School of Medical and Life Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 611137, People's Republic of China.
Institute of Translational Pharmacology and Clinical Application, Sichuan Academy of Chinese Medical Science, Chengdu, Sichuan, 610041, People's Republic of China.
Curr Pain Headache Rep. 2023 Sep;27(9):307-319. doi: 10.1007/s11916-023-01146-x. Epub 2023 Jul 26.
Postherpetic neuralgia is an annoying pain that mainly affects older people. In order to give patients more options, this review summarizes the pharmacological and interventional treatments for postherpetic neuralgia and updates the research on the efficacy, thereby providing doctors with more treatment options. The adverse effects and effective doses of its various treatments are also presented so that the therapy can be prescribed according to their concrete physical conditions. In a word, this review is dedicated to providing a comprehensive overview of the treatment options for postherpetic neuralgia and offering patients more choices.
Combinational therapy is more excellent than monotherapy. The local anesthesia and gabapentin comprised outstanding compatibility. In addition, two therapeutic tools for PHN patients, especially for the intractable ones, electroacupuncture (EA), and osteopathic manipulative treatment (OMT), show their efficacy and become potential options to alleviate pain. In terms of treatment, guidelines recommend patients use tricyclic antidepressants (TCAs), gabapentin, pregabalin, and 5% lidocaine patches as the first-line medications, and gabapentin is investigated most, especially the gabapentin enacarbil (GEn). And drug efficacy can be limited by adverse effects and tolerated doses. Interventional treatments, with their invasiveness and operational difficulty, are usually considered for intractable patients. Combinational therapies may be used when a single therapy cannot achieve the desired effect. Therapies such as OMT and EA have also been proposed to palliate pain in some cases, and future directions of treatment may be investigated in Chinese medicine and acupuncture.
带状疱疹后神经痛是一种常见的疼痛，主要影响老年人。为了给患者提供更多的选择，本综述总结了带状疱疹后神经痛的药物和介入治疗，并更新了其疗效的研究，从而为医生提供更多的治疗选择。还介绍了其各种治疗方法的不良反应和有效剂量，以便根据患者的具体身体状况进行处方。总之，本综述旨在全面概述带状疱疹后神经痛的治疗选择，并为患者提供更多选择。
联合治疗优于单一疗法。局部麻醉剂和加巴喷丁具有出色的兼容性。此外，针对 PHN 患者的两种治疗工具，特别是针对难治性患者的电针 (EA) 和整骨疗法 (OMT)，显示出其疗效，并成为缓解疼痛的潜在选择。在治疗方面，指南建议患者使用三环类抗抑郁药 (TCAs)、加巴喷丁、普瑞巴林和 5%利多卡因贴剂作为一线药物，其中加巴喷丁研究最多，特别是加巴喷丁恩卡他（GEn）。而且药物疗效可能会受到不良反应和耐受剂量的限制。介入治疗具有侵袭性和操作难度，通常仅考虑用于难治性患者。当单一疗法无法达到预期效果时，可以使用联合疗法。在某些情况下，也提出了 OMT 和 EA 等疗法来缓解疼痛，未来可能会在中医和针灸方面进行治疗方向的研究。
