摘要
目的探讨背根神经节联合皮损部位臭氧水注射在带状疱疹急性皮损期中的应用效果。方法前瞻性选择2021年2月至2024年4月长沙市中心医院门诊收治的胸腹部带状疱疹急性皮损期患者90例为研究对象。按照随机数字表法分为两组,各45例。对照组口服伐昔洛韦、普瑞巴林+弱激光皮损光照+莫匹罗星局部涂抹,观察组在对照组基础上于超声引导下进行背根神经节注射25μg/ml臭氧水10 ml,同时于皮损局部皮下注射25μg/ml臭氧水20 ml。比较两组局部病灶水泡停止生长、局部结痂及疼痛显著缓解时间,两组治疗过程中疼痛数字模拟量表(NRS)评分变化以及治疗过程中水泡内病毒包涵体比例变化,分析两组治疗10 d后睡眠质量、生活质量评分,治疗过程中的并发症。结果观察组局部病灶水泡停止生长、局部结痂及疼痛显著缓解时间均短于对照组(均P<0.05)。两组治疗48 h、10 d后,疼痛NRS评分低于治疗前(均P<0.05),且观察组治疗48 h、10 d后,疼痛NRS评分低于同期对照组(均P<0.05)。两组治疗48 h、10 d后,水泡内病毒包涵体比例均低于治疗前(均P<0.05),且观察组治疗48 h、10 d后,水泡内病毒包涵体比例低于同期对照组(均P<0.05)。观察组治疗10 d后睡眠质量、生活质量评分均优于对照组(均P<0.05),观察组治疗过程中局部感染、失眠、心悸和局部麻木等并发症的总发生率显著低于对照组(P<0.05)。结论胸腹部带状疱疹急性期皮损患者,背根神经节与皮损部位皮下注射臭氧水,可抑制局部水泡生长,促进皮损结痂,降低水泡内病毒包涵体水平,有效缓解患者疼痛,改善其睡眠质量和生活质量,减少并发症的发生。
Objective To investigate the application effect of injecting ozone water into the dorsal root ganglion combined with skin lesions in the acute stage of herpes zoster.Methods A prospective study was conducted on 90 patients with acute lesions of herpes zoster in the chest and abdomen who were admitted to the outpatient department of Changsha Central Hospital from February 2021 to April 2024.According to the random number table method,they were divided into two groups,each with 45 cases.The control group received oral administration of famciclovir,pregabalin,weak laser skin lesion illumination,and local application of mupirocin.The observation group received 10 ml of 25μg/ml ozone water injected into the dorsal root ganglion under ultrasound guidance on the basis of the control group,and 20 ml of 25μg/ml ozone water injected subcutaneously into the skin lesion.Two groups of local lesions were compared in terms of the cessation of blister growth,local scab formation,and significant pain relief time.The changes in pain Numeric Rating Scale(NRS)score and the proportion of viral inclusions in the blisters during the treatment were also analyzed.The sleep quality and quality of life scores,as well as complications during the treatment process,were analyzed after 10 days of treatment in both groups.Results The observation group had a shorter time for the cessation of local lesion blister growth,local scab formation,and significant pain relief compared to the control group(all P<0.05).After 48 hours and 10 days of treatment,the pain NRS score of both groups was lower than before treatment(all P<0.05),and the pain NRS score of the observation group was lower than that of the control group at the same time after 48 hours and 10 days of treatment(all P<0.05).After 48 hours and 10 days of treatment,the proportion of viral inclusions in the blisters of both groups was lower than before treatment(all P<0.05),and the observation group had a lower proportion of viral inclusions in the blisters than the control group at the same time(all P<0.05).After 10 days of treatment,the sleep quality and quality of life scores of the observation group were better than those of the control group(all P<0.05).The total incidence of complications such as local infections,insomnia,palpitations,and local numbness during the treatment process of the observation group was significantly lower than that of the control group(P<0.05).Conclusions Subcutaneous injection of ozone water into the dorsal root ganglion and lesion site of patients with acute stage herpes zoster can inhibit the growth of local blisters,promote scab formation,reduce the level of viral inclusions in blisters,effectively alleviate patient pain,improve their sleep quality and quality of life,and reduce the occurrence of complications.
作者
方懿
邱俊
徐玉
刘洋
吴青
刘松华
Fang Yi;Qiu Jun;Xu Yu;Liu Yang;Wu Qing;Liu Songhua(Department of Anesthesia Surgery,Changsha Central Hospital,Changsha 410006,China;the Second Tumor Ward,Hunan Provincial People′s Hospital(the First Affiliated Hospital of Hunan Normal University),Changsha 410016,China)
出处
《中国医师杂志》
CAS
2024年第9期1290-1294,共5页
Journal of Chinese Physician
基金
2022年度湖南省卫生健康委科研立项课题(202204112874)
2021年度湖南省科技创新计划项目(2021SK53404)。
关键词
带状疱疹
背根神经节
皮肤损伤
臭氧水
Herpes zoster
Dorsal root ganglion
Skin lesions
Ozone water
作者简介
通信作者:刘松华,Email:369491526@qq.com。
