OBJECTIVE: To observe the clinical efficacy of chicken-claw needling with blade needle for postherpetic neuralgia (PHN). METHODS: A total of 30 patients with PHN were treated with chicken-claw needling with blade needle, the most painful area, costal angle on the same side with the affected intercostal nerve and the midpoint of the line connecting the first two points along the intercostal nerve were selected as treatment points, without needle retained, once a week, a total of 2 times were required. Before and after treatment, the scores of pain visual analogue scale (VAS) and dermatology life quality index (DLQI) were observed, and the clinical efficacy was evaluated after treatment. The recurrence rate of neuralgia was evaluated on the 60th day after treatment. RESULTS: After treatment, the scores of VAS and DLQI were decreased compared with those before treatment (P<0.05). Of 30 patients, 4 cases were cured, 20 cases showed markedly efficacy, 4 cases were improved, 2 cases were ineffective, the total effective rate was 93.3% (28/30). The recurrence rate of neuralgia was 6.7% (2/30). CONCLUSION Chicken-claw needling with blade needle could effectively relieve the pain in patients with PHN, improve the quality of life and reduce the recurrence rate of neuralgia.
Humans ; Male ; Female ; Neuralgia, Postherpetic/therapy* ; Middle Aged ; Aged ; Acupuncture Therapy/methods* ; Acupuncture Points ; Treatment Outcome ; Needles ; Adult

BACKGROUND: Postherpetic neuralgia (PHN) is the most common complication of herpes zoster infection and affects patients' quality of life. Acupuncture therapy is regarded as a competitive method of treatment for analgesia. OBJECTIVE: To summarize evidence from systematic reviews (SRs) and evaluate the effectiveness and safety of different acupuncture therapies for treating PHN. METHODS: Eight electronic databases were searched from their inception to August 5, 2022, including 4 international electronic databases (PubMed, EMBASE, the Cochrane Library, and Web of Science) and 4 Chinese databases (Chinese Biomedical Database, China National Knowledge Infrastructure, VIP Database and Wanfang Database). Methodological quality was assessed by A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2). The Risk of Bias in Systematic Review (ROBIS) tool was used to assess the risk of bias in SRs. Evidence level was assessed by the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. RESULTS: Totally, 7 SRs were included, including 128 studies and 9,792 patients. In AMSTAR 2, most of the SRs were of low or critically low levels since they had more than 1 critical deficiency. In ROBIS, 1 SR (14.29%) was rated as high risk, and the other 6 (85.71%) were rated as low risk. In the GRADE system, 9 outcomes (28.13%) were valued as high level, 5 (15.63%) as moderate level, 1 (3.13%) as low, and 17 (53.13%) as very low. In the effectiveness of acupuncture therapy, the group "moxibustion vs. original medical treatment" [mean difference (MD)=-1.44, 95% confidence interval (CI): -1.80 to -1.08, I²=99%, P<0.00001] was of the highest heterogeneity and the group "bloodletting vs. original medical treatment" (MD=-2.80, 95% CI: -3.14 to -2.46, I²=0, P<0.00001) was of the lowest heterogeneity. Six SRs have reported the safety of their studies and no serious events were shown in the treatment and control groups. CONCLUSIONS Acupuncture therapy seems to be effective in treating PHN. Despite the evidence that suggested the advantages of acupuncture therapy in relieving pain and promoting efficacy and safety, the methodological quality was quite low. Further studies should pay more attention to the quality of original studies and evidence for SRs to confirm these findings. (PROSPERO registration No. CRD42022344790).
Humans ; Neuralgia, Postherpetic/therapy* ; Acupuncture Therapy/methods* ; Systematic Reviews as Topic

OBJECTIVE: To compare the clinical efficacy between the combined therapy of fire needling and cupping, and western medication on herpes zoster of acute stage, as well as the effects on Th17 and Treg cells and inflammatory factors, i.e. IL-10 and IL-17 in the peripheral blood. METHODS: Eighty patients with herpes zoster of acute stage were randomly divided into a combined therapy (fire needling plus cupping) group and a western medication group, 40 cases in each one. In the combined therapy group, the pricking and scattering techniques with fire needle were used at ashi points and Jiaji (EX-B 2) corresponding to the affected spinal segments; afterwards, cupping therapy was delivered. The combined treatment was given once daily. In the western medication group, valaciclovir hydrochloride tablet and vitamin B₁ tablet were administered orally. The duration of treatment in each group was 10 days. Before each treatment from day 1 to day 10 and on day 11 , the score of symptoms and physical signs was observed in the two groups separately. Before each treatment from day 1 to day 10 and on day 11, 30, 60, the score of visual analogue scale (VAS) and skin lesion indexes were observed in the two groups. On day 60, the incidence of postherpetic neuralgia was recorded in the two groups. The levels of Th17 and Treg cells, Th17/Treg ratio in the peripheral blood, as well as serum levels of IL-10 and IL-17 were detected before and after treatment in the two groups. The clinical efficacy was compared between the two groups. RESULTS: From day 6 to day 10 during treatment and on day 11, the scores of symptoms and physical signs in the combined therapy group were lower than those of the western medication group (P<0.05, P<0.01). On day 3, day 6 to day 10 during treatment and day 11, day 30, VAS scores in the combined therapy group were lower than those of the western medication group (P<0.05, P<0.01). On day 60, the incidence of postherpetic neuralgia in the combined therapy group was lower compared with that in the western medication group (P<0.05). The blister arresting time and scabbing time in the combined therapy group were shorter than those of the western medication group (P<0.05). After treatment, the level of Th17, and Th17/Treg ratio in the peripheral blood, as well as the serum levels of IL-10 and IL-17 were all lower in comparison with those in the western medication group (P<0.05). The curative and remarkably effective rate was 82.5% (33/40) in the combined therapy group, higher than 62.5% (25/40) in the western medication group (P<0.05). CONCLUSION The early application of fire needling combined with cupping therapy can effectively treat herpes zoster of acute stage, relieve pain, and reduce the incidence of postherpetic neuralgia, which may be related to reducing the levels of Th17 and Treg cells, and Th17/Treg ratio in the peripheral blood, as well as the serum levels of IL-10 and IL-17 so that the cellular immune balance is modulated.
Humans ; Neuralgia, Postherpetic ; Acupuncture Therapy/methods* ; Interleukin-10 ; Interleukin-17 ; T-Lymphocytes, Regulatory ; Cupping Therapy ; Th17 Cells ; Herpes Zoster/therapy* ; Treatment Outcome ; Tablets

