Meta-analysis Of Risk Factors For Postherpetic Neuralgia

Objective:To overview related risk factors of postherpetic neuralgia(PHN),and to provide evidence and guidance for early prevention of PHN.Methods:Observational study about related risk factors of PHN was searched by computer and manual in databases(CNKI?VIP?CBM?wanfang and PubMed?Medline?EMBASE?Cochrane Library)from 1988 to 2018,According to strict inclusion and exclusion criteria,the studies were screened?carried out quality assessed?data were extracted by two independent researchers,finally,RevMan 5.3 software was used for statistical analysis of the final data.Results:A total of 24 studies were included,the sample size ranged from 60 to 119,413 cases.The results of Meta-analysis showed that risk factors of PHN:OR values and 95% CI of Age?60(2.04,1.92~2.15),Female(1.16,1.02~1.32),Prodromal pain(1.82,1.14~2.90),Severe acute pain(5.88,2.92~11.81),Large area lesion(7.62,2.19~26.48),Initial treatment time ?72h(2.69,1.91~3.79),Depression or stress(4.74,1.12~20.05),Basic diseases:Cardiovascular disease(1.80,1.67~1.93)?Severe kidney disease(2.01,1.84~2.19)?Hypertensive(1.78,1.18~2.68)?Diabetes(1.76,1.44~2.14)?Respiratory illness(1.96,1.25~3.07)?Digestive diseases(3.29,1.11~9.81),The rash is located in the head and face(2.21,2.04~2.41),Trigeminal nerve affected(1.73,1.19~2.52),Blood blister bulla type(5.62,2.47~12.75),Treatment course<14d(4.93,2.15~11.30);has nothing to do with the onset of PHN :Heat,Combined corticosteroids,With hyperlipidemia?Long-term use of immunosuppressant?Cancer,The rash is located in the chest and back?waist and abdomen?limbs?multiple sites,The affected nerve:intercostal nerve?cervical brachial plexus nerve?lumbosacral plexus nerve,Skin lesion:forme fruste ?Disseminated or generalized,Educational grade,Abnormal feeling,Smoking.Conclusion:The risk factors for PHN are Severe acute pain?Large area of rash?Advanced age? Female?Prodromal pain?Initial treatment time over 72 hours?Anxiety or depression?Underlying diseases?The rash is located in the head and face?The affected nerve:Trigeminal nerve?Skin lesion:Blood blister bulla type,has nothing to do with Heat?Combined corticosteroids,early identification and intervention for patients with above risk factors of PHN,actively prevent the occurrence of PHN,reduce the waste of medical resources and improve the long-term quality of life of patients.