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Post-herpetic neuralgia

机译：疱疹后神经痛

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Background: In spite of the large body of evidence available in the literature, definition and treatment of Post-Herpetic Neuralgia (PHN) are still lacking a consistent and universally recognized standardization. Furthermore, many issues concerning diagnosis, prediction and prevention of PHN need to be clarified in view of recent contributions.Objectives: To assess whether PHN may be better defined, predicted, treated and prevented in light of recent data, and whether available alternative or adjunctive therapies may improve pain relief in treatment recalcitrant PHN.Methods: Systematic reviews, meta-analyses, randomized controlled trials, cohort studies and protocols were searched; the search sources included PubMed, Cochrane Library, NICE, and DARE. More than 130 papers were selected and evaluated.Results: Diagnosis of PHN is essentially clinical, but it can be improved by resorting to the many tools available, including some practical and accessible questionnaires. Prediction of PHN can be now much more accurate, taking into consideration a few well validated clinical and anamnestic variables. Treatment of PHN is presently based on a well characterized array of drugs and drug associations, including, among others, tricyclic antidepressants, gabapentinoids, opioids and many topical formulations. It is still unsatisfactory, however, in a substantial proportion of patients, especially those with many comorbidities and intense pain at herpes zoster (HZ) presentation, so that this frequent complication of HZ still strongly impacts on the quality of life of affected patients.Conclusion: Further efforts are needed to improve the management of PHN. Potentially relevant interventions may include early antiviral therapy of acute HZ, prevention of HZ by adult vaccination, as well as new therapeutic approaches for patients experiencing PHN.
机译：背景：尽管文献中有大量证据，但对于肝炎后神经痛（PHN）的定义和治疗仍缺乏一致且得到普遍认可的标准化方法。此外，鉴于最近的贡献，许多与PHN的诊断，预测和预防有关的问题需要澄清。目的：根据最近的数据评估是否可以更好地定义，预测，治疗和预防PHN，以及是否可以使用替代方案或辅助方案方法：系统评价，荟萃分析，随机对照试验，队列研究和方案进行了研究;搜索源包括PubMed，Cochrane Library，NICE和DARE。结果：PHN的诊断本质上是临床的，但是可以通过使用许多可用的工具来改善它，包括一些实用且可访问的问卷调查。考虑到一些经过充分验证的临床和记忆消除变量，PHN的预测现在可以更加准确。目前，PHN的治疗基于一系列特征明确的药物和药物组合，包括三环类抗抑郁药，加巴喷丁类药物，阿片类药物和许多局部用药。然而，在相当一部分患者中，尤其是那些合并症多且带状疱疹疼痛剧烈的患者中，它仍然不能令人满意，因此，这种频繁的HZ并发症仍然强烈影响着受影响患者的生活质量。 ：需要进一步努力来改善PHN的管理。潜在的相关干预措施可能包括急性HZ的早期抗病毒治疗，通过成人疫苗预防HZ以及针对经历PHN的患者的新治疗方法。

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