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经皮神经电刺激(TENS)——一种替代抗病毒药物治疗急性带状疱疹和预防疱疹后神经痛的方法。

TENS - an alternative to antiviral drugs for acute herpes zoster treatment and postherpetic neuralgia prevention.

机构信息

Department of family medicine, University of Ljubljana, Slovenia.

出版信息

Swiss Med Wkly. 2012 Jan 17;142:w13229. doi: 10.4414/smw.2012.13229. eCollection 2012.

Abstract

QUESTIONS UNDER STUDY

To evaluate the effectiveness of transcutaneous electrical nerve stimulation (TENS) in treatment of Herpes zoster (HZ), and prevention of postherpetic neuralgia (PHN) compared with antiviral drugs. PHN is frequent complication of HZ and may last for months, its treatment isn't very successful. Nonpharmacological regimens for treatment of HZ and prevention of PHN haven't been evaluated.

METHODS

Retrospective observational study of medical records of patients of three family physicians in Health centre Litija, Slovenia was done. 109 of 6613 patients on their lists had HZ from 1999 to 2008. 102 medical records were analyzed (6 could not be reached; one patient with corneal HZ was excluded).

RESULTS

Four treatment groups were compared: only TENS therapy, only antiviral drug, antiviral drug and TENS, no therapy (neither antiviral drug or TENS). All groups were similar with respect to demographic characteristics of patients with HZ. Patients treated only with TENS had no PHN, 28.6% of patients treated with antiviral drugs had PHN. Less analgesic drugs have been prescribed to patients treated only with TENS.

CONCLUSION

Study suggests TENS may be safe adjunct or even alternative to antiviral drugs for treatment of acute HZ. It looks that TENS may be at least as good as antiviral drugs for treatment of HZ, and it may be better in reducing and preventing PHN - such conclusion would necessitate controlled, prospective study. Use of TENS provided pain relief and resolution of skin lesions with no higher rate of other HZ complications compared to antiviral therapy.

摘要

研究问题

评估经皮神经电刺激(TENS)治疗带状疱疹(HZ)和预防带状疱疹后神经痛(PHN)的效果,并与抗病毒药物进行比较。PHN 是 HZ 的常见并发症,可能持续数月,其治疗效果并不理想。针对 HZ 和 PHN 的非药物治疗方案尚未得到评估。

方法

对斯洛文尼亚利特雅健康中心的三位家庭医生的患者病历进行回顾性观察研究。1999 年至 2008 年间,在其名单上的 6613 名患者中有 109 名患有 HZ。对 102 份病历进行了分析(有 6 份无法联系到;排除了一名患有角膜 HZ 的患者)。

结果

比较了四种治疗组:仅 TENS 治疗、仅抗病毒药物治疗、抗病毒药物联合 TENS 治疗、无治疗(既无抗病毒药物也无 TENS 治疗)。所有组在 HZ 患者的人口统计学特征方面均相似。仅接受 TENS 治疗的患者没有 PHN,接受抗病毒药物治疗的患者中有 28.6%患有 PHN。仅接受 TENS 治疗的患者开具的镇痛药较少。

结论

研究表明,TENS 可能是治疗急性 HZ 的安全辅助手段,甚至是抗病毒药物的替代品。TENS 可能与抗病毒药物一样有效治疗 HZ,并且在减少和预防 PHN 方面可能更好——这种结论需要进行对照、前瞻性研究。与抗病毒治疗相比,TENS 的使用可缓解疼痛并使皮损消退,而不会增加其他 HZ 并发症的发生率。

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