| Objective:Collecting and summarising shingles cases in hospitals,combining professional scales and Chinese medical evidence,studying the characteristics of shingles incidence,analysing possible risk factors of post-herpetic neuralgia,summarising treatment status and treatment methods,providing recommendations to further optimise the shingles treatment plan and early intervention to achieve the goal of reducing the prevalence of post-herpetic neuralgia.Methods:Patients with shingles who were diagnosed between November 2021 and 2022 were collected.A hemiplegia case sheet was completed with statistics on general personal information(gender,age and history of comorbidities),current disease onset(medical/meteorological data,first symptoms,lesion location,pain pattern,spinal segment involvement,rash pattern,lesion area,pain score).The rash was also treated with Chinese and Western medicine.Cases with symptoms such as pain after rash resolved within one month were classified as postherpetic neuralgia and vice versa for acute phase of hemiplegia.Data from all cases were pooled,clinical features of herpes zoster were analysed,and data from both groups were analysed univariately and bivariately and again subjected to statistical regression analysis for statistically significant factors.Results:1.Implementation: 149 hospital admissions were collected,89 women and 60 men.The number of female cases was 1.48 times the number of male cases.There were 149 cases of acute shingles and 49 cases of post-herpetic neuralgia.2.Age of onset: maximum age 87 years,minimum age 20 years,36 cases 45-60 years,68 cases 60-75 years and 32 cases over 70 years.67.11% of cases were over 60 years of age.3.Combined underlying conditions: 148 cases with underlying conditions,accounting for 99.33%,of which 86 cases with a single underlying condition,accounting for 57.72%;62 cases with multiple underlying conditions,accounting for 41.89%.The most common disease was hypertension,followed by diabetes,coronary heart disease,etc.4.Medical meteorology(season of illness): in the four seasons,the prevalence was relatively average,with no significant differences between the sunny seasons;only 10.3% of patients had a clear predisposing factor,and the main predisposing factor was fatigue followed by cold weather.5.Pain progression and localization: the most common type of pain was puncture pain,followed by burning pain and pain with disability;the most affected nerve segment was the thoracic segment,followed by the cervical,lumbar and sacral segments,with the left segment being more affected than the right segment;the minimum lesion area was 0.5%,the maximum lesion area was6% and the mean ± standard deviation was 2.27 ± 1.24%.6.Types of TCM syndromes: The most common is hepatobiliary fluid and heat syndrome,followed by liver-spleen disharmony syndrome,liver-spleen imbalance syndrome,liver deficiency syndrome,etc.;the most common type of tongue is red,followed by light red,dark red,light dark,etc.c;The most common tongue type is thin white layer followed by yellow fatty layer,white fatty layer,thin yellow layer,etc.;The most common pulse type is venous smooth pulse,while the others are venous pulse,venous pulse,deep pulse,etc.The majority of patients were treated with the integrated method of traditional Chinese and Western medicine.7.On univariate analysis,patients’ skin lesion area,pain score,TCM syndrome type,TCM blank period,TCM duration,antiviral drugs,TCM decoction and other factors were statistically significant(P<0.05)and there were differences between the two groups.Logistic regression analysis of the above factors showed that there were statistical differences between the two groups in skin lesion area,pain score,TCM void period and TCM duration(P<0.05).Logistic regression analysis was performed again for these four factors,and skin lesion area,pain score,TCM void period and TCM duration were still statistically significant.Conclusion:1.The occurrence of postherpetic neuralgia is related to the area of the skin lesion,the pain score,the blank period of traditional Chinese medicine and the duration of traditional Chinese medicine use.2.The extent of skin lesion,pain score and the void period of traditional Chinese medicine were risk factors for post-neuralgia(OR>1,P<0.05),whereas the duration of traditional Chinese medicine was a protective factor(OR<1,P<0.05).That is,conditional on controlling other factors,the larger the area of skin lesion,the higher the pain score and the longer the blank period of Chinese medicine intervention,the greater the risk of post-neuralgia;the longer the duration of receiving traditional Chinese medicine,the lower the risk of post-neuralgia.3.The inclusion of traditional Chinese medicine in the treatment of blisters and post-neuralgia has a positive effect.In clinical treatment,TCM interventions should be performed as early as possible and TCM treatment should be continued for a longer period of time. |
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