Peng Fen, Xia Tian-Bao
Department of Dermatology, Peking University Third Hospital, Beijing, People's Republic of China.
Department of Dermatology, People's Liberation Army Strategic Support Force Characteristic Medical Center, Beijing, People's Republic of China.
Infect Drug Resist. 2023 Apr 12;16:2159-2165. doi: 10.2147/IDR.S401972. eCollection 2023.
Postherpetic neuralgia (PHN), which represents the most common chronic complication of herpes zoster, is characterized by intense pain and is difficult to treat. In fact, no treatments are currently available that can effectively reduce the pain associated with PHN. Recent evidence has been presented indicating that Botulinum toxin (BoNT-A) can serve as an effective and safe treatment for peripheral neuropathic pain.
The effects of intradermal BoNT-A injections on herpes zoster related neuralgia were investigated in this study.
Patients diagnosed with herpes zoster related acute neuralgia (N=13 - acute group) and those diagnosed with postherpetic neuralgia (N=17 - PHN group) were enrolled in this study. The two groups were treated with intradermal injections of BoNT-A at the site of their affected pain areas and were then assessed at 1 day, 1 week, 2 weeks, 1 month, 2 months and 3 months after their BoNT-A treatments.
When compared with pre-treatment values, Visual Analogue Scores (VAS) in all patients were all significantly decreased at all times tested following BoNT-A injection. Before treatment, PHN patients had significantly higher VAS than those in the acute group. However, after 1 day of treatment, there was no difference in VAS between the two groups. None of the patients in the acute phase treated with BoNT-A developed PHN.
BoNT-A injections significantly reduced herpetic-related pain and proved to be a more effective treatment for the PHN versus acute pain group. Moreover, an early application of BoNT-A can alleviate the probability of developing PHN.
带状疱疹后神经痛（PHN）是带状疱疹最常见的慢性并发症，其特点是疼痛剧烈且难以治疗。事实上，目前尚无有效治疗方法能有效减轻与PHN相关的疼痛。最近有证据表明，肉毒杆菌毒素（BoNT-A）可作为外周神经性疼痛的一种有效且安全的治疗方法。
本研究探讨皮内注射BoNT-A对带状疱疹相关性神经痛的影响。
本研究纳入了诊断为带状疱疹相关性急性神经痛的患者（N = 13 - 急性组）和诊断为带状疱疹后神经痛的患者（N = 17 - PHN组）。两组患者均在其疼痛受累部位接受皮内注射BoNT-A治疗，然后在BoNT-A治疗后的第1天、1周、2周、1个月、2个月和3个月进行评估。
与治疗前值相比，所有患者在BoNT-A注射后的所有测试时间点，视觉模拟评分（VAS）均显著降低。治疗前，PHN患者的VAS显著高于急性组患者。然而，治疗1天后，两组患者的VAS无差异。接受BoNT-A治疗的急性期患者均未发生PHN。
BoNT-A注射显著减轻了疱疹相关性疼痛，并且对于PHN组而言，其治疗效果优于急性疼痛组。此外，早期应用BoNT-A可降低发生PHN的可能性。
