带状疱疹后遗神经痛的中西医治疗进展

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摘要带状疱疹后遗神经痛（PHN）是急性带状疱疹最常见的并发症，其疼痛持久，严重影响患者生活质量。目前PHN的治疗方法多样。抗惊厥药、抗抑郁药、阿片类药物和局部疗法（利多卡因贴剂、辣椒素贴剂）是治疗PHN最广泛的疗法，但因其不良反应，在老年患者或有明显合并症者中应谨慎使用。神经阻滞、神经调节等措施也对PHN的治疗起重要作用，使用这些侵入性方法时需密切监测疗效、耐受性和安全性。中医疗法治疗PHN副作用小，效果显著，应在分型的基础上进行个性化辨证施治。有部分PHN患者疼痛顽固，治疗效果欠佳，可考虑中西医结合治疗，充分发挥各自的优势。本文就PHN的中西医治疗进行综述，为临床治疗提供参考。

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	皇甫佳欣沈德新

关键词 ：带状疱疹后遗神经痛, 治疗, 中西医

Abstract：Postherpetic neuralgia (PHN) is the most common complication of acute herpes zoster. The persistence of pain has a substantial effect on the patients′ quality of life. At present, a variety of methods are used to treat PHN. Anticonvulsants, antidepressants, opioids and topical therapies including Lidocaine and Capsaicin are the most widely used therapies for the treatment of PHN, due to adverse effects, they should be used carefully in the elderly patients or with significant comorbidities. Nerve block, neuromodulation and other measures also play an important role in the treatment of PHN. However, the efficacy, tolerability and safety of these invasive methods should be closely monitored. Chinese medicine therapy have little side effects and significant effect for the treatment of PHN, we should be carried out individualized differentiation of symptoms and signs on the basis of types. For some PHN patients who have intractable pain and poor treatment effect, we can consider integrated traditional Chinese and Western medicine to give full play to their advantages. This paper reviews the traditional Chinese and Western medicine treatment of PHN, so as to provide reference for clinical treatment.

Key words： Postherpetic neuralgia Treatment Traditional Chinese and Western medicine

通讯作者: 沈德新（1969-），女，硕士，主任医师，硕士研究生导师；研究方向：儿童皮肤病。

引用本文:

皇甫佳欣沈德新. 带状疱疹后遗神经痛的中西医治疗进展[J]. 中国医药导报, 2020, 17(12): 65-68.
HUANGFU Jiaxin SHEN Dexin. Treatment progress on traditional Chinese and Western medicine of postherpetic neuralgia. 中国医药导报, 2020, 17(12): 65-68.

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http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2020/V17/I12/65

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