带状疱疹后遗神经痛相关危险因素分析

目的：明确带状疱疹后遗神经痛(postherpetic neuralgia,PHN)的危险因素。方法：分析潍坊医学院附属医院2017年9月至2019年2月带状疱疹住院患者的临床资料,依据发病后1个月是否有PHN,分为病例组和对照组。对两组患者进行单因素及多元logistic回归分析。结果：共筛选出513例患者,其中111例发生PHN（21.6%）。单因素分析示年龄、吸烟史、部位、皮疹面积、临床分型、前驱症状、早期治疗时间、使用糖皮质激素、糖尿病与PHN的发生有关。多因素Logistic回归分析结果显示,PHN的危险因素有年龄≥60岁、有吸烟史、发病诱因为精神/焦虑、初始治疗时间＞7天、急性期重度疼痛和糖尿病史(OR=6.013、3.391、6.800、22.071、21.996、3.163, 95％CI：1.694～21.341、1.219～9.436、1.310～35.296、4.049～120.314、2.864～168.946、1.281～7.811,均P＜0.05)。结论：年龄＞60岁、有吸烟史、发病诱因为精神/焦虑、早期治疗时间＞7天、重度急性期疼痛、糖尿病是PHN发生的危险因素。     

带状疱疹后遗神经痛的危险因素分析

目的 评估带状疱疹患者发生后遗神经痛(postherpetic neuralgia,PHN)的相关风险因素.方法 收集安徽医科大学第一附属医院皮肤性病科2017年1月至2018年1月间确诊的带状疱疹住院患者256例,采用问卷调查及电话等随访方式,综合评估患者发病年龄、性别等因素与PHN的关联性.结果 256例患者最终随...     

从中医理论探讨带状疱疹后遗神经痛的危险因素

目的运用中医理论指导探讨带状疱疹后遗神经痛(PHN)的危险因素。方法对121例带状疱疹患者进行问卷调查,其中35例发生PHN。对其年龄、性别、致病因素、辨证分型,三焦辨证的等结果,利用Logistic回归分析,对PHN可能的中医致病的危险因素先进行单因素分析,再进一步进行多因素分析,以期筛选出PHN中医方面的独立危险因素。结果多因素Logistic回归分析显示:发病年龄高;病位在上焦;火毒、湿热、脾虚湿盛是带状疱疹发生的独立危险因素。结论带状疱疹的中医致病因素为毒邪炽盛或湿邪浸淫,中医辨证分型为脾虚湿盛。对于年龄≥60岁的患者,应积极进行规范化的治疗,通过中医辨证整体治疗,降低PHN的发生率。     

带状疱疹后遗神经痛风险因素分析

目的：通过分析带状疱疹后遗神经痛临床相关的风险因素,为预防带状疱疹后遗神经痛的发生提供帮助。方法：对收集的165例带状疱疹患者的年龄、情绪状态、某些实验室检查、伴发疾病进行前瞻性分析。结果：带状疱疹后遗神经痛的发生率与高脂血症无关。而与年龄增高、情绪状态、白蛋白／球蛋白比值倒置、外周血CD4^＋、CD8^＋T细胞亚群异常及糖尿病有关。结论：年龄、焦虑和抑郁及合并糖尿病患者发生带状疱疹后遗神经痛的风险增加。机体免疫状态与带状疱疹后遗神经痛的发生可能有关,实验室检测的某些指标可能对带状疱疹后遗神经痛有一定的预测作用。     

建立和验证带状疱疹患者后遗神经痛风险因素预测模型

目的:探索建立带状疱疹后遗神经痛(PHN)风险因素预测模型,并进行PHN高危因素分析。方法:回顾性分析了2017年3月至2021年12月本院收住院治疗的急性期带状疱疹患者,根据是否发生PHN将其分为两组。使用LASSO联合Logistic回归分析建立预测模型,并进行危险因素评价。结果:共有307例患者入选本研究,101例(32.8%)患者出现了PHN。应用LASSO联合Logistic回归分析筛选出以下独立危险因素：年龄≥50岁(OR值3.522, 95%CI1.631～7.606,P=0.001)、合并糖尿病史(OR值2.182,95%CI 1.073～4.438,P=0.031)、急性期皮损面积≥5%(OR值2.756,95%CI 1.426～5.327,P=0.003)、先驱痛(OR值2.233,95%CI 1.216～4.099,P=0.010)、急性期疼痛程度评分(NRS)≥6分(OR值10.724,95%CI 5.549～20.725,P<0.001)。结论:年龄≥50岁、合并糖尿病史、急性期皮损面积≥5%、急性期先驱痛、急性期疼痛程度评分(NRS)≥6分为PHN发生...     

综合治疗带状疱疹后遗神经痛

我科自1999年12月至2002年8月,综合治疗带状疱疹后遗神经痛97例,现报导如下.     

