Cebeci Dua, Karasel Seide
Famagusta State Hospital, Dermatology and Venerelogy, Famagusta, Cyprus.
Famagusta State Hospital, Physical Medicine and Rehabilitation, Famagusta, Cyprus.
Mater Sociomed. 2022 Mar;34(1):55-59. doi: 10.5455/msm.2022.33.55-59.
Postherpetic neuralgia (PHN) is a frequent complication of herpes zoster (HZ). Treatment of this chronic pain syndrome and results are often not clear. Tricyclic antidepressants, gabapentinoids and potent opioids are first-line treatments and are highly effective, but their use is limited due to adverse effects that may occur in elderly patients with significant medical comorbidities or interaction due to multiple drug use. There are no head-to-head comparisons of non medical treatments. Dry needling appears comparable to conventional physical therapy for treating PHN.
Our aim is to determine the incidence of PHN in our population and to compare the treatments in patients with postherpetic neuralgia.
A search for HZ and PHN was conducted in a general practice research database, comprising 2 general practices (dermatologist and physiatrist) and representing 5600 people. We analyzed a retrospective 37 case with PNH of 170 herpes zoster patient admmited to the dermatology and physical therapy and rehabilitation outpatient clinic between October 2018 and October 2020. Dry needling and physical therapy methods applied in addition to medical treatment in PHN treatment were compared.
In patients with postherpetic neuralgia, both dry needling therapy group and physical therapy group LANSS scores decreased significantly in the first week and in the third week compared to baseline. Dry needling therapy group has also similar results in VAS scores in the first and third week. But in physical therapy group, the VAS score did not show a significant decrease in the first week compared to the baseline, but it decreased significantly in the third week.
PHN is a complex, difficult to treat and severe neuropathic pain that affects patients' daily function and quality of life. Various agents and methods are available to relieve the symptoms of PHN. This study shows as both physical therapy and dry needling therapy are effective treatment for postherpetic nevralgia..
带状疱疹后神经痛(PHN)是带状疱疹(HZ)常见的并发症。这种慢性疼痛综合征的治疗方法及效果往往并不明确。三环类抗抑郁药、加巴喷丁类药物和强效阿片类药物是一线治疗药物,且疗效显著,但由于老年患者存在严重的内科合并症时可能出现不良反应,或因多种药物联用产生相互作用,其应用受到限制。非药物治疗之间尚无直接对比研究。与传统物理治疗相比,针刺疗法在治疗PHN方面似乎效果相当。
我们的目的是确定本群体中PHN的发病率,并比较带状疱疹后神经痛患者的治疗方法。
在一个全科医学研究数据库中检索HZ和PHN,该数据库包含2个全科诊所(皮肤科和物理治疗科),代表5600人。我们对2018年10月至2020年10月间收治于皮肤科及物理治疗与康复门诊的170例带状疱疹患者中的37例PHN患者进行了回顾性分析。比较了在PHN治疗中除药物治疗外应用的针刺疗法和物理治疗方法。
在带状疱疹后神经痛患者中,与基线相比,针刺治疗组和物理治疗组的LANSS评分在第1周和第3周均显著降低。针刺治疗组在第1周和第3周的VAS评分也有相似结果。但在物理治疗组中,VAS评分在第1周与基线相比未显示出显著降低,而在第3周显著降低。
PHN是一种复杂、难治且严重的神经性疼痛,会影响患者的日常功能和生活质量。有多种药物和方法可缓解PHN的症状。本研究表明,物理治疗和针刺疗法都是治疗带状疱疹后神经痛的有效方法。