目的 探讨草乌甲素片联合利多卡因凝胶贴膏治疗带状疱疹后神经痛的临床疗效。方法 选取2022年4月—2023年12月河南科技大学第一附属医院收治的156例带状疱疹后神经痛患者，按随机数字表法将所有患者分为对照组和治疗组，每组各78例。对照组给予利多卡因凝胶贴膏，根据患者疼痛面积将贴膏剪块，单次同时使用≤3贴，控制24 h内贴敷时间≤12 h。治疗组在对照组治疗基础上口服草乌甲素片，1片/次，3次/d。两组疗程4周。观察两组的临床疗效，比较两组治疗前和治疗2、4周的疼痛视觉模拟量表（VAS）评分及治疗前后睡眠障碍评定量表（SDRS）、简式抑郁–焦虑–压力量表（DASS-21）评分、36项健康调查简表（SF-36）评分和血清β-内啡肽（β-EP）、环氧化酶-2（COX-2）、白细胞介素-6（IL-6）、神经元特异性烯醇化酶（NSE）水平。结果 治疗后，治疗组总有效率是94.87%，显著高于对照组的84.62%（P＜0.05）。两组患者治疗2、4周疼痛VAS评分均低于同组治疗前（P＜0.05）；治疗2、4周治疗组VAS评分均低于同期对照组（P＜0.05）。治疗后，两组SDRS、DASS-21评分均低于同组治疗前，SF-36评分均显著增高（P＜0.05）；治疗后，治疗组SDRS、DASS-21评分均低于对照组，SF-36评分高于对照组（P＜0.05）。治疗后，两组血清β-EP水平均显著上升，血清COX-2、IL-6、NSE水平低于同组治疗前（P＜0.05）；治疗后，治疗组血清β-EP、COX-2、IL-6、NSE水平改善优于对照组（P＜0.05）。结论 草乌甲素片联合利多卡因凝胶贴膏治疗带状疱疹后神经痛的疗效及安全性较好，能有效降低疼痛程度，改善患者睡眠质量、情绪状态和生活质量，抑制神经炎症及神经损害。

Objective To investigate the clinical effect of Bulleyaconitine A Tablets combined with Lidocaine Cataplasms in treatment of postherpetic neuralgia. Methods A total of 156 patients with postherpetic neuralgia admitted to the First Affiliated Hospital of Henan University of Science and Technology from April 2022 to December 2023 were selected and divided into control group and treatment group according to random number table method, with 78 cases in each group. Patients in control group were given Lidocaine Cataplasms, the paste was cut according to the pain area of the patient, and ≤3 patches were applied at the same time, and the application time within 24 h was controlled to ≤12 h. Patients in the treatment group were po administered with Bulleyaconitine A Tablets on the basis of control group, 1 tablet/time, 3 times daily. Both groups were treated for 4 weeks. The clinical efficacy of two groups was observed. The visual analogue scale (VAS) scores before treatment and 2 and 4 weeks of treatment, and Sleep disturbance Rating Scale (SDRS), simple depression-anxiety-stress Scale (DASS-21) scores, 36-item health survey summary form (SF-36) scores, serum β-endorphin (β-EP) and cyclooxygenase-2 (COX-2), interleukin-6 (IL-6), and neuron-specific enolase (NSE) in two groups before and after treatment were compared.Results After treatment, the total effective rate of the treatment group was 94.87%, which was significantly higher than that of the control group (84.62%, P < 0.05). Pain VAS scores in two groups after 2 and 4 weeks of treatment were lower than those before treatment (P < 0.05), and the VAS scores of the treatment groups were lower than those of the control group after 2 and 4 weeks of treatment (P < 0.05). After treatment, SDRS and DASS-21 scores in 2 groups were lower than those before treatment, but SF-36 scores were significantly increased (P < 0.05). After treatment: SDRS and DASS-21 scores in treatment group were lower than those in control group, but SF-36 scores were higher than those in the control group (P < 0.05). After treatment, serum β-EP levels in two groups were significantly increased, but serum COX-2, IL-6, and NSE levels were lower than those before treatment (P < 0.05). After treatment, the levels of β-EP, COX-2, IL-6, and NSE in treatment group were better than those in control group (P < 0.05). Conclusion Bulleyaconitine A Tablets combined with Lidocaine Cataplasms has good efficacy and safety in treatment of postherpetic neuralgia, and can effectively reduce the degree of pain, improve the sleep quality, emotional state and life quality of patients, which can inhibit neuroinflammation and nerve damage.

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