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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10d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(P<0.05)；观察组症状改善(止疱、结痂、止痛)优于对照组(P<0.05),视觉模拟评分(VAS)积分值优于对照组(P<0.05)；观察组后神经痛的发生率(
2、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(P<0.05),T淋巴细胞亚群CD3+、CD4+、CD4+/CD8+上调幅度优于对照组(P<0.05)；CD8+下调幅度优于对照组(P<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,
3、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：ObjectiveToobservethetherapeuticeffectofChinesemedicineintreatingelderlyherpeszoster,andstudy12theclinicalevaluationofthetreatmentwithChinesemedicinefromevidence-basedmedicine(EBM)view.MethodsAllthe156elderlypatientsdi
4、agnosedwithherpeszosterwererandomlydividedintotreatmentgroup(78)andcontrolgroup(78).TheformergroupwasadministeredwithChinesemedicinebyoraladministrationandtopicalapplication,whilethelattertookacicloviralone.Allthecaseweretreatedfor10days.ResultsTheoverallresponseratesofChinesemedicineandac
5、iclovirintreatmentherpeszosterwererespectively98.70%and84.62%(P<0.05).Symptomsimprovement(controllingherpes,crustandpain),VASpoints,thedescentdegreeofIgandCD8+,theascentdegreeofCD3+、CD4+、CD4+/CD8+oftreatmentgroupweresignificantlybetterthanthatincontrolgroup(P<0.05).TheincidenceofPHNo
6、ftreatmentgroupswaslesserthanthatofcontrolgroup(2.60%and39.7%respectively).StatisticsofEBM：oddsration(OR)was6.82with95%confidenceinterval(CI)from1.60to29.087；relativerisk(RR)was0.17wirh95%CIfrom0.04to0.73；relativeriskreduction(RRR)was83.0%with95%CIfrom27.0%to96.0%；absoluteriskreduction(ARR
7、)was12.8%with95%CIfrom4.00%to13.68%；Numberneededtotreat(NNT)was8with95%CIfrom4to25.ConclusionsChinesemedicinebyoraladministrationandtopicalapplicationiseffectiveforthe12treatmentofherpeszosterinelderlypatients,anditcanpreventneuralgiathatremainafterherpeszoste
