早期以Acyclovir或Famciclovir治療對三叉神經部位疱疹後神經痛之療效比較

Effect of Early Treatment of Acyclovir and Famciclovir on Post-herpetic Trigeminal Neuralgia

賴名耀(Ming-Yao Lai) ； 宗天一(Tien-Yi Tzung)

《中華皮膚科醫學雜誌》 21卷3期 (2003/09) Pp. 237-245

摘要

背景：疱疹後神經痛(PHN)是帶狀疱疹常見的併發症之一，Acylovir和famciclovir兩者
被用來治療帶狀疱疹的病人已經有多年的時間，然而，兩者對於疱疹後神經痛的效果在過去
並未被直接比較過。
目的：比較acyclovir與famciclovir對於疱疹後神經痛的效果以及分析疱疹後神經痛的相
關危險因子。
方法：36位三叉神經部位帶狀疱疹的病人被隨機分配使用acyclovir和famciclovir治療，
神經痛以VAS量表評估和紀錄病人神經痛的悄形，並追蹤三個月。
結果：Acyclovir和famciclovir在疱疹性痛和疱疹後神經痛的減少上均有相同顯著的效
果(於一個月和三個月追蹤時)。在第二個月追蹤時，以 famciclovir治療的病人，其PHN的嚴
重度比起使用acyclovir治療的病人有顯著的減少。Famciclovir的治療比起acyclovir的治療，
還能縮短疱疹後神經痛的時間。此外，我們發現深部刺痛、麻與急性期疼痛較為劇烈者
(VAS分數大於5分)，其併發疱疹後神經痛的機會也較高。
結論：抗病毒的藥，不論是acclovir或是famciclovir，都能用來減少疱疹急性痛和疱疹
後神經痛。和acyclovir相比，Famciclovir還能縮短疱疹庝痛的時間。(中華皮誌21:237-245,
2003)

並列摘要

Background: The postherpetic neuralgia (PHN) is a common complication of herpes zoster.
Acyclovir and famciclovir have been used to treat patients with herpes zoster for years. However, direct
comparison of effectiveness on PHN between these two drugs hasn’t been done in the past.
Objective: To compare the effectiveness of acyclovir and famciclovir on PHN and to elucidate the
risk factors for PHN.
Methods: 36 patients of herpes Zoster with trigeminal nerve involvement were randomly allocated
to acyclovir or famciclovir treatment. Neuralgia was recorded using the visual analogue scale (VAS)
before treatment and up to 3-month follow-up.

Results: Acyclovir and famciclovir are equally effective in reducing neuralgia of acute and pos-
therpetic phase (1-month and 3-month follow-up). However, at 2-month follow-up, the severity of
PHN in patients treated with famciclovir was significantly less than those treated with acyclovir. The
duration of PHN, which was treated with famciclovir, was shorter than those treated with acyclovir.
Besides, patients with deep stinging pain, numbness or severe acute pain ( VAS score ＞ 5 ) were more
likely to have PHN.

Conclusions: Antiviral treatment, either with acyclovir or famciclovir, can be used to reduce acute
pain of herpes zoster and postherpetic neuralgia. Compared with acyclovir, famciclovir can also shorten
the duration of PHN. (Dermatol Sinica 21:234-245, 2003)

並列關鍵字

Postherpetic neuralgia, Acyclovir, Famciclovir