目的 探讨草乌甲素软胶囊联合氨酚曲马多治疗带状疱疹后神经痛的临床疗效。方法 选取2023年9月—2024年9月河南科技大学第一附属医院收治的带状疱疹后神经痛患者110例，按随机数字表法分为对照组和治疗组，每组各55例。对照组口服氨酚曲马多片，1片/次，3次/d。治疗组在对照组的基础上口服草乌甲素软胶囊，1粒/次，2次/d。两组患者均治疗2周。观察两组患者临床疗效，比较治疗前后两组患者镇痛效果，疼痛视觉模拟量表（VAS）、阿森斯失眠量表（AIS）、症状自评量表（SCL-90）和世界卫生组织生活质量测定简表（WHOQOL-BREF）评分，及血清细胞因子肿瘤坏死因子-α（TNF-α）、白细胞介素-17（IL-17）、β-内啡肽（β-EP）、神经肽Y（NPY）和S100钙结合蛋白β（S100β）水平。结果 治疗后，治疗组总有效率明显高于对照组（94.55% vs 81.82%，P＜0.05）。治疗后，治疗组止痛起效时间和疼痛缓解时间均明显短于对照组（P＜0.05）。治疗后，两组疼痛VAS、AIS和SCL-90评分均低于同组治疗前，而WHOQOL-BREF评分均显著升高（P＜0.05），且治疗组评分明显好于对照组（P＜0.05）。治疗后，两组血清TNF-α、IL-17、NPY和S100β水平都低于同组治疗前，而β-EP水平均显著升高（P＜0.05），且治疗组患者血清因子水平明显好于对照组（P＜0.05）。结论 草乌甲素软胶囊联合氨酚曲马多治疗带状疱疹后神经痛，能有效减轻患者机体炎症反应及减少神经冲动传入，增强镇痛效果，降低神经痛与神经损伤程度，促进患者睡眠、心理状态和生活质量改善。

Objective To investigate the clinical efficacy of Bulleyaconitine Soft Capsules combined with tramadol hydrochloride paracetamol in treatment of postherpetic neuralgia. Methods Patients (110 cases) with postherpetic neuralgia in the First Affiliated Hospital of Henan University of Science and Technology from September 2023 to September 2024 were divided into control and treatment group according to random number table method, and each group had 55 cases. Patients in control group were po administered with Tramadol Hydrochloride Paracetamol Tablets, 1 tablet/time, three times daily. Patients in treatment group were po administered with Bulleyaconitine Soft Capsules on the basis of the control group, 1 grain/time, twice daily. Patients in two groups were treated for two weeks. After treatment, the clinical evaluations were evaluated, and the analgesic effects, the scores of VAS, AIS, SCL-90 and WHOQOL-BREF, and the levels of serum cytokine TNF-α, IL-17, NPY, S100β and β-EP in two groups before and after treatment were compared. Results After treatment, the total effective rate in the treatment group was significantly higher than that in the control group (94.55% vs 81.82%, P < 0.05). After treatment, the onset time of analgesia and pain relief time in the treatment group were significantly shorter than those in the control group (P < 0.05). After treatment, the pain VAS, AIS and SCL-90 scores in two groups were lower than those in the same group before treatment, while the WHOQOL-BREF scores were significantly increased (P < 0.05), and the scores in the treatment group were significantly better than those in the control group (P < 0.05). After treatment, the serum TNF-α, IL-17, NPY and S100β levels in two groups were lower than those in the same group before treatment, while the β-EP levels were significantly increased (P < 0.05), and the serum factor levels in the treatment group were significantly better than those in the control group (P < 0.05). Conclusion Bulleyaconitine Soft Capsules combined with tramadol hydrochloride paracetamol in treatment of postherpetic neuralgia can effectively reduce the inflammatory response and the afferent of nerve impulses, enhance the analgesic effect, reduce the degree of neuralgia and nerve damage, and promote the improvement of patients′ sleep, mental state and quality of life.

R971

河南科技大学青年科学基金资助项目（2020QN035）