臭氧联合亚甲蓝治疗带状疱疹后神经痛

目的观察臭氧联合亚甲蓝治疗带状疱疹后神经痛的临床疗效及不良反应。方法选择38例胸腰段带状疱疹后神经痛的患者,用10ml注射器抽取浓度40ug／ml,及用臭氧在疱疹的皮损处皮内分不同点成扇形注射,以神经分布近端为主,重点在压痛或触痛最敏感部位,每个点1ml,同时在同侧三角肌没注射0．2％亚甲蓝2ml,每周二次,连续注射三周,观察治疗后1、2、4、8周带状疱疹后神经痛严重程度及有无不良反应。结果臭氧联合亚甲蓝治疗后一周带状疱疹后神经痛严重程度较治疗前明显下降,（P〈0．01）疗效可至少维持两周,且无不良反应。结论带状疱疹后神经痛经臭氧联合亚甲蓝治疗效果显著,无不良反应。     

臭氧治疗带状疱疹后遗神经痛临床疗效观察

目的观察臭氧治疗带状疱疹对带状疱疹后遗神经痛发生率的影响。方法 80例急性带状疱疹患者随机分为两组,分别采用传统治疗方法(C组)和传统治疗方法联合臭氧治疗(O组),1年后进行随访,记录带状疱疹后遗神经痛的发生例数。结果治疗7 d后,O组VAS评分明显低于C组,差异具有统计学意义(P0.05)。1年后随访发现C组患者有16例发生带状疱疹后遗神经痛,O组患者只有4例发生了带状疱疹后遗神经痛,O组患者带状疱疹后遗神经痛的发生率低于C组,差异具有统计学意义(P0.05)。结论在传统治疗带状疱疹的基础上联合臭氧治疗,不仅可以有效地减轻带状疱疹神经痛,还可以大大降低带状疱疹后遗神经痛的发生率。     

硬膜外自控镇痛治疗带状疱疹后神经痛的护理

总结了89例应用硬膜外自控镇痛泵治疗带状疱疹后神经痛的病人护理体会,主要护理措施是:心理护理、监测生命体征、硬膜外管道系统管理、呼吸抑制、恶心呕吐、尿潴留、便秘等不良反应的观察及护理。     

臭氧在治疗带状疱疹中的应用

目的评价臭氧在治疗带状疱疹中的作用。方法选择80名急性带状疱疹神经痛患者随机分为2组,分别采用传统治疗方法组（A组）和臭氧组治疗组（B组）,并且记录治疗前后的VAS。结果两组比较,B组治疗后的VAS明显降低。结论应用臭氧治疗带状疱疹神经痛是一种有效的方法。     

臭氧皮内注射对胸背部带状疱疹后神经痛的疗效观察

目的 观察臭氧皮内注射治疗对胸背部带状疱疹后神经痛的疗效。 方法 选取胸背部带状疱疹后神经痛的患者50例，采用随机数字表法分为治疗者和对照组，治疗组采用臭氧皮内注射治疗，每周一、三、五各注射1次，连续治疗6次为1个疗程，共治疗1个疗程。对照组采用电针治疗，每周治疗5次，10次为1个疗程，共治疗1个疗程。2组患者均于治疗前、疗程结束后第1天、治疗结束30 d后进行疗效评价，评价内容包括视觉模拟评分（VAS）和疼痛影响患者的情绪评分（ES）。 结果 疗程结束后第1天和治疗结束30 d后，2组患者的VAS评分均较组内治疗前显著降低，差异均有统计学意义（P<0.05），且治疗结束30 d后，治疗组患者的VAS评分为（3.86±1.60）分，显著优于对照组同时间点，差异均有统计学意义（P<0.05）。疗程结束后第1天和治疗结束30 d后，2组患者的ES评分均较组内治疗前显著降低，差异均有统计学意义（P<0.05），且疗程结束后第1天和治疗结束30 d后，治疗组患者的ES评分均显著优于对照组同时间点，差异均有统计学意义（P<0.05）。 结论 臭氧皮内注射治疗可显著改善带状疱疹后神经痛患者的疼痛程度和情绪，且远期疗效优于电针治疗。     

带状疱疹后遗神经痛老年患者硬膜外自控镇痛治疗的护理

总结37例带状疱疹后遗神经痛老年患者行硬膜外自控镇痛治疗的护理。护理重点为做好疼痛评估记录,密切观察自控镇痛泵使用效果及做好导管护理,保证硬膜外自控镇痛治疗顺利进行,密切观察硬膜外自控镇痛使用的药物不良反应与导管植入相关的并发症,及时予以对症处理,评价硬膜外自控镇痛治疗效果和及时调整方案,降低患者疼痛程度,改善生活质量。     

