带状疱疹后遗神经痛发病相关因素流行病学分析

目的：探讨带状疱疹后遗神经痛（ postherpetic neuralgia,PHN）发生的相关因素及干预方法,为PHN的预防提供参考依据。方法通过对95例住院患者进行流行病学调查,对患者的一般信息、发病部位、皮损特点、合并病、治疗方法等方面的资料进行分层分析,应用统计学方法分析将各因素列为自变量,建立Logistic回归模型,利用先前逐步法筛选出有统计学意义的变量。结果PHN发生的危险因素包括：带状疱疹急性期疼痛程度（P=0．002,OR=14．507）、合并糖尿病（P=0．007,OR=7．066）或恶性肿瘤（P=0．007,OR=25．978）、皮损类型（χ^2=13．377,P=0．010）、前驱痛的发生（P =0．015,OR =5．366）、年龄（Z =-2．442,P =0．015）、皮损面积（Z =-2．203,P =0．028）。而性别、发病部位及诱发因素与PHN的发生无关。降低PHN发生的有利因素包括：发病开始治疗的时间（P=0．008,OR=9．785）及早期治疗方法（χ^2=9．535,P=0．009）。结论带状疱疹后遗神经痛的发病影响因素最大的是急性期的疼痛程度,其次是合并糖尿病、合并恶性肿瘤、早期治疗、皮损类型、前驱痛的发生、皮损面积等,而性别、发病部位、诱发因素则与本病发生无关。带状疱疹及早治疗以及治疗早期加入中药及适量激素对预防PHN的发生效果显著。

Pathogenic Relevant Factors Epidemiological Analysis of Postherpetic Neuralgia of Herpes Zoster

Objective To explore the related factors of the heritage neuralgia before and after the intervention methods, provides the reference for the prevention of PHN. Methods Through the epidemio-logical investigation of 95 cases hospitalized patients, the patients’ general information, risk, lesion charac-teristics, combination of disease and treatment of data were done with hierarchical analysis. applied statis-tics methods to analyze , We established a Logistic regression model and designed the various factors as in-dependent variables, and then gradually selected variables the statistically significant data. was. Results PHN of risk factors include：herpes zoster degree of acute pain （P=0. 002,OR=14. 507）,diabetes melli-tus（P =0.007,OR =7.066）OR malignant tumors（P =0.007,OR =25.978）,skin lesions type（χ2 =13. 377,P=0. 010）, the precursor of pain occurred （P=0. 015,OR=5. 366）, age （Z= -2. 442,P=0. 015）, the lesion area （Z= -2. 203,P=0. 028）. And sex, site and inducing factors and the occurrence of PHN has nothing to do. PHN reduced favorable factors include：the onset of treatment time to start （ P=0. 008, OR=9. 785） and early treatment method （χ^2 =9. 535,P =0. 009）. Conclusion Postherpetic neuralgia after herpes zoster occurred mostly related to the degree of acute pain, followed by the merger of diabetes, malignant tumor, early treatment, skin lesions type, precursor pain occurs, lesion area and so on, while sex, place, inducing factors was not associated with the occurrence of this disease Herpes zoster as soon as possible and Treatment with TCM independently or combined with little hormones in the early stage of PTN do good to prevent the happening of PHN.