祁战涛 杨靖

【摘要】目的：观察中西医结合治疗对生殖器疱疹患者临床症状及生活质量的改善情况，探讨生殖器疱疹中药治疗的价值，为优化治疗方案提供依据。方法：收集2012年3月至2015年3月我院皮肤科门诊诊治的生殖器疱疹患者120例，随机分为对照组和试验组各60例，对照组口服盐酸伐昔洛韦片，试验组在对照组的基础上根据中医证型采用相关方剂，同时随症加减。疗程结束后，观察其临床疗效，并在1、3、6个月进行随访，记录复发情况；采用生活质量量表（RGHQOL）对生活质量进行评估。结果：对照组痊愈30例，显效12例，有效10例，总有效率 86.7%；试验组痊愈45例，显效10例，有效3例，总有效率96.7%。两组总有效率比较具有统计学意义（χ2=3.93，P<0.05）。对照组在1个月、3个月及6个月内复发例数分别为3例、13例及20例，共36例，复发率60.00%；试验组分别为1例、5例及8例，共14例，复发率23.33%。两组治疗后1个月的复发情况无统计学差异（χ2=0.259，P=0.611），3个月和6个月复发情况比较，均具有统计学意义（χ2=4.196，P=0.041；χ2=6.708，P=0.010）。两组患者治疗前RGHQOL得分均偏低，无统计学差异（t=-0.452，P=0.652）；两组治疗后1个月、3个月及6个月RGHQOL得分均较治疗前明显升高（P<0.001），治疗后与治疗前组内比较差异差异均具有统计学意义（P<0.05），治疗后试验组与对照组比较差异有统计学意义（P<0.05）。结论：中西医结合治疗生殖器疱疹的疗效优于单用西药治疗，同时降低复发率，提高患者生活质量，值得在临床推广应用。

【关键词】中西医结合；生殖器疱疹；效果；复发；生活质量

【Abstract】Objectives： To observe the effect of integrative medicine for genital herpes， to explore the value of traditional Chinese medicine treatment for genital herpes in order to optimize treatment. Methods： 120 patients in our hospital from March 2012 to March 2015 for the diagnosis and treatment of herpes were randomly divided into control group and experiment group， each of 60 patients. The control group was treated with valacyclovir hydrochloride tablets， and on such basis， the experiment group adjusted its prescriptions according to its TCM characteristics. After treatment， the clinical efficacy was observed and followed up for 1， 3 and 6 months to record the recurrence and RGHQOL was adopted to assess the life quality. Results： In control group， there were 30 cases cured， 12 cases markedly effective and 10 cases effective， a total efficiency of 86.7%. In the experiment group， there were 45cases cured， 10 cases remarkly effective and 3 cases effective， a total efficiency of 96.7%. Difference in total effective rate was statistically significant （χ2 = 3.93， P<0.05）. In the control group， the number of relapse cases within 1， 3 and 6 months were 3， 13 and 20 cases respectively， a total of 36 cases with a recurrence rate of 60.00%； In the experiment group， they were 1， 5 and 8 cases， a total of 14 cases with a recurrence rate of 23.33%. Difference in relapse cases 1 month was of no significant difference （χ2 = 0.259， P = 0.611）， and that within 3 months and 6 months was statistically significant （χ2 = 4.196， P = 0.041； χ2 = 6.708， P = 0.010）. The RGHQOL scores of the two groups before treatment was of no significant difference （t = -0.452， P = 0.652）； and that a month， three months and six months after treatment was significantly higher than before treatment （P<0.001）. Difference within each group between before and after treatment was statistically significant （P< 0.05）， so as the difference between experiment group and control group after treatment （P< 0.05）. Conclusion： Integrative medicine is of better effect than western medicine alone in treating genital herpes， while reducing recurrence rate and improving the quality of life of patients， which is worth application in clinical.

【Key words】Integrative medicine； Genital herpes； Effect； Relapse； Quality of life

【中图分类号】R752.1【文献标志码】A

生殖器疱疹（genital herpes，GH）是单纯疱疹病毒（HSV）引起的皮肤黏膜感染性疾病，主要由HSV-2型经过性接触感染， 近年来发病率呈逐年上升的趋势[1]。初发者经合适治疗后，其症状、体征多能迅速缓解，然而大多数感染者会再次复发。治疗生殖器疱疹的关键在于有效的控制、降低复发率[2]。目前西药治疗主要使用抗病毒药物，虽然能够起到缓解症状的效果，但难以彻底根治[3]。传统中药的应用在治疗生殖器疱疹积累了大量的经验。本课题组通过收集2012年3月至2015年3月我院皮肤性病门诊的生殖器疱疹患者120例，观察中西医结合治疗的疗效、复发率及生活质量的改善情况，探讨生殖器疱疹中药治疗的价值。……