대상포진후 신경통의 저출력 레이저치료

Lower Level Laser Therapy on Postherpetic Neuralgia

1991년 3월 부터 1992년 2월까지 부산대학교병원 통증치료실에 내원한 27명의 대상포진후 신경통 환자를 대상으로 하여 저출력 레이저의 치료효과를 관찰한 바를 아래와 같이 요약한다. 1) 주된 병소부위는 흉추신경분포부위이었다. 2) 70세 미만의 환자에서는 VAS의 개선율이 57%로 효과가 있었으나, 70세 이상의 환자에서는 VAS 개선율이 27%로 현저히 감소하였다. 3) 발병후 치료시간 까지의 기간이 1개월 이내인 환자는 저출력 레이저에 의한 치료효과가 좋았으나, 12개월이상 경과한 환자는 치료효과가 좋지 않았다. 4) 발병후 1개월이내에 치료를 실시한 환자의 VAS개선율이 50%가 되기까지의 평균 조사횟수는 5.7회이었다.

Herpes zoster is an acute infectious viral disease which affects the posterior spinal root ganglion of the spinal nerve. A single posterior spinal root ganglion or a small number of adjacent ones may be affected, usually on the same side. The corresponding ganglia of the cranial nerve may also be similarly affected. The causative virus, varicella zoster, belongs to the group of host-specific DNA viruses. Postherpetic neuralgia is a continuation of herpes zoster in older patients. Although spontaneous resolution of herpes zoster may be expected in most patients, a significant number experience intractable pain. Postherpetic neuralgia is one of the most difficult problems encountered by physicians. There are many methods for management of postherpetic neuralgia, but there is no method that results in complete remission. Laser has lately come into use to reduce several acute or chronic pains. In order to determine the degree of pain relief by laser, 27 patients of postherpetic neuralgia were irradiated with He Ne, Infrared, and $CO_2$ combine scan moded lasers two to three times per week. The results were as follows: 1) The most frequent site was thoracic vertebral nerve area. 2) Patients younger than 70 years of age showed an improvement rate of 57% vs 27% for those patients older than 70 years of age. 3) Laser therapy proved effective of those patients who received the laser treatment within one month of the onset of the disease. 4) For those patients who received treatment within one month of the disease and reflecting a 50% improvement rate, the average irradiation time was 5.7.