目的 探討草烏甲素片聯(lián)合利多卡因凝膠貼膏治療帶狀皰疹后神經(jīng)痛的臨床療效。方法 選取2022年4月—2023年12月河南科技大學(xué)第一附屬醫(yī)院收治的156例帶狀皰疹后神經(jīng)痛患者，按隨機數(shù)字表法將所有患者分為對照組和治療組，每組各78例。對照組給予利多卡因凝膠貼膏，根據(jù)患者疼痛面積將貼膏剪塊，單次同時使用≤3貼，控制24 h內(nèi)貼敷時間≤12 h。治療組在對照組治療基礎(chǔ)上口服草烏甲素片，1片/次，3次/d。兩組療程4周。觀察兩組的臨床療效，比較兩組治療前和治療2、4周的疼痛視覺模擬量表（VAS）評分及治療前后睡眠障礙評定量表（SDRS）、簡式抑郁–焦慮–壓力量表（DASS-21）評分、36項健康調(diào)查簡表（SF-36）評分和血清β-內(nèi)啡肽（β-EP）、環(huán)氧化酶-2（COX-2）、白細(xì)胞介素-6（IL-6）、神經(jīng)元特異性烯醇化酶（NSE）水平。結(jié)果 治療后，治療組總有效率是94.87%，顯著高于對照組的84.62%（P＜0.05）。兩組患者治療2、4周疼痛VAS評分均低于同組治療前（P＜0.05）；治療2、4周治療組VAS評分均低于同期對照組（P＜0.05）。治療后，兩組SDRS、DASS-21評分均低于同組治療前，SF-36評分均顯著增高（P＜0.05）；治療后，治療組SDRS、DASS-21評分均低于對照組，SF-36評分高于對照組（P＜0.05）。治療后，兩組血清β-EP水平均顯著上升，血清COX-2、IL-6、NSE水平低于同組治療前（P＜0.05）；治療后，治療組血清β-EP、COX-2、IL-6、NSE水平改善優(yōu)于對照組（P＜0.05）。結(jié)論 草烏甲素片聯(lián)合利多卡因凝膠貼膏治療帶狀皰疹后神經(jīng)痛的療效及安全性較好，能有效降低疼痛程度，改善患者睡眠質(zhì)量、情緒狀態(tài)和生活質(zhì)量，抑制神經(jīng)炎癥及神經(jīng)損害。

Objective To investigate the clinical effect of Bulleyaconitine A Tablets combined with Lidocaine Cataplasms in treatment of postherpetic neuralgia. Methods A total of 156 patients with postherpetic neuralgia admitted to the First Affiliated Hospital of Henan University of Science and Technology from April 2022 to December 2023 were selected and divided into control group and treatment group according to random number table method, with 78 cases in each group. Patients in control group were given Lidocaine Cataplasms, the paste was cut according to the pain area of the patient, and ≤3 patches were applied at the same time, and the application time within 24 h was controlled to ≤12 h. Patients in the treatment group were po administered with Bulleyaconitine A Tablets on the basis of control group, 1 tablet/time, 3 times daily. Both groups were treated for 4 weeks. The clinical efficacy of two groups was observed. The visual analogue scale (VAS) scores before treatment and 2 and 4 weeks of treatment, and Sleep disturbance Rating Scale (SDRS), simple depression-anxiety-stress Scale (DASS-21) scores, 36-item health survey summary form (SF-36) scores, serum β-endorphin (β-EP) and cyclooxygenase-2 (COX-2), interleukin-6 (IL-6), and neuron-specific enolase (NSE) in two groups before and after treatment were compared.Results After treatment, the total effective rate of the treatment group was 94.87%, which was significantly higher than that of the control group (84.62%, P < 0.05). Pain VAS scores in two groups after 2 and 4 weeks of treatment were lower than those before treatment (P < 0.05), and the VAS scores of the treatment groups were lower than those of the control group after 2 and 4 weeks of treatment (P < 0.05). After treatment, SDRS and DASS-21 scores in 2 groups were lower than those before treatment, but SF-36 scores were significantly increased (P < 0.05). After treatment: SDRS and DASS-21 scores in treatment group were lower than those in control group, but SF-36 scores were higher than those in the control group (P < 0.05). After treatment, serum β-EP levels in two groups were significantly increased, but serum COX-2, IL-6, and NSE levels were lower than those before treatment (P < 0.05). After treatment, the levels of β-EP, COX-2, IL-6, and NSE in treatment group were better than those in control group (P < 0.05). Conclusion Bulleyaconitine A Tablets combined with Lidocaine Cataplasms has good efficacy and safety in treatment of postherpetic neuralgia, and can effectively reduce the degree of pain, improve the sleep quality, emotional state and life quality of patients, which can inhibit neuroinflammation and nerve damage.

R971