带状疱疹后神经痛病人痛觉异常的临床调查  

CLINICAL INVESTIGATION OF PAIN SENSITIZATION IN PATIENTS WITH POSTHERPETIC NEURALGIA

作　　者：赵倩男 刘辉 王永[2] 钱晓焱 方七五[2] 李彤[3] 安建雄 ZHAO Qian-Nan;LIU Hui;WANG Yong;QIAN Xiao-Yan;FANG Qi-Wu;LI Tong;AN Jian-Xiong(Department of Anesthesiology, Weifang Medical University, Weifang 261000, China;Department of Anesthesiology,Pain Medicine and Critical Care Medicine, Aviation General Hospital of China Medical University& Beijing Institute of Translational Medicine, Chinese Academy of Sciences, Beijing 100012, China;Lanzhou Maternity & Child Healthcare Hospital, Lanzhou 730030, China)

机构地区：[1]潍坊医学院麻醉学系,潍坊261000 [2]中国医科大学航空总医院暨中国科学院北京转化医学研究院麻醉疼痛与重症医学中心,北京100012 [3]兰州市妇幼保健院疼痛科,兰州730030

出　　处：《中国疼痛医学杂志》2019年第5期361-367,共7页Chinese Journal of Pain Medicine

基　　金：国家自然科学基金面上项目(81671076);兰州市人才创新创业科技计划资助(2016-RC-21)

摘　　要：目的:回顾性分析带状疱疹后神经痛(postherpetic neuralgia, PHN)病人痛觉异常的影响因素。方法:将425例病人分为E组(≥65岁)和M组(年龄<65岁),分析病人一般信息,临床症状。根据病程再分为三个亚组:1≤6月:E1、M1,6≤24月:E2、M2,≥24月:E3、M3,比较各亚组疼痛程度、特征,Logistics回归分析痛觉异常可能的影响因素。结果:E组疼痛程度显著高于M组,E1,E2组疼痛程度明显高于M1,M2组;E组痛觉过敏和痛觉超敏发生率高于M组,均以M3和E3亚组区别显著。Logistics分析结果示:痛觉过敏发生率与病人年龄呈正相关;带状疱疹急性期抗惊厥药治疗可减少痛觉异常发生;神经毁损则相反。结论:老年病人疼痛更剧烈,更易伴随痛觉过敏;急性期抗惊厥药可有效降低痛觉异常发生,但神经毁损相反。Objective: To retrospectively analyze the influence factors of abnormal pain perception in patients with postherpetic neuralgia(PHN). Methods: A total of 425 patients were divided into two groups, 266 cases(≥ 65-year-old) in the E group and 159 cases(< 65-year-old) in the M group by the age ranges. All patients clinical information and pain-related conditions were analyzed. The two groups of patients were devided into three subgroups according to the time-course: 1 ≤ 6 months:E1, M1;6 ≤ 24 months: E2, M2;≥ 24 months: E3, M3. The pain intensity and charaters were comared among subgroups, and the incidence of hypsesthesia and allodynia in each subgroup were compared with Logistics analysis of regression. Results: Pain intensity in E group was higher than that in M group, and the same as E1, E2 subgroups and M1, M2 subgroups. The incidence of hyperalgesia and allodynia in E group was higher than that in M group, especially in E3 group than M3 group. Logistics analysis shows:there was a signi?cant positive correlation between the age and the incidence of hyperalgesia, antiepileptics can reduce the occurrence of hyperalgesia in acute phase of shingles, and the result was opposite when treated by neuroablation. Conclusions: Aging patients with PHN suffer from exaggerated pain, and the incidence of hyperalgesia increases with age. Antiepileptic drugs used as early as possible in the acute phase of shingles can effectively reduce the incidence of pain sensitivity. However, neuroablative had the opposite effects.

关 键 词：带状疱疹后神经痛 痛觉过敏 痛觉超敏 抗惊厥药 神经毁损 

分 类 号：R752.12[医药卫生—皮肤病学与性病学]