Wood Martin
Department of Infection and Tropical Medicine, Heartlands Hospital, Birmingham B9 5SS, United Kingdom.
J Infect Dis. 2002 Oct 15;186 Suppl 1:S78-82. doi: 10.1086/342958.
After herpes zoster, immunocompetent persons frequently experience chronic pain and considerable suffering. Zoster-associated pain has a complex pathophysiology that begins with viral damage and increased sensitization of peripheral sensory neurons. The enhanced afferent barrage from these neurons sensitizes spinal neurons and leads to loss of synapses from descending inhibitory fibers, resulting in central neuropathic pain and allodynia. Antiviral therapy of acute zoster limits this sequence of pathophysiologic mechanisms. There is no clear consensus regarding the optimal means of determining the benefits of antiviral therapy in the management of pain of herpes zoster. A novel statistical approach utilizing rates of disappearance of pain of differing pathophysiologic mechanisms is proposed.
带状疱疹后，免疫功能正常的人经常会经历慢性疼痛和巨大痛苦。带状疱疹相关性疼痛具有复杂的病理生理学，始于病毒损伤和外周感觉神经元敏感性增加。这些神经元增强的传入冲动使脊髓神经元敏感化，并导致下行抑制纤维的突触丧失，从而导致中枢性神经病理性疼痛和异常性疼痛。急性带状疱疹的抗病毒治疗可限制这一系列病理生理机制。关于确定抗病毒治疗在带状疱疹疼痛管理中的益处的最佳方法，目前尚无明确共识。本文提出一种利用不同病理生理机制疼痛消失率的新型统计方法。
