A qualitative study of the psychological processes in patients with post-herpetic neuralgia

Objective:To understand the psychological process of patients with post-herpetic neuralgia(PHN)and provide references for the psychological management of PHN.Methods:The objective sampling method was used to conduct semi-structural in-depth interviews on 10 PHN patients,and Colaizzi’s phenomenological analysis method was used for data analysis.Results:According to the different pain durations of PHN patients,the patients were divided into three stages and five themes were extracted:the need for strong pain relief,the helpless tolerance of pain,the self-feeling burden,the need for health education,and the positive response to pain.Conclusions:PHN has complex psychological activities,so it is necessary to pay attention to the psychological process of patients and take effective psychological measures to intervene negative psychology so that patients can actively cope with the pain.

Correlation of p38MAPK,ERK1/2 and JNK expression in peripheral blood with the cytokines and pain mediators in patients with post-herpetic neuralgia

Objective: To study the correlation of p38MAPK, ERK1/2 and JNK expression in peripheral blood with the cytokines and pain mediators in patients with post-herpetic neuralgia (PHN). Methods: Patients who were diagnosed with herpes zoster for the first time in the Second Hospital of Hanbin District Ankang City between March 2015 and April 2016 were selected and divided into the PHN group who were combined with post-herpetic neuralgia and the pure HZ group who were without neuralgia, and the healthy volunteers who received physical examination in the Second Hospital of Hanbin District Ankang City during the same period were selected as control group. The peripheral blood was collected to determine the expression of MAPK signaling molecules, and serum was collected to determine the contents of cytokines and pain mediators. Results: p38MAPK, ERK1/2 and JNK mRNA expression in peripheral blood as well as 5-HT, CGRP, SP, NSE, S100B, IFN-γ, TNF-α and IL-17 levels in serum of PHN group and HZ group were significantly higher than those of control group while β-EP levels were significantly lower than that of control group;p38MAPK, ERK1/2 and JNK mRNA expression in peripheral blood as well as 5-HT, CGRP, SP, NSE, S100B, IFN-γ, TNF-α and IL-17 levels in serum of PHN group were significantly higher than those of HZ group while β-EP level was significantly lower than that of HZ group. p38MAPK, ERK1/2 and JNK expression in peripheral blood of PHN patients were positively correlated with CGRP, 5-HT, SP, NSE, S100B, IFN-γ, TNF-α and IL-17 levels in serum, and negatively correlated with β-EP level in serum. Conclusion: The high expression of p38MAPK, ERK1/2 and JNK in peripheral blood of PHN patients can increase the secretion of cytokines and algogenic mediators and decrease the secretion of analgesic mediators.

Correlation of serum inflammatory cytokine and immunoglobulin content with post-herpetic neuralgia in patients with acute herpes zoster

Objective:To study the correlation of serum inflammatory cytokine and immunoglobulin content with post-herpetic neuralgia in patients with acute herpes zoster.Methods:Patients diagnosed with herpes zoster in our hospital between May 2012 and October 2015 were selected and divided into herpes zoster-post-herpetic neuralgia group (VZV-PHN group) and herpes zoster-control group (VZV-Con group) according to the incidence of post-herpetic neuralgia (PHN);healthy volunteers receiving physical examination in our hospital during the same period were selected as normal control group (Con group).Results: Serumβ-EP, NT, IFN-γ and IL-2 levels of VZV-PHN group and VZV-Con group were significantly lower than those of Con group (P<0.05), while SP, VGF, CGRP, IL-4, IL-6, IL-17, IL-21, TNF-α, IL-10, TGF-β1, IgG, IgM and IgA levels were significantly higher than those of Con group (P<0.05);serumβ-EP, NT, IFN-γ, IL-2, IgG, IgM and IgA levels of VZV-PHN group were significantly lower than those of VZV-Con group (P<0.05) while SP, VGF, CGRP, IL-4, IL-6, IL-17, IL-21, TNF-α, IL-10 and TGF-β1 levels were significantly higher than those of VZV-Con group (P<0.05);β-EP and NT were positively correlated with IFN-γ, IL-2, IgG, IgM and IgA, and negatively correlated with IL-4, IL-6, IL-17, IL-21, TNF-α, IL-10 and TGF-β1;SP, VGF and CGRP were negatively correlated with IFN-γ, IL-2, IgG, IgM and IgA, and positively correlated with IL-4, IL-6, IL-17, IL-21, TNF-α, IL-10 and TGF-β1.Conclusions:Abnormal secretion of inflammatory cytokines and immunoglobulin caused by humoral immune and cellular immune response disorder is associated with the occurrence of post-herpetic neuralgia in patients with acute herpes zoster.

