CAJ | 학술논문

目的：探讨七叶皂苷钠联合伐昔洛韦治疗中老年带状疱疹的疗效。方法120例患者均为门诊或住院部中老年带状疱疹患者，将其随机分为A、B、C三组，每组40例。其中，A组采用基础治疗方案，即口服伐昔洛韦（每次0．3 g，每日2次）和甲钴胺（每次0．5 mg，每日3次），外加莫匹罗星软膏每日2次外搽；B组和C组采用与A组相同治疗方案的同时，分别加用地塞米松（5 mg／d）或七叶皂苷钠（20 mg／d）静脉滴注治疗，3组疗程均为9 d。结果治疗后B组和C组疗效显著高于A组，比较差异有统计学意义（qA-B ＝3．72，P＜0．05和qA-C ＝3．51，P＜0．05），而B组和C组间疗效比较差异无统计学意义（qB-C ＝1．29，P＞0．05）。治疗后B组和C组患者的疼痛缓解时间、止痛时间、结痂时间、VAS评分明显低于A组（P均＜0．01），C组疼痛缓解时间低于B组，而B、C两组的止痛时间、结痂时间比较差异无统计学意义（P＞0．05）。C组患者疱疹后遗神经痛（PHN ）发生率显著低于A组，比较差异有统计学意义（χ2＝4．30，P＜0．017）。结论对中老年带状疱疹患者早期给予七叶皂苷钠治疗，不但可收到较好的疗效，而且可以减少PHN的发生，同时又能避免应用糖皮质激素可能产生的不良反应。
목적：탐토칠협조감납연합벌석락위치료중노년대상포진적료효。방법120례환자균위문진혹주원부중노년대상포진환자，장기수궤분위A、B、C삼조，매조40례。기중，A조채용기출치료방안，즉구복벌석락위（매차0．3 g，매일2차）화갑고알（매차0．5 mg，매일3차），외가막필라성연고매일2차외차；B조화C조채용여A조상동치료방안적동시，분별가용지새미송（5 mg／d）혹칠협조감납（20 mg／d）정맥적주치료，3조료정균위9 d。결과치료후B조화C조료효현저고우A조，비교차이유통계학의의（qA-B ＝3．72，P＜0．05화qA-C ＝3．51，P＜0．05），이B조화C조간료효비교차이무통계학의의（qB-C ＝1．29，P＞0．05）。치료후B조화C조환자적동통완해시간、지통시간、결가시간、VAS평분명현저우A조（P균＜0．01），C조동통완해시간저우B조，이B、C량조적지통시간、결가시간비교차이무통계학의의（P＞0．05）。C조환자포진후유신경통（PHN ）발생솔현저저우A조，비교차이유통계학의의（χ2＝4．30，P＜0．017）。결론대중노년대상포진환자조기급여칠협조감납치료，불단가수도교호적료효，이차가이감소PHN적발생，동시우능피면응용당피질격소가능산생적불량반응。
Objective To investigate the clinical efficacy of sodium aescinate in combination with va-laciclovir in the treatment of herpes zoster in middle-aged and elderly patients. Method A total of 120 cases of herpes zoster admitted to the in-patients and out-patients in hospital were randomly divided into groups A,B and C (n=40 for each group). Patients in group A received basic treatment including oral intake of valaciclov-ir (0. 3 g,twice a day),orally mecobalamine (0. 5 mg,three times a day)and external topical use of mupiro-cin ointment twice a day. Patients in groups B and C were treated with dexamethasone 5 mg/d i. v. drip or so-dium aescinate 20 mg/d i. v. drip,besides the basic treatment delivered in group A. The course of treatment endured for 9 days. Results The therapeutic effects in groups B and C were significantly higher than that in group A (qA-B =3. 72,P<0. 05 and qA-C =3. 51,P<0. 05),whereas no significant difference was found be-tween groups B and C (qB-C =1. 29,P>0. 05). The time of pain relief,time of analgesia,time of scarring and VAS in both groups B and C were remarkably shorter and lower than those in group A (all P<0. 01). Mo-reover,the time of pain relief in group C was shorter than that in group B whereas no significant difference was found between groups B and C regarding time of scarring and time of analgesia (P>0. 05 ). Finally,the inci-dence of postherpetic neuralgia (PHN)in group C was significantly lower than that in group A (χ2 =4. 30,P<0. 017). Conclusions The application of sodium aescinate is efficacious in the treatment of early-stage her-pes zoster in middle-aged and elderly patients. Moreover,it reduces the incidence of PHN and prevents the oc-currence of adverse events induced by use of glucocorticoid.