Galluzzi Katherine E
Philadelphia College of Osteopathic Medicine, 4190 City Avenue, Philadelphia, PA 19131-1633, USA.
J Am Osteopath Assoc. 2007 Mar;107(3 Suppl 1):S8-S13.
Evidence-based strategies for the management of herpes zoster and postherpetic neuralgia (PHN) include the use of antiviral agents in acute zoster and specific analgesics in PHN. Antiviral agents are effective in reducing the severity and duration of acute herpes zoster when given within 72 hours of rash onset, but they do not prevent PHN. Anticonvulsants, tricyclic antidepressants, opioids, and topical treatment modalities such as lidocaine-containing patches and capsaicin cream offer moderate pain relief to some patients with PHN, but they may be associated with adverse events that limit their use. Therefore, prevention of herpes zoster and PHN with prophylactic vaccination using the zoster virus vaccine is an effective strategy to reduce the morbidity of these conditions. Treatment modalities are available, however, that may shorten the duration of acute herpes zoster and alleviate the pain of PHN.
带状疱疹及带状疱疹后神经痛（PHN）的循证管理策略包括在急性带状疱疹时使用抗病毒药物，以及在PHN时使用特定的镇痛药。抗病毒药物在皮疹出现72小时内使用时，可有效减轻急性带状疱疹的严重程度并缩短其病程，但不能预防PHN。抗惊厥药、三环类抗抑郁药、阿片类药物以及局部治疗方式，如含利多卡因的贴片和辣椒素乳膏，可为一些PHN患者提供适度的疼痛缓解，但它们可能会伴有不良事件，从而限制其使用。因此，使用带状疱疹病毒疫苗进行预防性接种以预防带状疱疹和PHN是降低这些疾病发病率的有效策略。不过，现有一些治疗方式可能会缩短急性带状疱疹的病程并减轻PHN的疼痛。
