帶狀疱疹及疱疹後神經痛之治療

Therapy of Herpes Zoster and Postherpetic Neuralgia

盧盈辰(Ying-Chen Lu) ； 林佩姿(Pei-Tzu Lin) ； 戴慶玲(Ching-Ling Tai)

《臺灣臨床藥學雜誌》 22卷1期 (2014/03) Pp. 43-50

https://doi.org/10.6168/FJCP.2014.2201.06

摘要

帶狀疱疹好發在60歲以上的老年人或免疫功能低下患者，並且隨著年紀越大，疾病的發生率及持續時間都相對較長，治療藥物主要以核苷（nucleoside）類的抗病毒藥物為主，在病灶出現的72小時內給予抗病毒藥物，臨床反應較佳，能夠減輕發疹期間的嚴重度、持續時間以及疼痛，且安全性高僅有少許的副作用。帶狀疱疹的併發症以疱疹後神經痛（postherpetic neuralgia, PHN）最為常見，疼痛可能持續數月甚至數年以上，三環類抗憂鬱劑（tricyclic antidepressant, TCA）、gabapentin、pregabalin以及lidocaine貼片皆為PHN治療的第一線藥物。在預防方面建議50歲以上成年人，可施打活性減毒的帶狀疱疹疫苗，降低帶狀疱疹及PHN發生。

關鍵字

帶狀疱疹 ； 疱疹後神經痛 ； 抗病毒治療 ； 帶狀疱疹疫苗

並列摘要

Herpes zoster occurs more common in the elderly over 60 years of age or immune-compromised patients. In addition, the incidence and duration of the disease are relatively long with increasing age. Three nucleoside antiviral drugs have been approved for the treatment of herpes zoster. Antivirals should be initiated within 72 hours of onset, to reduce the severity and duration of the eruptive phase and to reduce acute pain. All three drugs are safe and well tolerated, only a few side effects such as headache, nausea. The patients who develop complications including postherpetic neuralgia (PHN) may have neuropathic pain that persists for many months or even years. TCA, gabapentin, pregabalin and topical lidocaine patches are first-line therapies for PHN. A live attenuated herpes zoster vaccine is recommended for persons 50 years of age or older to prevent herpes zoster and PHN.

並列關鍵字

Herpes Zoster ； Postherpetic Neuralgia ； Antiviral Therapy ； Herpes Zoster Vaccine