Johnson Robert W
Pain Management Clinic, University of Bristol and Bristol Royal Infirmary, Bristol, UK.
Herpes. 2003 Aug;10(2):38-45.
Post-herpetic neuralgia (PHN) is the most common complication of herpes zoster (HZ, shingles), particularly in the elderly and those with severe acute phase symptoms. Unless or until varicella vaccination reduces the incidence of HZ and attenuates the risk and/or severity of complications, PHN will continue to result in patient suffering and remain a significant cause of healthcare and social support resource consumption. There have been useful advances in PHN management (e.g. use of the anticonvulsant gabapentin and topical local anaesthetic patches), but some cases remain intractable. Prevention is an important strategy, and antiviral drugs, while not totally effective, provide the most accepted method. Other acute interventions require further evaluation (nerve blocks, acute phase use of tricyclic antidepressants or anticonvulsants). As prevention of PHN requires early recognition and prompt management of at-risk patients presenting with acute HZ, public education and provision of information to relevant healthcare personnel are important. This article discusses issues relevant to PHN management and prevention, and provides a review of the pertinent literature.
带状疱疹后神经痛（PHN）是带状疱疹（HZ，俗称缠腰龙）最常见的并发症，在老年人以及急性期症状严重的患者中尤为常见。除非水痘疫苗能够降低HZ的发病率并减轻并发症的风险和/或严重程度，否则PHN将继续给患者带来痛苦，并仍然是医疗保健和社会支持资源消耗的重要原因。PHN的治疗已经取得了一些有益的进展（例如使用抗惊厥药物加巴喷丁和局部麻醉贴片），但仍有一些病例难以治疗。预防是一项重要策略，抗病毒药物虽然并非完全有效，但却是最被认可的方法。其他急性干预措施需要进一步评估（神经阻滞、急性期使用三环类抗抑郁药或抗惊厥药）。由于预防PHN需要早期识别并及时治疗有急性HZ的高危患者，因此公众教育以及向相关医护人员提供信息非常重要。本文讨论了与PHN管理和预防相关的问题，并对相关文献进行了综述。
