐昔洛韦治疗带状疱疹神经痛有助于提高临床效果,能减轻患者疼痛,改善炎症因子水平,且安全性较高,值得推广应用。更多还原

【Abstract】 Objective To investigate the clinical effect of gabapentin combined with valacyclovir in patients with herpes zoster neuralgia and its impact on VAS score. Method 94 patients with herpes zoster neuralgia admitted in our department from June 2015 to August 2017 were divided into 47 cases in valacyclovir group and 47 cases in combination group according to different treatment methods. The valacyclovir group was treated with valacyclovir, and the combination group was treated with gabapentin on the basis of valacyclovir. The visual analog scale(VAS) scale was used to evaluate the pain of the two groups at different time points. The levels of β-endorphin in the two groups before and after treatment were measured by radioimmunoassay. The levels of β-endorphin in the two groups before and after treatment were measured by enzyme-linked immunosorbent assay.The levels of TNF-α and IL-1β were measured by ELISA. The immune function of CD3~+, CD4~+, CD8~+ and CD4~+/CD8~+ before and after treatment were measured by flow cytometry. Impact on VAS score. Result The VAS score of the combination group was lower than that of the valacyclovir group at 3 d, 1 and 2 weeks after treatment(P<0.05). The β-endorphin level of the combination group was higher than that of the valacyclovir(P<0.05). The levels of tumor necrosis factor-a and interleukin-1β in the combination group were lower than those in the valacyclovir group(P<0.05), and the levels of CD3~+, CD4 ~+, CD4 ~+/CD8 ~+levels were higher than those in valaciclovir group(P<0.05); CD8~+ levels in combination group were lower than those in valaciclovir group(P<0.05). The adverse drug reaction rate was not statistically significant with valacyclovir(P>0.05). Conclusion Gabapentin combined with valacyclovir in the treatment of herpes zoster neuralgia can help to improve the clinical efficacy, reduce pain, improve the level of inflammatory cytokines and high drug safety, which is worth popularizing and applying.更多还原