Analgesia in Herpes Zoster and Postherpetic Neuralgia

描述（由申请人提供）：带状疱疹是一种常见且疼痛的 由水痘带状疱疹复发引起的神经系统疾病 病毒带状疱疹疼痛，持续愈合后的急性感染， 称为带状疱疹后神经痛（PHN），一种慢性疼痛综合征， 对所有治疗无效。预计PHN的患病率将增加 在未来几十年内，由于带状疱疹的发病率和 PHN的风险将随着人口老龄化而增加。虽然研究 目前正在继续改进治疗，但多达一半的患者没有 目前获得救济。因此，制定干预措施， 预防PHN将大大减少残疾，痛苦和使用 保健资源。根据风险因素研究结果， 对于PHN及其病理生理机制，可以假设， 联合抗病毒和止痛治疗后，尽快开始， - 带状疱疹的发作将降低PHN的风险。其具体目的是 规划补助金是为临床试验制定方案和程序 来验证这个假设拟议的试验将有以下主要内容 目的：主要目的是检验PHN风险 在带状疱疹患者中， 和阿片类镇痛药相比， 和匹配的安慰剂。支持这一假设将对 带状疱疹的治疗方法有哪些？ 降低PHN的患病率。第二个主要目标是 拟议的审判所完成的是确定是否启动 慢性神经性疼痛的中枢机制可以通过减弱 剧烈疼痛。这个问题的答案将提供重要的信息 关于长时间疼痛的机制，并对其 预防

DESCRIPTION (provided by applicant): Herpes zoster is a common and painful neurological disease that is caused by reactivation of the varicella-zoster virus. Herpes zoster pain that persists after healing of the acute infection is termed postherpetic neuralgia (PHN), a chronic pain syndrome that is often refractory to all treatment. The prevalence of PHN is expected to increase substantially in the coming decades because the incidence of herpes zoster and the risk of PHN will both increase as the population ages. Although research to improve treatment is continuing, as many as half of all patients do not currently obtain relief. For this reason, the development of interventions that prevent PHN would lead to major reductions in disability, distress, and use of health care resources. On the basis of the results of research on risk factors for PHN and its pathophysiologic mechanisms, it can be hypothesized that combined antiviral and analgesic treatment begun as soon as possible after the -onset of herpes zoster will reduce the risk of PHN. The specific aim of this planning grant is to develop the protocol and procedures for a clinical trial to test this hypothesis. The proposed trial will have the following major objectives: The primary aim will be to test the hypothesis that the risk of PHN is reduced by half in herpes zoster patients treated with an antiviral agent and an opioid analgesic compared with patients treated with the antiviral agent and matching placebo. Support for this hypothesis would have a major impact on the treatment of patients with herpes zoster and lead to a substantial reduction in the prevalence of PHN. A second major aim that will be accomplished by the proposed trial is determining whether the initiation of central mechanisms of chronic neuropathic pain can be prevented by attenuating acute pain. The answer to this question will provide important information about mechanisms of prolonged pain and have major implications for its prevention.