Postherpetic neuralgia: epidemiology, pathophysiology and management.
Postherpetic neuralgia: epidemiology, pathophysiology and management.
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DOI：
10.1586/14737175.7.11.1581
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发表时间：
2007-11-01
影响因子：
4.3
通讯作者：
Baron, Ralf
中科院分区：
文献类型：
--
作者：
Johnson, Robert W;Wasner, Gunnar;Baron, Ralf
带状疱疹后神经痛是一种神经性疼痛综合征，是带状疱疹（HZ；带状疱疹）最常见的并发症。PHN主要发生在60岁及以上的HZ患者中，特别是那些患有更严重的急性疼痛和皮疹的患者。抗病毒药物的使用减少了与HZ相关的疼痛持续时间。在皮肤敏感性降低或增加的患者之间，PHN的病理生理可能有明显不同。治疗是使用三环类药物（如去甲替林），α - 2 - δ配体（如加巴喷丁）或阿片类药物与辅助外用利多卡因或辣椒素。以机制为基础的治疗是一个理想的目标，但迄今为止证明是难以捉摸的。由于寿命延长和越来越多的患者接受损害细胞介导免疫的治疗，HZ和PHN的发病率可能会增加。成人带状疱疹疫苗可降低HZ和PHN的发病率，以及与这些疾病相关的疾病负担。
Postherpetic neuralgia (PHN) is a neuropathic pain syndrome and is the most common complication of herpes zoster (HZ; shingles). PHN occurs mainly in HZ patients 60 years of age and older, in particular in those suffering from more severe acute pain and rash. Administration of antiviral drugs reduces the duration of pain associated with HZ. The pathophysiology of PHN may be distinctly different between patients with either reduced or increased skin sensitivity. Therapy is with tricyclic drugs (e.g., nortriptyline), alpha 2 delta-ligands (e.g., gabapentin) or opiates with adjunctive topical lidocaine or capsaicin. Mechanism-based therapy is a desirable goal but so far proves elusive. The incidence of HZ, and therefore that of PHN, is likely to increase as a result of greater longevity and increasing numbers of patients receiving treatment that compromises cell-mediated immunity. A zoster vaccine for administration to adults reduces the incidence of HZ and PHN, as well as the burden of illness associated with these conditions.