中药内调外敷治疗老年性带状疱疹临床的研究.docVIP

PAGE \* MERGEFORMAT 1 中药内调外敷治疗老年性带状疱疹临床研究【摘要】 目的 观察中药内调与外敷相结合治疗老年性带状疱疹的疗效,从循证医学角度对其进行疗效评估。方法 采用随机、开放、阳性药平行对照的试验方法,将符合入选标准的156例患者随机分为观察组和对照组(各78例)。观察组给予中药内调配合外敷,对照组给予阿昔洛韦、聚肌胞。均以10 d为1个观察周期。结果 观察组总有效率(98.70%)高于对照组(84.62%),２组比较差异显著(Plt;0.05)；观察组症状改善(止疱、结痂、止痛)优于对照组(Plt;0.05),视觉模拟评分(VAS)积分值优于对照组(Plt;0.05)；观察组后神经痛的发生率(2.60%)低于对照组(39.7%),免疫球蛋白(IgM、IgG、IgA)下调幅度优于对照组(Plt;0.05),T淋巴细胞亚群CD3+、CD4+、CD4+/CD8+上调幅度优于对照组(Plt;0.05)；CD8+下调幅度优于对照组(Plt;0.05)。循证医学临床价值评估：OR=6.82,95%CI=1.60～29.089；RR=0.17, 95%CI=0.04～0.73；RRR=83.0%,95%CI=27.0%～96.0%；ARR=12.8%,95%CI=4.00%～13.68%；NNT=8,95%CI=4～25(例)。结论 中药内外合治法治疗老年性带状疱疹疗效好,可有效预防带状疱疹治愈后的后遗神经痛,并可调节老年性带状疱疹患者的免疫功能。 【关键词】 外敷疗法；中医药疗法；阿昔洛韦；带状疱疹 Abstract：Objective To observe the therapeutic effect of Chinese medicine in treating elderly herpes zoster, and study the clinical evaluation of the treatment with Chinese medicine from evidence-based medicine (EBM) view. Methods All the 156 elderly patients diagnosed with herpes zoster were randomly divided into treatment group (78) and control group (78). The former group was administered with Chinese medicine by oral administration and topical application, while the latter took aciclovir alone. All the case were treated for 10 days. Results The overall response rates of Chinese medicine and aciclovir in treatment herpes zoster were respectively 98.70% and 84.62% (Plt;0.05). Symptoms improvement (controlling herpes, crust and pain), VAS points, the descent degree of Ig and CD8+, the ascent degree of CD3+、CD4+、CD4+/CD8+ of treatment group were significantly better than that in control group (Plt;0.05). The incidence of PHN of treatment groups was lesser than that of control group (2.60% and 39.7% respectively). Statistics of EBM：odds ration (OR) was 6.82 with 95% confidence interval (CI) from 1.60 to 29.087；relative risk (RR) was 0.17 wirh 95%CI from 0.04 to 0.73；relative risk reduction (RRR) was 83.0% with 95%CI from 27.0% to 96.0%；absolute risk reduction (ARR) was 12.8% with 95%CI from 4.00% to 13.68%；