Wallis Katharine A, Hood Lynley J, Rao Kavita
Department of General Practice and Rural Health, Dunedin School of Medicine, University of Otago, PO Box 56, Dunedin, New Zealand.
J Prim Health Care. 2014 Jun 1;6(2):108-13.
Herpes zoster and its sequelae can have a serious impact on quality of life, particularly in the elderly. The duration and severity of herpes zoster symptoms can be reduced with antiviral treatment. Early treatment is most effective.
To identify how soon after onset of herpes zoster symptoms adults presented to a suburban Dunedin general practice and to describe which patients received antiviral treatment.
Adult herpes zoster cases were identified from a large suburban general practice from 2004 to 2009. Duration of symptoms at presentation and antiviral prescription were identified from medical records and described by patient characteristics.
We identified 278 incident cases. Approximately one-third presented within three days of symptoms, one-third after three days, and in one-third of cases the duration of symptoms was not documented. A higher percentage of patients with ophthalmic herpes zoster presented within three days (45%), while a lower percentage of men (24%) and patients from the lowest socioeconomic quintile (25%) presented within three days. Most incident cases received antiviral treatment. A higher percentage of patients with ophthalmic herpes zoster and patients who presented within three days of symptoms received antiviral treatment. Some patients who presented after seven days of symptoms also received treatment. Antiviral prescribing did not increase with patient age.
Despite many adults with acute herpes zoster presenting after three days of symptoms, most received antiviral treatment. It is not known why many presented late. It is not known whether late treatment is effective.
带状疱疹及其后遗症会对生活质量产生严重影响，在老年人中尤为如此。抗病毒治疗可减轻带状疱疹症状的持续时间和严重程度。早期治疗最为有效。
确定成人带状疱疹症状出现后多久到但尼丁郊区的一家普通诊所就诊，并描述哪些患者接受了抗病毒治疗。
从2004年至2009年一家大型郊区普通诊所中识别出成人带状疱疹病例。从病历中确定就诊时的症状持续时间和抗病毒药物处方，并按患者特征进行描述。
我们识别出278例新发病例。约三分之一的患者在症状出现后三天内就诊，三分之一在三天后就诊，三分之一病例的症状持续时间未记录。眼部带状疱疹患者在三天内就诊的比例较高（45%），而男性（24%）和社会经济地位最低五分位的患者在三天内就诊的比例较低（25%）。大多数新发病例接受了抗病毒治疗。眼部带状疱疹患者和症状出现后三天内就诊的患者接受抗病毒治疗的比例较高。一些症状出现七天后就诊的患者也接受了治疗。抗病毒药物的处方量并未随患者年龄增加。
尽管许多急性带状疱疹成人患者在症状出现三天后才就诊，但大多数接受了抗病毒治疗。尚不清楚许多患者就诊延迟的原因。也不清楚延迟治疗是否有效。
