Abstract: OBJECTIVE: To observe the clinical efficacy of semiconductor laser combined with valacyclovir and mecobalamin tablets in the treatment of herpes zoster. METHODS: Fifty-eight patients were randomly divided into two groups: 30 patients in the treatment group were treated with semiconductor laser combined with oral valacyclovir and mecobalamin tablets; 28 patients in the control group were treated with oral valacyclovir and mecobalamin tablets alone. Results: The efficiency of the semiconductor laser treatment group was 90%; the efficiency of the control group was 60.71%. The difference between the two groups was significant (p < 0.05). CONCLUSION: The efficacy of semiconductor laser irradiation combined with oral valacyclovir and mecobalamin tablets in the treatment of herpes zoster is high.
Keywords: herpes zoster; semiconductor laser; vaxilovir
Background: Herpes zoster is an acute inflammatory skin disease caused by varicella zoster virus, which is known in Chinese medicine as “entangled fire dragon” and “entangled fire dan”. Herpes zoster is characterized by clustered blisters that are distributed in clusters along one side of the peripheral nerve, often accompanied by significant neuralgia. The neuralgia mainly includes persistent burning pain, paroxysmal stabbing pain or tenderness. The disease has a high incidence in spring and autumn. Neuralgia seriously affects the quality of life of patients, especially herpes zoster that occurs in special areas such as the eyes and ears, which can cause severe pain or ulcers, and if left untreated or improperly treated, it may also cause posterior neuralgia, which prevents patients from working and living normally. The traditional treatment of herpes zoster is anti-viral, immunity improvement and pain relief, but there are still problems of long treatment course and easy legacy neuralgia. 30 cases of herpes zoster were treated with semiconductor laser combined with vaxilovir and mecobalamin tablets in our department from June 2010 to June 2011, and satisfactory results were achieved, which are reported below.
1.Data and methods
1.1 Clinical data A total of 58 patients with typical symptoms and signs were diagnosed herpes zoster patients from our hospital outpatient clinic. 58 patients were divided into: 30 patients in the treatment group, 17 males and 13 females, aged 17-76 years old; 28 patients in the control group, 17 males and 11 females, aged 12-85 years old. All patients had a disease duration of 3-10 d and did not take or use topical antiviral drugs before consultation.
1.2 Treatment method The treatment group was treated with a dual-wavelength semiconductor laser treatment machine with wavelength (810) nm and power (100-1200) mv, which irradiated the wound or painful area once a day for 15 min each time, and 7 times as a course of treatment. The probe was placed at a distance of 5-10 cm from the affected area, and vaxilovir tablets 0.3 orally twice a day and mecobalamin tablets 0.5 mg orally three times a day were given at the same time as laser irradiation for 7 days. In the control group, only vaxilovir tablets 0.3 were given orally twice daily and mecobalamin tablets were given orally three times daily for 7 days. After 1 course of treatment in both groups, some patients could continue to give mecobalamin tablets for nerve nutrition treatment. Both groups observe the efficacy at the end of the course of treatment and follow up for 1 month after the end of 1 course of treatment to observe and record the time of crusting and pain relief.
1.3 Evaluation criteria of efficacy Healing was defined as complete regression of skin lesions and disappearance of pain; apparent effect was defined as 76%-99% regression of skin lesions and basic disappearance of pain; effective was defined as 50%-74% regression of skin lesions and reduction of pain; ineffective was defined as less than 50% regression of skin lesions and no reduction of pain. The percentage of the number of cured cases plus the number of effective cases was calculated as the effective rate.
1.4 Statistical methods Statistical analysis was performed using SPSS10.0 software, and x2 test was used for counting data. p＜0.05 difference was statistically significant.
2, Results
2.1 Treatment results are shown in Table 1
Group
Number of cases
Cured
Effective
Effective
Ineffective
Effective
Treatment group
30
18
9
2
1
90 %
Control group
28
11
8
6
3
60.71%
The efficacy of the two groups of patients with herpes zoster was: 18 cases were cured, 9 cases were effective, 2 cases were effective, and 1 case was invalid in the treatment group, with an effective rate of 90%; 11 cases were cured, 8 cases were effective, 6 cases were invalid, and 3 cases were invalid in the control group, with an effective rate of 60.71%. P < 0.05 for the comparison of the two groups.
2.2 Only one case in the treatment group had burning sensation in the irradiated area, and the above symptoms disappeared after reducing the irradiation power, and still insisted on continuing the treatment.
3 Discussion
Herpes zoster is a skin disease caused by varicella-zoster virus. When the body’s immune function is weakened, the varicella-zoster virus latent in the posterior roots of spinal nerves or ganglion neurons is activated, causing inflammation or necrosis of the invaded ganglion, producing neuralgia and clustered blisters on the skin of the corresponding area. Neuralgia is one of the features of the disease and is often severe and unbearable in older patients. In some patients, neuralgia may persist for months to years after the rash has completely resolved. The conventional treatment for herpes zoster is antiviral, nerve nutrition, immune system improvement and pain relief, but there are still problems of long treatment course and post-neuralgia.
Semiconductor laser belongs to the category of weak laser, which has a wide range of biological effects and penetrates deeper into the tissue than He-Ne laser [1]. The wavelength of the semiconductor laser we use for the treatment of herpes zoster is 700/850 nm, and the power is continuously adjustable from 0 to 800 mw. By irradiating the lesion area and peripheral nerve roots, it can promote local blood circulation, accelerate the absorption of exudates, reduce chemical and mechanical irritation of nerve endings at the injury site, regulate nerve endings excitability, and have anti-inflammatory p analgesic effects [2,3]. The results of this study showed that the overall efficiency of the treatment group was significantly higher than that of the control group. Most patients showed significant pain reduction or disappearance after 4-5 treatments, which may be related to the release of analgesic substances in the tissues after local irradiation, the reduction of peripheral nerve excitability and the repair of nerve damage by low-intensity laser [4]; while some patients showed immediate disappearance of pain at the time of irradiation, which may be related to its light-closure effect.
In conclusion, semiconductor laser treatment of herpes zoster has the advantages of good pain relief, short blister crusting time, painless and non-invasive, which provides an effective method for its clinical treatment.
References
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