[开放获取]    带状疱疹中国专家共识

doi:10.3760/cma.j.issn.0412-4030.2018.06.001

中华皮肤科杂志 ›› 2018, Vol. 51 ›› Issue (6): 403-408.doi: 10.3760/cma.j.issn.0412-4030.2018.06.001

• 指南与共识 • 下一篇

[开放获取] 带状疱疹中国专家共识

中国医师协会皮肤科医师分会带状疱疹¹,李若瑜²

1.
2. 北京大学第一医院皮肤科

收稿日期:2018-03-12 修回日期:2018-04-28 发布日期:2018-05-30
通讯作者: 李若瑜 E-mail:mycolab@126.com

Consensus of Chinese experts on herpes zoster

Received:2018-03-12 Revised:2018-04-28 Published:2018-05-30

摘要/Abstract

摘要： 带状疱疹是由长期潜伏在脊髓后根神经节或颅神经节内的水痘-带状疱疹病毒（varicella?zoster virus，VZV）经再激活引起的感染性皮肤病。带状疱疹是皮肤科常见病，除皮肤损害外，常伴有神经病理性疼痛，常出现在年龄较大、免疫抑制或免疫缺陷的人群中，严重影响患者生活质量。目前国内带状疱疹的临床诊疗仍存在不少问题，譬如其在各年龄段人群中的流行病学资料如何？患病的高危因素有哪些？如何诊断？如何与其他疾病鉴别？如何早期规范化治疗以改善患者预后？如何处理常见的并发症——带状疱疹后神经痛（post herpetic neuralgia，PHN）？为了切实解决带状疱疹临床诊治问题，中国医师协会皮肤科医师分会组织该领域专家，以近年国内外发表的重要文献为基础，对文献进行评价并综合分析，提交专家组反复讨论、修改，最终达成本共识，希望能指导带状疱疹的临床规范化诊治，为患者提供经济、高效的诊治方案……

中国医师协会皮肤科医师分会带状疱疹李若瑜. [开放获取] 带状疱疹中国专家共识[J]. 中华皮肤科杂志, 2018,51(6):403-408. doi:10.3760/cma.j.issn.0412-4030.2018.06.001

