疱疹后神经痛

Irsyah Dwi Rohmayanti, S. Kurniawan
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摘要

带状疱疹后神经痛(PHN)是带状疱疹爆发后持续3个月或更长时间的慢性神经性疼痛。带状疱疹,特别是急性带状疱疹,与水痘患者体内灭活的水痘带状疱疹病毒的再激活有关。PHN与持续性且常常难治性神经性疼痛有关。患者可能会经历几种类型的疼痛,包括深度疼痛、无法忍受的疼痛、灼痛、阵发性疼痛、刺痛、痛觉过敏和异常性疼痛。PHN的药物治疗可包括多种药物,包括α -2 δ配体(加巴喷丁和普瑞巴林)、其他抗痉挛药(卡马西平)、三环抗抑郁药(阿米替林、去甲替林、多虑平)、局部镇痛药(5%利多卡因贴片、辣椒素)、曲马多或其他阿片类药物。常用口服药物的巨大副作用通常限制了它们的实际使用,局部和全身药物的组合可能需要达到最佳效果。医生和其他护理提供者必须根据患者的个体反应调整治疗。
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POST HERPETIC NEURALGIA
Postherpetic neuralgia (PHN) is a chronic neuropathic pain condition that lasts 3 months or more after an outbreak of shingles. Herpes zoster, especially acute herpes zoster, is associated with the reactivation of the inactivated varicella zoster virus in individuals who have had chickenpox. PHN is associated with persistent and often refractory neuropathic pain. Patients may experience several types of pain, including deep pain, intolerable pain, burning, paroxysmal pain, stabbing pain, hyperalgesia, and allodynia. Pharmacological treatment of PHN may include a variety of drugs, including alpha-2 delta ligands (gabapentin and pregabalin), other anticonvulsants (carbamazepine), tricyclic antidepressants (amitriptyline, nortriptyline, doxepin), topical analgesics (5% lidocaine patch, capsaicin) tramadol, or other opioids. The sizeable side effect profile of commonly used oral drugs often limits their practical use, and a combination of topical and systemic agents may be required for optimal results. Doctors and other care providers must adapt treatment based on individual patient responses.
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