目的 探討龍膽瀉肝丸聯(lián)合伐昔洛韋治療帶狀皰疹的臨床效果。方法 選取2018年10月—2020年9月南陽市中心醫(yī)院收治的80例帶狀皰疹患者，隨機(jī)分為對照組和治療組，每組各40例。對照組患者餐前空腹口服鹽酸伐昔洛韋片，0.3 g/次，2次/d。治療組在對照組基礎(chǔ)上口服龍膽瀉肝丸，6 g/次，2次/d。兩組均連續(xù)治療10 d。觀察兩組的臨床療效，比較兩組McGill疼痛問卷簡表（SF-MPQ）評分、焦慮自評量表（SAS）評分及血清P物質(zhì)（SP）、白細(xì)胞介素-4（IL-4）水平和外周血T淋巴細(xì)胞亞群水平的變化情況。結(jié)果 治療后，治療組總有效率為97.5%，顯著高于對照組的85.0%（P<0.05）。治療組止皰時間、結(jié)痂時間及疼痛緩解時間均顯著短于對照組（P<0.05）；治療組后遺神經(jīng)痛發(fā)生率為5.0%，較對照組20.0%顯著降低（P<0.05）。與本組治療前比較，兩組患者治療后SF-MPQ中各部分（PRI、VAS、PPI）評分及SAS評分均顯著下降（P<0.05）；且治療組SF-MPQ、SAS評分顯著低于對照組（P<0.05）。治療后，兩組血清SP、IL-4及外周血CD8⁺水平均顯著低于本組治療前（P<0.05），但外周血CD3⁺、CD4⁺水平則均顯著高于本組治療前（P<0.05）；但均以治療組的改善更顯著（P<0.05）。結(jié)論 龍膽瀉肝丸聯(lián)合伐昔洛韋治療帶狀皰疹的總體療效確切，能安全有效地改善患者臨床癥狀，減輕疼痛，緩解焦慮情緒，降低后遺神經(jīng)痛的發(fā)生風(fēng)險，并使患者體內(nèi)疼痛介質(zhì)和外周血T淋巴細(xì)胞亞群的表達(dá)得到改善，值得臨床推廣應(yīng)用。

Objective To investigate the clinical effect of Longdan Xiegan Pills combined with valacyclovir in treatment of herpes zoster. Methods A total of 80 patients with herpes zoster admitted to Nanyang Central Hospital from October 2018 to September 2020 were randomly divided into control group and treatment group, with 40 patients in each group. Patients in the control group were po administered with Valacyclovir Hydrochloride Tablets on an fasting stomach before meal, 0.3 g/time, twice daily. Patients in the treatment group were po administered with Longdan Xiegan Pills on the basis of the control group, 6 g/time, twice daily. Patients in two groups were treated for 10 d. After treatment, the clinical efficacy was evaluated, and the McGill Pain Questionnaire (SF-MPQ) score, SAS score, serum substance P (SP), interleukin-4 (IL-4) levels and peripheral blood T lymphocyte subsets were compared between the two groups. Results After treatment, the total effective rate of the treatment group was 97.5%, which was significantly higher than that of the control group (85.0%, P<0.05). The blister stopping time, scab forming time and pain relief time in treatment group were significantly shorter than those in control group (P<0.05). The incidence of neuralgia in the treatment group was 5.0%, which was significantly lower than that in the control group (20.0%, P<0.05). Compared with before treatment, SF-MPQ scores (PRI, VAS, PPI) and SAS scores in two groups were significantly decreased after treatment (P<0.05). The scores of SF-MPQ and SAS in treatment group were significantly lower than those in control group (P<0.05). After treatment, the serum SP, IL-4, and peripheral blood CD8⁺ levels in two groups were significantly lower than before treatment (P<0.05), but the peripheral blood CD3⁺ and CD4⁺ levels were significantly higher than before treatment (P<0.05). However, the improvement in the treatment group was more significant (P<0.05). Conclusion Longdan Xiegan Pills combined with valacyclovir has a definite overall effect in treatment of herpes zoster, and can safely and effectively improve the clinical symptoms of patients, and relieve pain and anxiety, also can reduce the risk of neuralgia occurrence, and improve the expression of pain mediators and peripheral blood T lymphocyte subsets in patients, which is worthy of clinical promotion and application.

R986

南陽市衛(wèi)計委科研項目（ZD201738）