带状疱疹后神经痛与带状疱疹综合征

Post-herpetic neuralgia and herpes zoster syndrome

背景带状疱疹后神经痛(post-herpetic neuralgia,PHN)是带状疱疹(herpes zoster,HZ)常见并发症,其表现形式多样,疼痛机制复杂,临床疗效欠佳。目的本文从PHN不同表现形式入手,提出一个概念供探讨,应从整体上将HZ和PHN看成一个序贯事件。内容带状疱疹及其疼痛是由机体免疫力下降引起的潜伏水痘-带状疱疹病毒(varicella zoster virus,VZV)复制为始动因素,继而造成组织损伤,并由此启动外周和中枢敏化机制,且心理和精神因素参与的以皮疹、水疱、疼痛、感觉缺失、感觉异常、触摸痛及心理障碍为表现的一组综合症状。趋向带状疱疹及其疼痛综合征需多学科多模式综合治疗以早期阻断其级联反应从而提高患者生活质量降低医疗资源投入。

Objective Background:Post-herpetic neuralgia(PHN) is a common complication of herpes zoster(HZ).It has various manifestations,complex pain mechanisms,and poor clinical efficacy.Objective:This paper starts with the different manifestations of PHN,and puts forward a concept for discussion which the HZ and PHN should be regarded as a sequential event in general.Content:The starting factor of herpes zoster and its pain is the reactivation of latent varicella zoster virus(VZV),which causes tissue damage,and initiates peripheral and central sensitization mechanisms,with psychological and psychiatric factors involved.It is a group of syndromes characterized by rash,shingles,pain,loss of sensation,paresthesia,allodynia and psychological disorders.Trend:Herpes zoster and pain syndrome need multidisciplinary and multimodal comprehensive therapies to block their cascades early to improve patient care and reduce investment in medical resources.