文献简介

出版社:2014 Massengill and Kittredge.

作  者:Jamie S Massengill,John L Kittredge

编  号:

关键字:herpes zoster, postherpetic neuralgia, primary care, clinical practice, pharmacological treatment, practical guidelines

年  份:2014   点击量:1010

文献摘要 全文翻译

Abstract: An estimated one million individuals in the US are diagnosed with herpes zoster (HZ; shingles) each year. Approximately 20% of these patients will develop postherpetic neu¬ralgia (PHN), a complex HZ complication characterized by neuropathic pain isolated to the dermatome that was affected by the HZ virus. PHN is debilitating, altering physical function and quality of life, and commonly affects vulnerable populations, including the elderly and the immunocompromised. Despite the availability of an immunization for HZ prevention and several approved HZ treatments, the incidence of PHN is increasing. Furthermore, management of the neuropathic pain associated with PHN is often suboptimal, and the use of available therapeutics may be complicated by adverse effects and complex, burdensome treatment regimens, as well as by patients’ comorbidities and polypharmacy, which may lead to drug–drug interactions. Informed and comprehensive assessments of currently available pharmacological treatment options to achieve effective pain control in the primary care setting are needed. In this article, we discuss the situation in clinical practice, review currently recommended prevention and treatment options for PHN, and outline practical considerations for the management of this neuropathic pain syndrome, with a focus on optimal, individual-based treatment plans for use in the primary care setting.

摘要:
在美国,每年大约有一百万人被诊断为带状疱疹(HZ)。大约20%的患者发展为带状疱疹后遗神经痛(PHN),PHN是一种复杂的HZ并发症,以HZ病毒引起的单一皮节神经痛为特征。PHN使人感到虚弱,改变患者生理功能,影响其生活质量,通常会影响虚弱人群,如老年人和免疫力低下的患者。尽管免疫接种可以有效的预防HZ,并且有很多治疗HZ的方法,但是PHN的发病率仍逐年升高。此外,对于与PHN相关的神经痛的治疗往往不太理想,并且目前可用的治疗方案可能产生不良反应和其他并发症,而且治疗方案比较复杂,由于患者具有合并症和多重用药,可能导致药物与药物之间的相互作用。初级保健机构需要对于目前可用的药物治疗方案,进行全面的了解以及综合评估,以获得对疼痛有效的控制。在本文中,我们讨论了其临床现状,回顾了目前对于PHN预防和治疗方法,并且概述这种神经病理性疼痛综合征治疗的实践思考虑,其重点在于为初级保健机构选择最佳的、基于个体的治疗方案。