| Objecctive:Herpes zoster(HZ)is a common infectious disease caused by reactivation of varicella-zoster virus(VZV),which is latent in sensory ganglia,and 90% of patients with severe neuralgia.Part of the clinical observation showed that early low dose GC treatment combined with conventional therapy can promote early healing of skin lesions,alleviate the severity of acute pain,shorten the duration of acute pain of patients with HZ.But the small dose,short course of GC combined with conventional treatment of HZ will cause the spread of viral infection,increase nerve damage,increase the severity of the disease has been controversial,the focus is when GC combined with conventional therapy whether affects the immune function of patients with HZ.In this study,the clinical efficacy were observed;the peripheral blood VZV DNA,plasma S100? protein concentration,T cell subsets were measured to explore the effect of GC combined with conventional treatment of HZ patients,to provide a theoretical basis for the treatment of HZ with low dose and short course of GC.1.100 cases of hospitalized patients with HZ in the acute phase were collected as HZ group and 40 cases of healthy blood donors were collected as C group.The patients in HZ group were divided into GC group(52 cases)and non-GC group(48 cases)according to use GC or not during treatment.Recored the cessation time of blisters,pian,scabbing,VAS and disease score before and after 1 and 2 weeks of treatment.HZ patient were followed up after they left hospital for 1 mouth.Before and after 2 weeks of treatment peripheral blood was collected to detect VZV DNA load,S100? content.Compared the change situation of GC group and non-GC group clinical efficacy,VZV DNA load,S100? content.Methods:2.Randomly selected 50 patients with HZ as HZT group(from GC group selected 25 cases as GC_T group,from non-GC group selected 25 cases as non-GC_T group)and from C group selected 20 cases as CT group.Peripheral blood was collected before and after 2 weeks of treatment,detected the T cell subsets(CD3~+T,CD4~+T,CD8~+T,CD4~+CD25~+Foxp3~+ Treg,CD4~+CD25~+GITR~+Treg)by flow cytometry.SPSS17.0software was used to analyze and copared the changes of T cell subsets in GC_T group and non-GC_T group.Results: 1.After treatment,the cessation time of blisters,pain,scabbing and VAS,disease score after 1 weeks of treatment of the GC group were both lower than non-GC group(P<0.05);Compared with the non-GC group,the VAS,score of the disease,S100? content,VZV DNA load after 2 weeks of treatment in the GC group were lower than those,but without statistic difference(P>0.05).After leaving hospital for 1 mouths,the incidence of PHN in GC group was lower than that in non-GC group,but without statistic difference(P>0.05).2.Compared with CT group,before and after 2 weeks of treatment the T cell subsets(CD4~+T,CD8~+T,CD4~+T/CD8~+T ratio)were significantly lower in the HZT group(P<0.01);the percentage of Treg(CD4~+CD25~+Treg,CD4~+ CD25~+Foxp3~+Treg,CD4~+CD25~+GITR~+Treg)were significantly higher(P<0.01).3.Comparision of HZT group before and after treatment,T cell subsets(CD4~+T CD8~+T,CD4~+CD25~+Treg,CD4~+CD25~+Foxp3~+Treg,CD4~+CD25~+ GITR~+Treg and CD4~+T/CD8~+T ratio)were significantly difference(P<0.05).4.T cell subsets(CD4~+T,CD8~+T,CD4~+CD25~+Treg,CD4~+CD25~+Foxp3~+ Treg,CD4~+CD25~+GITR~+Treg and CD4~+T/CD8~+T ratio)were not significantly different between GC_T group and non GC_T group after 2 weeks of treatment.Conclusions: 1.Small dose,short course GC combined with conventional treatment in patients with acute phase HZ is helpful to reduce the symptoms and signs of HZ patients,and the peripheral blood VZV DNA load,plasma S100? has no effect;2.Small dose,short course GC combined with conventional treatment of acute phase HZ has no significant effect on T cell subsets;3.Small dose,short course GC combined with conventional treatment of acute phase HZ is a safe and effective treatment. |
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