Analysis Of Herpes Zoster Cases And Research On Risk Factors Of Herpes Zoster Sequelae Neuralgia

Objective:To reduce the incidence of postherpetic neuralgia,the clinical characteristics of herpes zoster and the possible risk factors of postherpetic neuralgia were investigated and analyzed by statistical data of patients with herpes zoster,professional scales and TCM syndromes.Method:Collect the patients with herpes zoster from October 2017 to September 2018 in the Department of Dermatology and Venereal Diseases,Oriental Hospital of Beijing University of Traditional Chinese Medicine.Fill in the case sheet of herpes zoster,and statistics the general personal data(gender,age,nationality,BMI value,history of smoking and alcohol,exercise,temperament,eating habits and history of combined basic diseases),pre-morbidity(whether the first onset,medical meteorology).The incidence of the disease(incentives,first symptoms,initial diagnosis time,first confirmed diagnosis,pain nature,involved spinal cord segments,rash classification,pre-hospital treatment history,pain score,skin lesion area,rash specialty,TCM syndrome score,ERSG score,HAMD score,the treatment,herpes evaluation index and complications,etc.).The patients with pain and other symptoms 3 months after the rash disappeared were divided into postherpetic neuralgia group and herpes zoster group.Statistical data of all cases,analysis of the clinical characteristics of herpes zoster,and two groups of data for single factor analysis,for the statistical significance of the factors again Logistic regression analysis.Result:1.Most cases come from inpatients;female cases are 1.6 times as many as male cases;more than 60%of patients are older than 60 years old;52%of patients have normal BMI,47.40%are overweight and obese;21.56%have smoking history,20.18%have drinking history;86.70%have combined basic diseases,involving 188 related diseases,the highest frequency of hypertension.Secondly,hyperlipidemia,diabetes mellitus,fatty liver and so on;the majority of patients are the first time to get sick;the incidence of the disease is relatively average throughout the year,and there is no significant difference in the incidence of each season;63.3%of patients have a clear cause of disease,fatigue is the main cause of disease,followed by emotional factors;57.14%of patients suffer from pain and then skin lesions,29.49%of patients suffer from skin lesions and pain.Pain occurred at the same time;the first diagnosis rate was 81.65%;the first diagnosis time was 4.15+2.975 days;The main types of pain were needle-like pain,burning-like pain and knife-cut-like pain.The most common types of pain were moderate to severe pain,and the mean(+standard deviation)of VAS score was 6.07(+1.858).The most common type of rash was the thoracic segment,followed by the cervical,lumbar and sacral segments,with no significant difference between left and right sides.The most common tongue coating is thin yellow coating,followed by yellow greasy coating,thick yellow coating,white greasy coating,thin white coating,etc.The most common pulse pattern is slippery pulse,the others are string pulse,fine astringent pulse,thin white coating,etc.Chord slippery pulse,moistening pulse,sink slippery pulse,chord fine pulse,etc.The mean(+standard deviation)of the emotional scale of TCM liver image was 33.34(+5.917),of which 136 cases were in the emotional abnormality group.The mean(+standard deviation)of the Hamilton Depression Scale was 7.14(+4.274).The largest proportion of depressive symptoms is not,followed by possible depressive symptoms.The vast majority of patients are treated with integrated traditional Chinese and Western medicine.38.07%of the patients had complications,and the most common complications were skin infection.2.After univariate analysis,whether the patients had a history of cancer,whether they were treated before hospital,whether they were treated with traditional Chinese medicine,whether they used antiviral,analgesic,nutritional nerve drugs,lesion area,scores of TCM syndromes,ERSG scores and grades(liver meridian factor,depression factor score),HAMD scores and grades,pain scores,the treatment(whether they were antiviral,analgesic and use).Hormone drugs,blister stopping time,scab formation time,scab removal time and remission time were all P<0.05,with statistical significance.There were differences between the two groups.Logistic regression analysis showed that the lesion area,liver meridian factors and HAMD grade P<0.05.There were significant differences between the two groups.Logistic regression analysis of the three factors showed that there were significant differences in lesion area and HAMD grade.Conclusion:The occurrence of postherpetic neuralgia is related to the lesion area and HAMD grade.The regression coefficient of lesion area was 0.397>0,P=0.023<0.05,Exp(B)=OR=1.487>1.There was significant difference between the two groups.That is to say,under the premise of controlling other factors,the probability of patients suffering from postherpetic neuralgia increases by 1.487 times for every 1%increase in the area of skin lesions.The regression coefficients of HAMD grade were 1.721>0,P=0.000<0.05,Exp(B)=OR=5.591>1.There was significant difference between the two groups.That is to say,under the premise of controlling other factors,the probability of patients suffering from postherpetic neuralgia increases by 5.591 times for each increase of HAMD grade.