Portenoy R K, Duma C, Foley K M
Ann Neurol. 1986 Dec;20(6):651-64. doi: 10.1002/ana.410200602.
The pain of acute herpes zoster (HZ) may be severe, but it is usually transitory. A minority of patients, with the elderly at particular risk, go on to develop persistent, severe, often disabling pain called postherpetic neuralgia. Though the clinical features of these conditions are well known, the pathology of PHN is poorly described and the pathogenesis of the pain in both remains conjectural. During the past 60 years, an extraordinary number of pharmacological, anesthetic, and surgical therapies have been applied in an attempt to ameliorate the symptoms of acute herpes zoster, enhance its healing, prevent its transition to postherpetic neuralgia, and treat the pain of those with this complication. Relatively few treatments have been studied in a controlled manner, and fully reliable, safe, and effective therapeutic approaches for preventing and treating postherpetic neuralgia have not yet been found. This review summarizes current information on the epidemiology, clinical features, and pathology of herpes zoster and postherpetic neuralgia, and critically examines the accumulated experience with the various treatments. Guidelines for management are suggested.
急性带状疱疹（HZ）的疼痛可能很严重，但通常是暂时的。少数患者，尤其是老年人，有发展为持续性、严重且常常致残的疼痛的风险，这种疼痛称为带状疱疹后神经痛（PHN）。尽管这些病症的临床特征广为人知，但PHN的病理学描述较少，两者疼痛的发病机制仍属推测。在过去60年中，人们应用了大量的药理学、麻醉学和外科治疗方法，试图改善急性带状疱疹的症状、促进其愈合、防止其转变为带状疱疹后神经痛，并治疗患有这种并发症者的疼痛。相对较少的治疗方法经过对照研究，尚未找到完全可靠、安全且有效的预防和治疗带状疱疹后神经痛的治疗方法。本综述总结了关于带状疱疹和带状疱疹后神经痛的流行病学、临床特征和病理学的当前信息，并严格审视了各种治疗方法积累的经验。文中提出了管理指南。