带状疱疹后遗神经痛并发白癜风1例

患者男,65岁。因左侧头面部疼痛1年、皮肤白斑半年,于2005年7月10日来我院就诊。1年前,患者左侧头面部疼痛,起丘疹、水疱,在当地医院诊断为带状疱疹,经治疗,水疱逐渐干涸结痂,自觉疼痛减轻,于是停用药物治疗。嗣后左侧头面部疼痛间断存在,呈阵发性发作,时轻时重,虽经治疗病情未     

带状疱疹后遗神经痛的防治

<正>带状疱疹(HZ)是由于水痘带状疱疹病毒在人体内的再次活跃引起的一种综合症,它可以发生在任何年龄段,但常见于大于60岁的人和免疫力低下的患者。疱疹后遗神经痛(PHN)现并没有一致的定义,很多学者认为带状疱     

带状疱疹后遗神经痛的防治

带状疱疹(HZ)是由于水痘带状疱疹病毒在人体内的再次活跃引起的一种综合症,它可以发生在任何年龄段,但常见于大于60岁的人和免疫力低下的患者.疱疹后遗神经痛(PHN)现并没有一致的定义,很多学者认为带状疱疹神经痛分三个阶段:急性疱疹神经痛,亚急性疱疹神经痛和慢性神经痛(又称为PHN).关于带状疱疹后遗神经痛(PHN)现比较公认的为皮疹愈合后疼痛持续超过3个月,是带状疱疹最常见并且棘手的并发症.在老年人群,PHN极大影响了患者的生活质量.本文主要介绍PHN的药物治疗与预防.     

针刺治疗带状疱疹后遗神经痛300例

笔者于2002年1月-2005年1月运用针刺疗法治疗带状疱疹后遗神经痛取得满意疗效.现总结如下.     

Thermography as a predictor of postherpetic neuralgia in acute herpes zoster patients: a preliminary study

Background/purpose: Infrared thermal images in patients suffering from herpes zoster (HZ) may exhibit thermal asymmetry due to the unilateral distribution of HZ lesions. This study examined the usefulness of infrared thermography in acute HZ as a predictor for the development of postherpetic neuralgia (PHN). Methods: The authors collected demographic and clinical data including age, sex, onset of skin lesion, pain intensity by a visual analogue scale (VAS) and the development of PHN from a total of 55 patients diagnosed with HZ. We evaluated the body surface thermographic parameters between the lesion and contralateral normal skin: maximal difference in the temperature (ΔT) and the size of the body surface area (BSA) showing thermal asymmetry. Results: Temperatures of the lesions were found to be warmer than the control side in most patients with acute HZ. We compared the patient group who developed PHN with those who did not. In univariate analysis, patients with PHN were older (P=0.004), had a higher VAS score for pain (P<0.001), higher ΔT (P<0.001) and larger BSA (P=0.001). In logistic regression analysis to identify independent risk factors of PHN, older age (>60 years old) and ΔT more than 0.5 °C were found to be statistically significant.     

Efficacy of low dose gabapentin in acute herpes zoster for preventing postherpetic neuralgia: a prospective controlled study

Postherpetic neuralgia (PHN) is a sequela of herpes zoster that adversely affects quality of life seriously. The risk factors for PHN are well known but the effective interventions that reduce the incidence of PHN are less studied. The objective of this study is to evaluate the efficacy of treatment with gabapentin in patients with acute herpes zoster for preventing PHN. We performed a prospective randomized controlled study of 120 participants diagnosed with acute herpes zoster, aged 50 and over and complaining moderate to severe pain. All patients were treated with valacyclovir and acetaminophen. Half of the participants were assigned to the gabapentin group and received gabapentin 300 mg three times a day additionally. The intensity of pain at every visit and the incidence of PHN in both groups were measured. Total 52 and 49 patients in the gabapentin group and the control group, respectively, had completed 12 weeks of follow‐up period. Although the incidence of PHN was higher in the control group, the difference was not statistically significant (6.1% vs. 3.8%, p = 0.67). Our results indicate that the use of low‐dose gabapentin in acute herpes zoster seems not effective in the prevention of PHN.     

Effectiveness and safety of lidocaine patch 5% to treat herpes zoster acute neuralgia and to prevent postherpetic neuralgia

Herpes zoster is often associated to acute neuralgia and postherpetic neuralgia (PHN). Their therapeutic management is still challenging: among therapeutic options, lidocaine patch 5% was rarely used in acute neuralgia on lesional skin, and its efficacy to prevent PHN was never studied. The efficacy and tolerability of lidocaine patch 5% was evaluated in 38 patients with acute neuralgia (19) and PHN (19). Pain intensity was investigated using DN4 questionnaire and NRS‐11 scale at baseline and at week 2, 4, and 8. The use of rescue therapy was also evaluated. A significant reduction of DN4 and NRS‐11 was observed already at W2, with further improvement at W4 and W8. A complete response to treatment (DN4 and NRS‐11 = 0) at week 8 was higher in patients with acute neuralgia (63.2%) than PHN (31.6%). Rescue therapy gradually decreased in acute neuralgia patients from week 2 (57.9%) to week 8 (10.5%), with only two patients needing neuroleptics. In PHN patients rescue therapy remained stable (68.4%). According to our results, lidocaine patch 5% applied on lesional skin was well tolerated and ensured a rapid pain relief in acute neuralgia; if early used, it prevented PHN in almost all patients.     