硬膜外不同输注方式对带状疱疹后神经痛的治疗效果

目的:比较持续性和间断性硬膜外镇痛两种方法对带状疱疹后神经痛(postherpetic neuralgia,PHN)的治疗效果,并评估其临床应用价值。方法:选择符合标准的PHN患者96例,随机分为A、B两组,A组患者予以持续硬膜外镇痛,B组患者予以间断硬膜外镇痛。分别于治疗前和治疗后2、4、8、14天,共5次对A组和B组的患者采用视觉模拟评分(Visual analogue scale,VAS)进行评价,并观察两种治疗方法的并发症,以及需要执行补救措施的病例数。结果:两组治疗后2、4、8、14天的VAS评分,组间对照无显著性差异。两组治疗前和治疗后各时间点的VAS评分,组内对照存在显著性差异。B组患者除1例患者发生导管脱出外未出现其它明显的不良反应。结论:两种治疗方法对PHN均有一定的效果,且治疗效果无明显的差异,可以酌情采取合适的方式。     

硬膜外自控镇痛治疗早期带状疱疹后神经痛的疗效分析

目的:本研究试图观察硬膜外自控镇痛联合普瑞巴林治疗早期带状疱疹后神经痛(postherpetic neuralgia,PHN)的临床疗效。方法:本研究选取了60例带状疱疹后神经痛的患者,随机分配成2组,口服普瑞巴林组(A组),硬膜外自控镇痛联合普瑞巴林组(B组),在治疗前,治疗后7天,治疗后1月,治疗后3月进行简式Mc Gill疼痛问卷(SF-MPQ)评定。在治疗前,治疗后6月进行简明疼痛评估量表(BPI)评定,并对药物的不良反应进行统计。结果:两组患者治疗后各时间点SF-MPQ评分和BPI评分均较治疗前显著下降(P<0.01)。B组SF-MPQ中各项评分较A组在术后7天,术后1月,术后3月显著下降(P<0.01),B组较A组术后6月的BPI评分显著下降(P<0.01)。结论:本研究结果表明硬膜外自控镇痛联合普瑞巴林是治疗早期带状疱疹后神经痛相对安全有效的方法。     

硬膜外阻滞治疗带状疱疹后神经痛1例

患，女，34岁。持续性上腹部疼痛2周。每日间断发作性烧灼样剧烈疼痛数次，每次持续约2～3小时。以急腹症收入普外科，经查体及辅助检查，无阳性体征及异常检查报告。给予禁食水、抗炎、解痉止痛、补液治疗1周，疼痛无明显减轻。经仔细查体发现患上腹部皮肤有带状成簇的色索沉着，患自诉1个月前上腹部皮肤曾发现疱疹，有轻微针刺样疼痛。据以上病史诊断为带状疱疹后神经痛。2％利多卡因3ml 维生B12 500μg 病毒唑100mg行上腹部皮肤色素沉着处局部注射，无明显疗效。     

Predictors of Postherpetic Neuralgia Among Patients With Herpes Zoster: A Prospective Study

Postherpetic neuralgia (PHN) is the most common complication of herpes zoster (HZ). The main objectives of this study were to: 1) estimate the severity and duration of PHN; and 2) identify the predictors of PHN. From October, 2005 to July, 2006, 261 outpatients with HZ, aged ≥50, were recruited within 14 days of rash onset during the routine clinical practice of 83 physicians across Canada. Physicians documented HZ characteristics, treatments, general health, functional, and immune status. HZ pain was measured at recruitment and on days 7, 14, 21, 30, 60, 90, 120, 150, and 180 following recruitment. PHN was defined as a worst pain ≥3 persisting or appearing more than 90 days after rash onset. Predictors of PHN were obtained by hierarchical log-binomial regression. Twenty-two percent of 249 immunocompetent subjects with HZ developed PHN. Median duration of PHN was 77 days. Independent predictors of PHN included: older age, limitation in performing usual activities prior to HZ, and pain severity at recruitment. This study confirms that older age and greater acute pain severity are predictors of PHN, while functional status emerges as a novel independent predictor of PHN that deserves further exploration. These findings will contribute to optimal use of the HZ vaccine and testing of new therapies that might prevent PHN.     

神经阻滞联合抗病毒药物治疗早期带状疱疹神经痛

[目的]观察神经阻滞联合抗病毒药物治疗早期带状疱疹神经痛的疗效.[方法]选择急性带状疱疹神经痛发病1～2周的患者64例,随机分成抗病毒药物治疗组(A组)和神经阻滞联合抗病毒药物组(B组),每组32例.分别在治疗前和治疗后进行视觉模拟评分(VAS),1周评估一次,随诊12周,了解患者睡眠、疼痛情况及带状疱疹后遗神经痛(P...     

Herpes Zoster Pain,Postherpetic Neuralgia,and Quality of Life in the Elderly

Herpes zoster pain and postherpetic neuralgia (PHN) particularly affect older persons. This literature review presents how quality of life is evaluated and the consequences of shingles and PHN on the quality of life of older persons. Although more than 150 articles have been published on herpes zoster and its consequences, specific studies focusing on the older population are needed, in several domains like epidemiology, preventive medicine, neuropsychology, and pharmacology.     

