CAJ | 학술논문

目的探究采用卡介菌多糖核酸联合膦甲酸钠治疗带状疱疹的临床疗效及安全性,为临床治疗提供指导意义.方法选取自2014年2月到2015年6月来我院治疗的带状疱疹患者65例作为研究对象,随机分为对照组和研究组.对照组32例,采用注射用膦甲酸钠注射液1.94g,加入0.9％氯化钠注射液250ml,静滴1次/d治疗,持续14d;研究组33例,在膦甲酸钠治疗采用在此基础上,同时肌肉注射卡介菌多糖核酸1ml,每周3次,持续2个月.观察并记录治疗前后患者皮疹、疼痛恢复情况,评定两组患者临床治疗效果,记录观察两组患者止痛(疼痛消失)、止疱(无新水疱出现、原有水疱干涸)、结痂(水疱全部干涸结痂)及痊愈(脱痂及疼痛等症状消失)时间,所有患者在治疗前后抽外周血,检测外周血T淋巴细胞亚群、自然杀伤细胞(NK细胞),治疗后随访观察治疗后患者不良反应和后遗神经痛发生状况.结果所有患者均顺利完成治疗,没有因为无法耐受药物而退出者,对照组患者有效率为68.75％,研究组有效率为90.91％,两组患者在临床治疗效果上存在显著差异(P＜0.05);研究组患者在止痛时间、止疱时间、结痂时间、痊愈时间、住院时间上显著低于对照组患者(P＜0.01);两组患者在治疗后CD3、CD4、CD8、CD4/CD8、NK方面,两组患者存在差异(P＜0.05);对照组患者后遗神经痛12例,VAS评分为4.15±1.33,研究组患者后遗神经痛3例,VAS评分为2.31±0.86,均存在统计学差异(P＜0.05);两组均无血尿常规、肝肾功能异常,对照组出现轻度头晕1例、1例恶心呕吐,研究组3例肌肉注射部位出现红肿、结节,无统计学差异(P＞0.05).结论卡介菌多糖核酸联合膦甲酸钠治疗带状疱疹效果显著,明显缩短病程,不良反应低,值得推广.
목적 탐구채용잡개균다당핵산연합련갑산납치료대상포진적림상료효급안전성,위림상치료제공지도의의.방법 선취자2014년2월도2015년6월래아원치료적대상포진환자65례작위연구대상,수궤분위대조조화연구조.대조조32례,채용주사용련갑산납주사액1.94g,가입0.9％록화납주사액250ml,정적1차/d치료,지속14d;연구조33례,재련갑산납치료채용재차기출상,동시기육주사잡개균다당핵산1ml,매주3차,지속2개월.관찰병기록치료전후환자피진、동통회복정황,평정량조환자림상치료효과,기록관찰량조환자지통(동통소실)、지포(무신수포출현、원유수포간학)、결가(수포전부간학결가)급전유(탈가급동통등증상소실)시간,소유환자재치료전후추외주혈,검측외주혈T림파세포아군、자연살상세포(NK세포),치료후수방관찰치료후환자불량반응화후유신경통발생상황.결과 소유환자균순리완성치료,몰유인위무법내수약물이퇴출자,대조조환자유효솔위68.75％,연구조유효솔위90.91％,량조환자재림상치료효과상존재현저차이(P＜0.05);연구조환자재지통시간、지포시간、결가시간、전유시간、주원시간상현저저우대조조환자(P＜0.01);량조환자재치료후CD3、CD4、CD8、CD4/CD8、NK방면,량조환자존재차이(P＜0.05);대조조환자후유신경통12례,VAS평분위4.15±1.33,연구조환자후유신경통3례,VAS평분위2.31±0.86,균존재통계학차이(P＜0.05);량조균무혈뇨상규、간신공능이상,대조조출현경도두훈1례、1례악심구토,연구조3례기육주사부위출현홍종、결절,무통계학차이(P＞0.05).결론 잡개균다당핵산연합련갑산납치료대상포진효과현저,명현축단병정,불량반응저,치득추엄.
Objective To investigate the clinical effect of Bacillus Calmette-Guerin (BCG) polysaccharide nucleic acid combinated with foscarnet sodium in treating of herpes zoster.Methods 65 patients with herpes zoster collected from February 2014 to June 2015 were randomly divided into two groups.The control group was given foscarnet sodium injection 1.94 g/d i.v.for 14 days.The experimental group was given BCG polysaccharide nucleic acid 1 mL/2days i.m.for 2 months besides foscarnet sodium treatment.The times of pain-alleviating,herpes-stop growing,herpes-scabbing and symptoms recovering in both groups were observed and recorded.And the peripheral blood of all the patients was taken before and after treatment and the levels of T lymphocyte subsets and natural killer cells (NK cells) were detected.The adverse reaction and postherpetic neuralgia of all the patients were followed up after treatment.ResultsAll patients successfully completed treatment,no one exited because of drug intolerance.The effective rate in the control group and experimental group was 68.75％ and 90.91％ respectively with significant differences (P ＜ 0.05).The pain-relieving time,herpes-stop growing time,herpes-scabbing time,recovering time and hospital stays time in the experimental group were significantly shorter than those in the control group (P ＜ 0.01).Significant differences were detected in CD3,CD4,CD8,CD4/CD8 and NK between the two groups after treatment (P ＜0.01).12 patients in the control group had postherpetic neuralgia and the VAS score in the control group was 4.15 ± 1.33,while only 3 patients in the experimental group with postherpetic neuralgia and VAS score was 2.31 ±0.86,with significant differences (P ＜0.05).No abnormal was detected in the blood routine examination,urine routine examination and hepatorenal function.In the control group,one case had mild dizziness,one case had nausea and vomiting,and in the experiment group,three patients appeared red,swollen and tuberous in the muscle injection site.Conclusions BCG polysaccharide nucleic acid combined with foscarnet sodium had notable clinical effect in treating of herpes zoster with shorter disease course and less adverse reaction,which was worthy of a wide clinical application.