参考文献 48

［1］	Bao L, Wei G, Gan H, et al. Immunogenicity of varicella zoster virus glycoprotein E DNA vaccine［J］. Exp Ther Med, 2016,11（5）:1788⁃1794. doi: 10.3892/etm.2016.3086.<br />
［2］	Gershon AA, Gershon MD, Breuer J, et al. Advances in the understanding of the pathogenesis and epidemiology of herpes zoster［J］. J Clin Virol, 2010,48（Suppl 1）:S2⁃7. doi: 10.1016/S1386⁃6532（10）70002⁃0.<br />
［3］	Sauerbrei A. Diagnosis, antiviral therapy, and prophylaxis of varicella⁃zoster virus infections［J］. Eur J Clin Microbiol Infect Dis, 2016,35（5）:723⁃734. doi: 10.1007/s10096⁃016⁃2605⁃0.<br />
［4］	Yawn BP, Gilden D. The global epidemiology of herpes zoster［J］. Neurology, 2013,81（10）:928⁃930. doi: 10.1212/WNL.0b013e3182a 3516e.<br />
［5］	Kawai K, Gebremeskel BG, Acosta CJ. Systematic review of incidence and complications of herpes zoster: towards a global perspective［J］. BMJ Open, 2014,4（6）:e004833. doi: 10.1136/bmjopen⁃2014⁃004833.<br />
［6］	Chen LK, Arai H, Chen LY, et al. Looking back to move forward: a twenty⁃year audit of herpes zoster in Asia⁃Pacific［J］. BMC Infect Dis, 2017,17（1）:213. doi: 10.1186/s12879⁃017⁃2198⁃y.<br />
［7］	Kawai K, Yawn BP, Wollan P, et al. Increasing incidence of herpes zoster over a 60⁃year period from a population⁃based study［J］. Clin Infect Dis, 2016,63（2）:221⁃226. doi: 10.1093/cid/ciw296.<br />
［8］	Bricout H, Haugh M, Olatunde O, et al. Herpes zoster⁃associated mortality in Europe: a systematic review［J］. BMC Public Health, 2015,15:466. doi: 10.1186/s12889⁃015⁃1753⁃y.<br />
［9］	Yenikomshian MA, Guignard AP, Haguinet F, et al. The epidemi⁃ology of herpes zoster and its complications in Medicare cancer patients［J］. BMC Infect Dis, 2015,15:106. doi: 10.1186/s12879⁃015⁃0810⁃6.<br />
［10］	Grabar S, Tattevin P, Selinger⁃Leneman H, et al. Incidence of herpes zoster in HIV⁃infected adults in the combined antiretro⁃viral therapy era: results from the FHDH⁃ANRS CO4 cohort［J］. Clin Infect Dis, 2015,60（8）:1269⁃1277. doi: 10.1093/cid/ciu1161.<br />
［11］	Zhu Q, Zheng H, Qu H, et al. Epidemiology of herpes zoster among adults aged 50 and above in Guangdong, China［J］. Hum Vaccin Immunother, 2015,11（8）:2113⁃2118. doi: 10.1080/21645515.2015.1016672.<br />
［12］	Lin YH, Huang LM, Chang IS, et al. Disease burden and epidemiology of herpes zoster in pre⁃vaccine Taiwan［J］. Vaccine, 2010,28（5）:1217⁃1220. doi: 10.1016/j.vaccine.2009.11.029.<br />
［13］	朱学骏, 王宝玺, 孙建方, 等. 皮肤病学［M］. 2版. 北京: 北京大学医学出版社, 2011:1483⁃1494.<br />
［14］	张建中. 中外皮肤病诊疗指南［M］. 北京: 中华医学电子音像出版社, 2014:86⁃94.<br />
［15］	Jeon YH. Herpes zoster and postherpetic neuralgia: practical consideration for prevention and treatment［J］. Korean J Pain, 2015,28（3）:177⁃184. doi: 10.3344/kjp.2015.28.3.177.<br />
［16］	Chen N, Li Q, Yang J, et al. Antiviral treatment for preventing postherpetic neuralgia［J］. Cochrane Database Syst Rev, 2014,（2）:CD006866. doi: 10.1002/14651858.CD006866.pub3.<br />
［17］	Lamoureux C, Flatrès C, Vallet S, et al. Aseptic meningitis caused by the Varicella⁃zoster virus after primary infection in an immunocompetent child: a case report［J］. Ann Biol Clin （Paris）, 2018,76（2）:234⁃236. doi: 10.1684/abc.2018.1331.<br />
［18］	Werner RN, Nikkels AF, Marinovic B, et al. European consensus⁃based （S2k） Guideline on the Management of Herpes Zoster ⁃ guided by the European Dermatology Forum （EDF） in coope⁃ration with the European Academy of Dermatology and Venereology （EADV）, Part 2: Treatment［J］. J Eur Acad Dermatol Venereol, 2017,31（1）:20⁃29. doi: 10.1111/jdv.13957.<br />
［19］	Yoon H, Rhew KY. Famciclovir as an antiviral agent for a patient with acute renal failure［J］. Int J Clin Pharm, 2013,35（2）:173⁃175. doi: 10.1007/s11096⁃012⁃9737⁃9.<br />
［20］	Tunkel AR, Glaser CA, Bloch KC, et al. The management of encephalitis: clinical practice guidelines by the Infectious Diseases Society of America［J］. Clin Infect Dis, 2008,47（3）:303⁃327. doi: 10.1086/589747.<br />
［21］	Duda JF, Castro JG. Bilateral retrobulbar optic neuritis caused by Varicella zoster virus in a patient with AIDS［J］. Br J Med Med Res, 2015,5（11）:1381⁃1386. doi: 10.9734/BJMMR/2015/14259.<br />
［22］	Whitley RJ, Cloud G, Gruber W, et al. Ganciclovir treatment of symptomatic congenital cytomegalovirus infection: results of a phase II study. National Institute of Allergy and Infectious Diseases Collaborative Antiviral Study Group［J］. J Infect Dis, 1997,175（5）:1080⁃1086.<br />
［23］	Han Y, Zhang J, Chen N, et al. Corticosteroids for preventing postherpetic neuralgia［J］. Cochrane Database Syst Rev, 2013,（3）:CD005582. doi: 10.1002/14651858.CD005582.pub4.<br />
