目的 探讨龙胆泻肝丸联合伐昔洛韦治疗带状疱疹的临床效果。方法 选取2018年10月—2020年9月南阳市中心医院收治的80例带状疱疹患者，随机分为对照组和治疗组，每组各40例。对照组患者餐前空腹口服盐酸伐昔洛韦片，0.3 g/次，2次/d。治疗组在对照组基础上口服龙胆泻肝丸，6 g/次，2次/d。两组均连续治疗10 d。观察两组的临床疗效，比较两组McGill疼痛问卷简表（SF-MPQ）评分、焦虑自评量表（SAS）评分及血清P物质（SP）、白细胞介素-4（IL-4）水平和外周血T淋巴细胞亚群水平的变化情况。结果 治疗后，治疗组总有效率为97.5%，显著高于对照组的85.0%（P<0.05）。治疗组止疱时间、结痂时间及疼痛缓解时间均显著短于对照组（P<0.05）；治疗组后遗神经痛发生率为5.0%，较对照组20.0%显著降低（P<0.05）。与本组治疗前比较，两组患者治疗后SF-MPQ中各部分（PRI、VAS、PPI）评分及SAS评分均显著下降（P<0.05）；且治疗组SF-MPQ、SAS评分显著低于对照组（P<0.05）。治疗后，两组血清SP、IL-4及外周血CD8⁺水平均显著低于本组治疗前（P<0.05），但外周血CD3⁺、CD4⁺水平则均显著高于本组治疗前（P<0.05）；但均以治疗组的改善更显著（P<0.05）。结论 龙胆泻肝丸联合伐昔洛韦治疗带状疱疹的总体疗效确切，能安全有效地改善患者临床症状，减轻疼痛，缓解焦虑情绪，降低后遗神经痛的发生风险，并使患者体内疼痛介质和外周血T淋巴细胞亚群的表达得到改善，值得临床推广应用。

Objective To investigate the clinical effect of Longdan Xiegan Pills combined with valacyclovir in treatment of herpes zoster. Methods A total of 80 patients with herpes zoster admitted to Nanyang Central Hospital from October 2018 to September 2020 were randomly divided into control group and treatment group, with 40 patients in each group. Patients in the control group were po administered with Valacyclovir Hydrochloride Tablets on an fasting stomach before meal, 0.3 g/time, twice daily. Patients in the treatment group were po administered with Longdan Xiegan Pills on the basis of the control group, 6 g/time, twice daily. Patients in two groups were treated for 10 d. After treatment, the clinical efficacy was evaluated, and the McGill Pain Questionnaire (SF-MPQ) score, SAS score, serum substance P (SP), interleukin-4 (IL-4) levels and peripheral blood T lymphocyte subsets were compared between the two groups. Results After treatment, the total effective rate of the treatment group was 97.5%, which was significantly higher than that of the control group (85.0%, P<0.05). The blister stopping time, scab forming time and pain relief time in treatment group were significantly shorter than those in control group (P<0.05). The incidence of neuralgia in the treatment group was 5.0%, which was significantly lower than that in the control group (20.0%, P<0.05). Compared with before treatment, SF-MPQ scores (PRI, VAS, PPI) and SAS scores in two groups were significantly decreased after treatment (P<0.05). The scores of SF-MPQ and SAS in treatment group were significantly lower than those in control group (P<0.05). After treatment, the serum SP, IL-4, and peripheral blood CD8⁺ levels in two groups were significantly lower than before treatment (P<0.05), but the peripheral blood CD3⁺ and CD4⁺ levels were significantly higher than before treatment (P<0.05). However, the improvement in the treatment group was more significant (P<0.05). Conclusion Longdan Xiegan Pills combined with valacyclovir has a definite overall effect in treatment of herpes zoster, and can safely and effectively improve the clinical symptoms of patients, and relieve pain and anxiety, also can reduce the risk of neuralgia occurrence, and improve the expression of pain mediators and peripheral blood T lymphocyte subsets in patients, which is worthy of clinical promotion and application.

R986

南阳市卫计委科研项目（ZD201738）