Jeon Young Hoon
Department of Anesthesiology and Pain Medicine, School of Dentistry, Kyungpook National University, Daegu, Korea.
Korean J Pain. 2015 Jul;28(3):177-84. doi: 10.3344/kjp.2015.28.3.177. Epub 2015 Jul 1.
Herpes zoster (HZ) is a transient disease caused by the reactivation of latent varicella zoster virus (VZV) in spinal or cranial sensory ganglia. It is characterized by a painful rash in the affected dermatome. Postherpetic neuralgia (PHN) is the most troublesome side effect associated with HZ. However, PHN is often resistant to current analgesic treatments such as antidepressants, anticonvulsants, opioids, and topical agents including lidocaine patches and capsaicin cream and can persist for several years. The risk factors for reactivation of HZ include advanced age and compromised cell-mediated immunity (CMI). Early diagnosis and treatment with antiviral agents plus intervention treatments is believed to shorten the duration and severity of acute HZ and reduce the risk of PHN. Prophylactic vaccination against VZV can be the best option to prevent or reduce the incidence of HZ and PHN. This review focuses on the pathophysiology, clinical features, and management of HZ and PHN, as well as the efficacy of the HZ vaccine.
带状疱疹（HZ）是一种由潜伏在脊髓或颅神经感觉神经节中的水痘-带状疱疹病毒（VZV）重新激活引起的短暂性疾病。其特征为在受影响的皮节出现疼痛性皮疹。带状疱疹后神经痛（PHN）是与HZ相关的最麻烦的副作用。然而，PHN通常对当前的镇痛治疗（如抗抑郁药、抗惊厥药、阿片类药物以及包括利多卡因贴片和辣椒素乳膏在内的局部用药）具有耐药性，且可能持续数年。HZ重新激活的危险因素包括高龄和细胞介导免疫（CMI）受损。抗病毒药物早期诊断和治疗加干预治疗被认为可缩短急性HZ的病程和严重程度，并降低PHN的风险。预防性接种VZV疫苗可能是预防或降低HZ和PHN发病率的最佳选择。本综述重点关注HZ和PHN的病理生理学、临床特征及管理，以及HZ疫苗的疗效。
