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带状疱疹后神经痛的镇痛治疗方法:一种叙述性综述。

Analgesic Treatment Approach for Postherpetic Neuralgia: A Narrative Review.

机构信息

Edmundo Gónima Valero, M.D, Anesthesiologist and Pain Management Specialist, Chief - Pain Management and Palliative Care Department, Hospital Militar Central, Bogotá, Colombia.

Walter Antanas Sosa Mendoza, M.D, Pain Management and Palliative Care Fellow, Universidad Militar Nueva Granada, Bogotá, Colombia.

出版信息

J Pain Palliat Care Pharmacother. 2023 Jun;37(2):184-193. doi: 10.1080/15360288.2023.2174632. Epub 2023 Feb 2.

Abstract

Post-herpetic neuralgia (PHN) is an entity derived from peripheral nerve damage that occurs during the reactivation of the Varicella Zoster Virus (VZV), which manifests itself through pain with neuropathic characteristics. This can prove to be very difficult to manage in the chronic stages of disease reappearance. There currently exists a multitude of treatment alternatives for PHN, however, prevention through the early initiation of antiviral regimens is vital. There are various pharmacological options available, but it is important to individualize each patient to maximize efficacy and minimize adverse effects. Interventional procedures have become a cornerstone in difficult-to-manage cases, and have shown promising outcomes when used in a multimodal approach by experienced specialists. It is necessary to make an objective diagnosis of PHN and start early treatment. Additionally there is current evidence that vouches for interventional therapies as well as individualization, with a clear establishment of therapeutic objectives according to the needs of each patient.

摘要

带状疱疹后神经痛(PHN)是一种源自外周神经损伤的病症,发生在水痘带状疱疹病毒(VZV)再激活期间,表现为具有神经病理性特征的疼痛。在疾病复发的慢性阶段,这种疼痛可能非常难以控制。目前有多种治疗带状疱疹后神经痛的方法,但通过早期启动抗病毒治疗来预防是至关重要的。有多种药物治疗选择,但为每个患者进行个体化治疗以最大程度提高疗效并最小化不良反应非常重要。介入性治疗已成为难以治疗的病例的基石,并且当由经验丰富的专家以多模式方法使用时,已经显示出了有前途的结果。有必要对 PHN 进行客观诊断并尽早开始治疗。此外,目前有证据表明介入治疗以及个体化治疗是有效的,根据每个患者的需求明确确立治疗目标。

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