PDF(Pubmed)
Abstract：
UNASSIGNED: Herpes zoster (HZ) typically manifests in the acute phase with distinct blisters and severe neuropathic pain. Remarkably, a subset of patients initially presents with only a mild skin rash and moderate pain that gradually intensifies, following a parabolic pattern. Despite being frequently observed in clinical settings, the underlying causes of this trajectory and its potential connection with post-herpetic neuralgia (PHN) remain unclear.
UNASSIGNED: To investigate this phenomenon in-depth, we conducted a meticulous retrospective study involving 529 eligible HZ patients. All these patients sought medical care at the Third Central Hospital of Tianjin, China, between January 2020 and December 2023.
UNASSIGNED: The research identified that 14.6% of the sample (77 patients) experienced pain scores aligning with a parabolic curve. This trend was significantly more prevalent in patients aged 60 and above, accounting for 90.9% of this group, and demonstrated a positive correlation with age. Moreover, 87.0% of these patients had pre-existing medical conditions, highlighting the potential role of comorbidities in influencing the pain trajectory. A concerning 45.5% of patients sought medical attention more than seven days after the onset of symptoms, a delay that could exacerbate neurological damage. Notably, among those following a parabolic pain pattern, 66.2% eventually developed PHN, a considerably higher rate compared to the broader patient population.
UNASSIGNED: We emphasize that healthcare practitioners meticulously assess patients who initially report lower pain scores for high-risk factors potentially leading to parabolic pain increases, including being over 60 years old, having comorbid conditions, and delaying medical consultation beyond seven days from symptom onset. Early implementation of supplementary pain management therapies may mitigate the risk of PHN development and enhance the quality of life for patients. This study furnishes clinicians with a deeper understanding of the variations in HZ-related pain trajectories, promising to improve treatment approaches and prognoses for HZ patients while paving the way for enriched clinical practice in the future.
UNASSIGNED: To investigate this phenomenon in-depth, we conducted a meticulous retrospective study involving 529 eligible HZ patients. All these patients sought medical care at the Third Central Hospital of Tianjin, China, between January 2020 and December 2023.
UNASSIGNED: The research identified that 14.6% of the sample (77 patients) experienced pain scores aligning with a parabolic curve. This trend was significantly more prevalent in patients aged 60 and above, accounting for 90.9% of this group, and demonstrated a positive correlation with age. Moreover, 87.0% of these patients had pre-existing medical conditions, highlighting the potential role of comorbidities in influencing the pain trajectory. A concerning 45.5% of patients sought medical attention more than seven days after the onset of symptoms, a delay that could exacerbate neurological damage. Notably, among those following a parabolic pain pattern, 66.2% eventually developed PHN, a considerably higher rate compared to the broader patient population.
UNASSIGNED: We emphasize that healthcare practitioners meticulously assess patients who initially report lower pain scores for high-risk factors potentially leading to parabolic pain increases, including being over 60 years old, having comorbid conditions, and delaying medical consultation beyond seven days from symptom onset. Early implementation of supplementary pain management therapies may mitigate the risk of PHN development and enhance the quality of life for patients. This study furnishes clinicians with a deeper understanding of the variations in HZ-related pain trajectories, promising to improve treatment approaches and prognoses for HZ patients while paving the way for enriched clinical practice in the future.
摘要：
■带状疱疹（HZ）通常在急性期表现为明显的水疱和严重的神经性疼痛。值得注意的是,一部分患者最初仅表现为轻度皮疹和逐渐加剧的中度疼痛，遵循抛物线模式。尽管在临床环境中经常观察到，这一轨迹的根本原因及其与带状疱疹后神经痛(PHN)的潜在联系尚不清楚.
■为了深入研究这种现象，我们进行了一项细致的回顾性研究,纳入529例符合条件的HZ患者.这些病人都到天津市第三中心医院求医,中国,2020年1月至2023年12月。
■研究发现，样本中有14.6％（77名患者）的疼痛评分与抛物线一致。这种趋势在60岁及以上的患者中更为普遍，占该组的90.9%，与年龄呈正相关。此外，这些患者中87.0%有既往疾病,强调合并症在影响疼痛轨迹方面的潜在作用。约45.5%的患者在症状出现后七天以上求医,可能会加剧神经损伤的延迟。值得注意的是,在那些遵循抛物线疼痛模式的人中，66.2%的人最终开发了PHN，与更广泛的患者人群相比，发病率要高得多。
我们强调，医疗从业者会仔细评估最初报告疼痛评分较低的患者，以评估可能导致抛物线性疼痛增加的高风险因素。包括60多岁，有合并症的情况，并将医疗咨询推迟到症状发作后七天以上。早期实施辅助疼痛管理疗法可以减轻PHN发展的风险并提高患者的生活质量。这项研究使临床医生对HZ相关疼痛轨迹的变化有了更深入的了解。有望改善HZ患者的治疗方法和预后，同时为将来丰富的临床实践铺平道路。
■为了深入研究这种现象，我们进行了一项细致的回顾性研究,纳入529例符合条件的HZ患者.这些病人都到天津市第三中心医院求医,中国,2020年1月至2023年12月。
■研究发现，样本中有14.6％（77名患者）的疼痛评分与抛物线一致。这种趋势在60岁及以上的患者中更为普遍，占该组的90.9%，与年龄呈正相关。此外，这些患者中87.0%有既往疾病,强调合并症在影响疼痛轨迹方面的潜在作用。约45.5%的患者在症状出现后七天以上求医,可能会加剧神经损伤的延迟。值得注意的是,在那些遵循抛物线疼痛模式的人中，66.2%的人最终开发了PHN，与更广泛的患者人群相比，发病率要高得多。
我们强调，医疗从业者会仔细评估最初报告疼痛评分较低的患者，以评估可能导致抛物线性疼痛增加的高风险因素。包括60多岁，有合并症的情况，并将医疗咨询推迟到症状发作后七天以上。早期实施辅助疼痛管理疗法可以减轻PHN发展的风险并提高患者的生活质量。这项研究使临床医生对HZ相关疼痛轨迹的变化有了更深入的了解。有望改善HZ患者的治疗方法和预后，同时为将来丰富的临床实践铺平道路。
