5%利多卡因凝胶贴膏联合普瑞巴林及抗病毒药治疗急性期带状疱疹的临床观察*

Clinical observation of 5% lidocaine gel paste in the treatment of acute herpes zoster

摘要:

目的：研究5%利多卡因凝胶贴膏联合抗病毒药和普瑞巴林治疗急性带状疱疹相关疼痛的临床治疗效果与其安全性,并观察带状疱疹后神经痛(Postherpetic neuralgia ,PHN)的发生率。方法：回顾门诊82例急性期带状疱疹患者,根据是否加用5%利多卡因凝胶贴膏,分为观察组和对照组。对照组采用普瑞巴林镇痛、泛昔洛韦抗病毒、腺苷钴胺营养神经、重组人干扰素a2b凝胶外用治疗；观察组在对照组的基础上加用5%利多卡因凝胶贴膏4周。在0周、1周、2周、3周、4周对两组患者进行定期随访。每次随访观察对患者疼痛的缓解程度、皮损改善指标等进行综合评估。结果：根据数字评价量表(numerical rating scale,NRS)数据显示：在1~4周的随访观察期间,观察组评分均明显低于对照组,差异有统计学意义(P＜0.05)。在McGill 疼痛问卷简表( Short－form McGill Pain Question-naire,SF-MPQ)评分方面：观察组SF-MPQ、PPI当前疼痛强度(present pain intensity ,PRI)、视觉模拟评分(Visual Analogue Scale, VAS)、感觉情感评分等在随访终点(4周)时均低于传统治疗组,治疗终点与基线相比,两者的差值具有统计学差异(P＜0.05)。在PHN发生率方面：观察组的发生率明显低于对照组,差异有统计学意义(P<0.05)。结论：早期使用5%利多卡因凝胶贴膏联合普瑞巴林和抗病毒药物治疗急性期带状疱疹相关性疼痛,镇痛效果更好,可以显著减少PHN的发生,患者的疼痛程度有明显缓解,改善疾病对患者情绪的影响,增加患者的治疗信心。

Abstract:

Objective: Clinical efficacy and safetyof 5% lidocaine gel paste combined with pregabalin and antivirals versus pregabalin and antivirals in the treatment of pain associated with acute herpes zoster and the incidence of Postherpetic neuralgia. Methods: 82 patients with acute herpes zoster in the Department of Dermatology,were divided into observation group and control group according to whether 5% lidocaine gel plaster was used or not. The control group was treated with pregabalin analgesia, famciclovir antiviral therapy, adenosine cobalamin neurotrophic therapy and topical recombinant human interferon a2b gel. The observation group was treated with 5% lidocaine gel plaster on the basis of the control group, and the patients were treated with 5% lidocaine gel plaster for 4 weeks on the basis of conventional pregabalin treatment. Patients in both groups were followed up at 0, 1, 2, 3 and 4 weeks. The patients" pain relief and clinical performance scores should be comprehensively evaluated at each follow-up. Results: In terms of numerical rating scale (NRS) score, the observation group had significantly lower scores than the control group during the follow-up observation period of 1-4 weeks (P < 0.05). In terms of Short-form McGill Pain Question-naire (SF-MPQ) scores: The SF-MPQ, PPI present pain intensity (PRI), Visual Analogue Scale (VAS) and sensory emotion score of the observation group were lower than those of the traditional treatment group at 4 weeks after the end of follow-up. The difference between the end point and the baseline was also statistically significant (P < 0.05). The incidence of Postherpetic neuralgia (PHN) in the observation group was significantly lower than that in the control group, the difference was statistically significant (P＜ 0.05). Conclusion: Early application of 5% lidocaine gel plaster combined with pregabalin in the treatment of acute herpes zoster related pain has better analgesic effect, and can reduce the incidence of PHN, significantly reduce the degree of pain in patients, improve the emotional impact of the disease on patients, and increase the treatment confidence of patients.