臭氧介入综合治疗顽固性疱疹后神经痛5年随访研究

目的：本文报道使用以臭氧介入为主的规范化诊疗综合方案用于顽固性、激惹型疱疹后神经痛患者的5年随访结果。方法：统计资料完整的顽固性躯干部疱疹后神经痛30例住院患者，病史4个月～4年，患者最多住院达10次。入院后接受以臭氧介入为主的规范化诊疗方案，即口服药物＋病人自控硬膜外镇痛＋臭氧介入治疗，采用自身对照方法考察治疗前、后抑郁量表、疼痛程度、红外线热图、患区遗留症状和睡眠质量等指标。随访评估五年。使用Poisson列联系数法进行统计资料处理。结果：年龄60～85岁（平均70.3±5．9岁）。患区剧烈疼痛住院72小时内即得到有效控制，治疗前平均视觉模拟评分（visual analoguescale，VAS）评分为6．7±1．8分，抑郁评分（hamilto ndepression score，HAMD）评分为22．6±4．2分，局部温度为36．4±2．6℃。治疗后平均VAS评分为3．1±0．8分，HAMD评分为13．5±3．1分，局部温度差为3．64-0．6℃.本组患者未出现与治疗方案相关的并发症。结论：CT监护下以臭氧介入为主的规范化治疗可快速控制剧烈疼痛，使原发和继发损伤区消失或明显缩小，局部温度趋于正常，在长达5年左右随访期间效果比较稳定，疼痛程度及VAS评分未出现明显波动，患者情绪好转，绝大部分患者生活质量明显改善。

Two proved cases of treating herpes zoster pain by needling wei

Two cases of herpes zoster neuralgia treated by shallow needling combined with electroacupuncture were introduced. The literature basis and possible mechanisms were discussed.

刺络放血拔罐结合电针围刺治疗带状疱疹后神经痛临床观察

Objective:To explore the clinical efficacy of collateral-pricking and blood-letting cupping combined with surrounding needling technique electroacupuncture in the treatment of post-herpetic neuralgia(PHN).Methods:Seventy-two patients with post-herpetic neuralgia were randomized into observation group and control group.Of the 72 cases,12 cases fell off,so finally 30 cases in each group.The observation group was treated with collateral-pricking and blood-letting cupping combined with surrounding needling technique electroacupuncture,while the control group was treated simply with pregabalin capsules for 20 consecutive days.On the basis of the western medication pregabalin capsules,the same as that of the control group,collateral-pricking and blood-letting cupping combined with electroacupuncture in a surrounding needling technique,was adopted for the observation group,once every two days,ten days as one course of treatment,a total of two courses.The immediate visual analogue scale(VAS)before and after treatment were observed in the two groups,and their clinical effects were compared.Results:The VAS scores of PHN patients in the two groups after treatment were lower than those before treatment(both P<0.01),and the scores of observation group were lower than those of control group(P<0.05).The total effective rate of the observation group was 86.7%,higher than 73.3% of the control group.Conclusion:The clinical effect of collateral-pricking and blood-letting cupping combined with electroacupuncture is relatively satisfactory in the treatment of post-herpetic neuralgia.