阿米替林预防带状疱疹后遗性神经痛的研究

目的评价阿米替林在预防中老年带状疱疹后遗神经痛（post herpetic neuralgia，PHN）的效果。方法采用随机对照研究，117例门诊患者随机分为两组，对照组给予常规治疗，试验组在常规治疗的基础上加用阿米替林，观察疗程1个月。结果试验组疼痛缓解、疼痛消失时间明显缩短，优于对照组，1个月后PHN的发生率显著低于对照组，并有统计学意义（P〈0．01）。结论带状疱疹急性期运用小剂量阿米替林可较快减轻疼痛症状，预防PHN的发生。     

带状疱疹309例临床分析

目的：探讨带状疱疹（Hz）的发病特点、治疗与疱疹后遗神经痛（PHN）的相关性。方法：回顾性分析309例患者的一般资料、临床表现、实验室检查及临床转归。结果：病程及PHN的发生与患者年龄、初诊时间、治疗用药相关。结论：早期治疗、合理用药对缩短病程及防止PHN发生起一定的作用。     

地塞米松防治带状疱疹所致神经痛疗效评价

目的:评价地塞米松在治疗带状疱疹神经痛以及预防带状疱疹后遗神经痛中的有效性和安全性。方法:将60例带状疱疹患者随机分为治疗组和对照组,两组患者均静滴更昔洛韦,口服甲钴胺、维生素B_1、氨芬曲马多。治疗组同时给予地塞米松5 mg静滴,每日1次。结果:治疗4天后,治疗组VAS评分低于对照组,有显著统计学意义(P0.05)。治疗组和对照组的后遗神经痛的发病率分别为9.67%和27.59%(P0.05)。结论:早期使用地塞米松可有效缓解带状疱疹神经痛,并能有效预防后遗神经痛。     

Burden of herpes zoster and postherpetic neuralgia in Japanese adults 60 years of age or older: Results from an observational,prospective, physician practice‐based cohort study

Approximately one in three persons will develop herpes zoster during their lifetime, and it can lead to serious complications such as postherpetic neuralgia. However, evidence on burden of herpes zoster and postherpetic neuralgia in Japan is limited. This prospective, observational, multicenter, physician practice‐based cohort study was conducted in Kushiro, Hokkaido, Japan ( Clinicaltrials.gov identifier NCT01873365) to assess the incidence and hospitalization rates of herpes zoster, and the proportion, clinical burden and risk factors for postherpetic neuralgia in adults aged 60 years or more. Within the study area, 800 subjects developed herpes zoster and 412 were eligible for the study. Herpes zoster incidence was 10.2/1000 person‐years and higher among women and older subjects. Subjects with herpes zoster required on average 5.7 outpatient consultations. Herpes zoster‐associated hospitalization rate was 3.4% (27/800). The proportion of postherpetic neuralgia and other complications was 9.2% (38/412) and 26.5% (109/412), respectively. Statistically significant association with the development of postherpetic neuralgia was male sex (odds ratio [OR], 2.51; 95% confidence interval [CI], 1.17–5.38), age of 70–74 years (OR, 3.51; 95% CI, 1.09–11.3), immunosuppressive therapy (OR, 6.44; 95% CI, 1.26–32.9), severe herpes zoster pain at first consultation (OR, 3.08; 95% CI, 1.10–8.62) and rash on upper arms (vs no rash on upper arms; OR, 3.46; 95% CI, 1.10–10.9). Considerable herpes zoster and postherpetic neuralgia burden exists among elderly in Japan, and there may be predictive factors at the first visit which could be indicative of the risk of developing postherpetic neuralgia.     

Postherpetic neuralgia and recalcitrant cystic lesions following herpes zoster: A case report and review of treatment options

Acute herpes zoster lesions in most cases are self‐limited except in older and immunocompromised patients, wherein the pain can cause significant suffering. Postherpetic neuralgia is a painful situation for patients that can compromise the quality of life. Here, we report a 30‐year‐old healthy young man who developed treatment‐resistant postherpetic neuralgia after herpes zoster (fourth/fifth thoracic segment) without any underlying immunocompromised state. He also developed some cystic lesions, which were removed by aspiration and surgery. The skin lesions improved 2 weeks after the surgery and postherpetic neuralgia was completely cured after 5 months, however cystic lesions recurred multiple times and were excised completely during each visit. Postherpetic neuralgia has a significant impact on the health‐care cost borne by the society and affected individual, hence, it is essential to select appropriate treatment to manage the pain of postherpetic neuralgia.