［24］	Watanabe D, Mizukami A, Holl K, et al. The potential public health impact of herpes zoster vaccination of people aged ≥ 50 years in Japan: results of a Markov model analysis［J］. Dermatol Ther （Heidelb）, 2018. doi: 10.1007/s13555⁃018⁃0236⁃3.<br />
［25］	Gan EY, Tian EA, Tey HL. Management of herpes zoster and post⁃herpetic neuralgia［J］. Am J Clin Dermatol, 2013,14（2）:77⁃85. doi: 10.1007/s40257⁃013⁃0011⁃2.<br />
［26］	Lapolla W, Digiorgio C, Haitz K, et al. Incidence of postherpetic neuralgia after combination treatment with gabapentin and vala⁃cyclovir in patients with acute herpes zoster: open⁃label study［J］. Arch Dermatol, 2011,147（8）:901⁃907. doi: 10.1001/archdermatol. 2011.81.<br />
［27］	Migita T. Can early administration of pregabalin reduce the incidence of postherpetic neuralgia?［J］. Clin Exp Dermatol, 2014,39（6）:755⁃756. doi: 10.1111/ced.12386.<br />
［28］	Liang L, Li X, Zhang G, et al. Pregabalin in the treatment of herpetic neuralgia: results of a multicenter Chinese study［J］. Pain Med, 2015,16（1）:160⁃167. doi: 10.1111/pme.12564.<br />
［29］	Sáez⁃Llorens X, Yogev R, Arguedas A, et al. Pharmacokinetics and safety of famciclovir in children with herpes simplex or varicella⁃zoster virus infection［J］. Antimicrob Agents Chemother, 2009,53（5）:1912⁃1920. doi: 10.1128/AAC.01054⁃08.<br />
［30］	Kimberlin DW, Jacobs RF, Weller S, et al. Pharmacokinetics and safety of extemporaneously compounded valacyclovir oral suspension in pediatric patients from 1 month through 11 years of age［J］. Clin Infect Dis, 2010,50（2）:221⁃228. doi: 10.1086/649212.<br />
［31］	Rao S, Abzug MJ, Carosone⁃Link P, et al. Intravenous acyclovir and renal dysfunction in children: a matched case control study［J］. J Pediatr, 2015,166（6）:1462⁃1468.e1⁃4. doi: 10.1016/j.jpeds.2015.01.023.<br />
［32］	De Paschale M, Clerici P. Microbiology laboratory and the management of mother⁃child varicella⁃zoster virus infection［J］. World J Virol, 2016,5（3）:97⁃124. doi: 10.5501/wjv.v5.i3.97.<br />
［33］	刘巧. 中西医结合皮肤病治疗学［M］. 北京：人民军医出版社,2014,125.<br />
［34］	李成宾, 李芸. 加味龙胆泻肝汤治疗带状疱疹60例［J］.光明中医, 2010,25（5）:800⁃801. doi: 10.3969/j.issn.1003⁃8914.2010.05. 032.<br />
［35］	林燕, 郭晓宇, 栾杨. 带状疱疹的中成药及民间偏方疗法［J］.中国临床医生, 2011,39（8）:20⁃22. doi: 10.3969/j.issn.1008⁃1089.2011.08.009.<br />
［36］	杨志波, 范瑞强, 邓丙戌. 中医皮肤性病学［M］. 北京: 中国中医药出版社, 2010:33.<br />
［37］	王伟芳. 除湿胃苓汤加减治疗脾虚湿蕴型蛇串疮的临床观察［D］. 武汉: 湖北中医药大学, 2012.<br />
［38］	中华中医药学会皮肤科分会. 蛇串疮中医诊疗指南（2014年修订版）［J］.中医杂志, 2015,56（13）:1163⁃1168. doi: 10.13288/j.11⁃2166/r.2015.13.022.<br />
［39］	Liu H, Lu F, Zhou D, et al. The analgesic and emotional response to intravenous lidocaine infusion in the treatment of postherpetic neuralgia: a randomized, double⁃blinded, placebo⁃controlled study［J］. Clin J Pain, 2018. doi: 10.1097/AJP. 0000000000000623.<br />
［40］	Chen YT, Wang HH, Wang TJ, et al. Early application of low⁃level laser may reduce the incidence of postherpetic neuralgia （PHN）［J］. J Am Acad Dermatol, 2016,75（3）:572⁃577. doi: 10.1016/j.jaad.2016.03.050.<br />
［41］	张学军. 皮肤性病学［M］. 8版. 北京: 人民卫生出版社, 2013:67.<br />
［42］	Préaud E, Uhart M, Böhm K, et al. Cost⁃effectiveness analysis of a vaccination program for the prevention of herpes zoster and post⁃herpetic neuralgia in adults aged 50 and over in Germany［J］. Hum Vaccin Immunother, 2015,11（4）:884⁃896. doi: 10.1080/21645515.2015.1011561.<br />
［43］	带状疱疹后神经痛诊疗共识编写专家组. 带状疱疹后神经痛诊疗中国专家共识［J］. 中国疼痛医学杂志, 2016,22（3）:161⁃167. doi: 10.3969/j.issn.1006⁃9852.2016.03.001.<br />
［44］	Stratman E. Visceral zoster as the presenting feature of disseminated herpes zoster［J］. J Am Acad Dermatol, 2002,46（5）:771⁃774.<br />
［45］	Giovanni G, Nicoletta V, Parvanè K, et al. Prevention of herpes zoster and its complications: from the clinic to the real⁃life experience with the vaccine［J］. J Med Microbiol, 2016,65（12）:1363⁃1369. doi: 10.1099/jmm.0.000386.<br />
［46］	Pellissier JM, Brisson M, Levin MJ. Evaluation of the cost⁃effectiveness in the United States of a vaccine to prevent herpes zoster and postherpetic neuralgia in older adults［J］. Vaccine, 2007,25（49）:8326⁃8337. doi: 10.1016/j.vaccine.2007.09.066.<br />
［47］	Ansaldi F, Trucchi C, Alicino C, et al. Real⁃world effectiveness and safety of a live⁃attenuated herpes zoster vaccine: a comprehensive review［J］. Adv Ther, 2016,33（7）:1094⁃1104. doi: 10.1007/s12325⁃016⁃0355⁃0.<br />
［48］	Barnabas RV, Baeten JM, Lingappa JR, et al. Acyclovir prophy⁃laxis reduces the incidence of herpes zoster among HIV⁃infected individuals: results of a randomized clinical trial［J］. J Infect Dis, 2016,213（4）:551⁃555. doi: 10.1093/infdis/jiv318.<br />

[开放获取] 带状疱疹中国专家共识

Consensus of Chinese experts on herpes zoster

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献 48

相关文章 0

Metrics

本文评价

推荐阅读 10