中西医结合治疗带状疱疹后遗神经痛18例体会

目的:采用小剂量糖皮质激素结合中医辨证论治治疗带状疱疹后遗神经痛,观察其有效性和安全性。方法:2009年9月～2011年7月,对18例带状疱疹后遗神经痛患者予以静脉点滴小剂量地塞米松配合甲氰咪胍,地塞米松逐步减量至停药,以及口服中药,疗程为14～17d。结果:痊愈11例,显效4例,有效2例,无效1例。结论:小剂量糖皮质激素结合中医辨证论治治疗带状疱疹后遗神经痛可有效缓解疼痛。     

17. Herpes Zoster and Post‐Herpetic Neuralgia

Herpes zoster infection is caused by a reactivation of the latent varicella zoster virus that causes chicken pox. It appears predominantly in older adults whose immunity for the virus has waned. The natural course of the disease is usually favorable, and the symptoms disappear spontaneously within a few weeks. Some patients, however, have prolonged pain: post‐herpetic neuralgia. The diagnosis of acute zoster infection is made on the clinical signs including the appearance of rash. Post‐herpetic neuralgia is described as sharp, burning, aching, or shooting constantly present in the dermatome that corresponds with the earlier rash. The objectives of treating herpes zoster are: (1) acute pain reduction; (2) promotion of recovery of epidermal defects and prevention of secondary infections; and (3) reduction or prevention of post‐herpetic neuralgia. The objective of the treatment of post‐herpetic neuralgia is primarily pain alleviation and improvement of the quality of life. Early treatment of the infection and the pain is believed to reduce the risk for post‐herpetic neuralgia. This persistent pain syndrome is difficult to treat. Antiepileptic drugs and tricyclic antidepressants are the first choice. Interventional treatments, such as epidural injections of corticosteroids and local anesthetic drugs, have an effect on the acute pain but are of limited use in preventing post‐herpetic neuralgia. When conservative treatment fails in providing satisfactory relief of post‐herpetic neuralgia, a sympathetic block may be considered (2 C+); if this treatment provides unsatisfactory results, spinal cord stimulation may be considered, in a study context (2 C+). ?     

Psychosocial Risk Factors for Postherpetic Neuralgia: A Prospective Study of Patients With Herpes Zoster

The results of previous studies using retrospective methods or small samples have suggested that there may be psychosocial risk factors for postherpetic neuralgia (PHN). We conducted a prospective study in which 110 patients with herpes zoster were assessed within the first month after rash onset with measures of acute pain and five broad domains of psychosocial functioning-physical, role, social, and emotional functioning, and stress and social support. Twenty of the 102 patients with follow-up data were diagnosed with PHN, defined as pain that had persisted for 4 months after rash onset. Measures of role functioning, personality disorder symptoms, and disease conviction during herpes zoster each made independent contributions to predicting either presence or intensity of PHN in logistic and linear regression analyses that controlled for relevant demographic and clinical variables, including age and acute pain intensity. These findings indicate that psychosocial variables are risk factors for the development of PHN. PERSPECTIVE: The results of this prospective study of patients with herpes zoster suggest that future research on the mechanisms and prevention of PHN should consider psychosocial as well as neurobiologic processes.     

Use of S-LANSS,a Tool for Screening Neuropathic Pain,for Predicting Postherpetic Neuralgia in Patients After Acute Herpes Zoster Events: A Single-Center, 12-Month,Prospective Cohort Study

Postherpetic neuralgia (PHN) is one of the most severe sequelae of herpes zoster events. Several risk factors have been reported for PHN, including old age, severe skin rash, and intense pain. This study therefore aims to evaluate the usefulness of the Self-completed Leeds Assessment of Neuropathic Symptoms and Signs pain scale (S-LANSS) in conjunction with previously reported risk factors for predicting PHN. A group of herpes zoster patients (N = 305) were included in the cohort study. Subjects were asked for their demographic information, clinical symptoms and signs, intensity of pain by visual analog scale (VAS), and S-LANSS. They were followed up in clinical visits or via telephone for 12 months. Nineteen patients (6.2%) suffered from PHN in this study. Using logistic regression, 3 risk factors for PHN were identified: age ≥70 years, high VAS scores, and high S-LANSS scores. Prediction of PHN using VAS (≥8) and S-LANSS (≥15) criteria achieved a sensitivity of 78.9% and specificity of 78.0%. Prediction of PHN in elderly patients (≥70 years), using the criteria of VAS (≥6) and S-LANSS (≥15) as well, achieved 100% sensitivity and 57.1% specificity. S-LANSS could be a useful prediction tool for PHN, particularly if combined with previously well-known risk factors and VAS.PerspectiveAmong acute herpes zoster patients, subjects with characteristics of neuropathic pain showed high frequency of PHN. The tools for screening neuropathic pain like S-LANSS could be helpful for predicting PHN and enabling early intervention of pain management.