Professor 's clinical experience of using mind-regulation acupuncture for postherpetic neuralgia is summarized. Professor believes that the physical pain symptoms in patients could cause negative emotions, which often lead to a series of mental symptoms, which in turn aggravate or induce pain. Therefore, the treatment for this disease should start with mind regulation, with Baihui (GV 20) through , Shenmen (HT 7), Neiguan (PC 6), Shenmai (BL 62), Zhaohai (KI 6), Siguan (Hegu (LI 4) and Taichong (LR 3)), Sanyinjiao (SP 6), Shuigou (GV 26) and Suliao (GV 25) as main acupoints to regulate mind and relieve pain, in combination of local analgesia and ear acupuncture, which has obtained satisfied curative effect.
Acupuncture Points ; Acupuncture Therapy ; Acupuncture, Ear ; Humans ; Neuralgia, Postherpetic ; therapy ; Pain Management

OBJECTIVETo evaluate the clinical efficacy of intradermal injection of methylene blue for treatment of moderate to severe acute thoracic herpes zoster and prevention of postherpetica neuralgia in elderly patients.

METHODSSixty-four elderly patients with herpes zoster were randomized to receive a 10-day course of intradermal injection of methylene blue and lidocaine plus oral valaciclovir (group A, 32 cases) and intradermal injection of lidocaine plus oral valaciclovir (group B).Herpes evaluation index, pain rating index, incidence of postherpetic neuralgia, and comprehensive therapeutic effect were compared between the two groups at 11, 30 and 60 days after the treatment.

RESULTSThe baseline characteristics were comparable between the two groups (all P>0.05). Compared with that in group B, the time for no new blister formation, blister incrustation and decrustation, and pain relief was significantly shortened in group A (P<0.05) with also obviously lower pain intensity after the treatment. The incidence of postherpetic neuralgia was significantly lower in group A than in group B at 30 days (P<0.05), but not at 60 and 90 days after the treatment. The total clinical response rate was 93.8% in group A, much higher than that in group B (62.5%, P<0.05).

CONCLUSIONIntradermal injection of methylene blue can effectively shorten the disease course, reduce the pain intensity and prevent the development of postherpetic neuralgia in elderly patients with herpes zoster.

Acyclovir ; administration & dosage ; analogs & derivatives ; therapeutic use ; Aged ; Herpes Zoster ; complications ; Humans ; Incidence ; Injections, Intradermal ; Lidocaine ; administration & dosage ; therapeutic use ; Methylene Blue ; administration & dosage ; therapeutic use ; Neuralgia, Postherpetic ; therapy ; Pain Measurement ; Valine ; administration & dosage ; analogs & derivatives ; therapeutic use

Acupuncture Therapy ; Herpes Zoster ; complications ; Humans ; Male ; Middle Aged ; Motor Neuron Disease ; etiology ; therapy ; Neuralgia, Postherpetic ; etiology ; therapy

Postherpetic neuralgia (PHN) is a difficult medical issue and symptomatic treatment with medication is common. One case of PHN was cured by nerve avulsion and microtherm plasma nerve block. The male patient was 48-year-old with PHN on the right side of the nose, suffering recurrent pains within one year. The symptoms occurred irregularly and lasted for several minutes to hours every time. Electroacupuncture and Chinese medicine treatments in other hospitals made little efficacy. Physical examination showed skin of right side of the nose and nasal mucosa was normal and all laboratory reports confirmed negative. After microtherm plasma treatment in nasal cavity and corresponding area of nasal septum, the pain disappeared.
Humans ; Male ; Middle Aged ; Nerve Block ; Neuralgia, Postherpetic ; therapy ; Nose ; pathology

Acupuncture Therapy ; adverse effects ; instrumentation ; methods ; Adult ; Humans ; Male ; Neuralgia, Postherpetic ; complications ; therapy ; Thrombophlebitis ; etiology

OBJECTIVETo compare efficacy differences between fire filiform needle combined with mild moxibustion and gabapentin combined with sham acupuncture for postherpetic neuralgia (PHN).

METHODSOne hundred cases of PHN were randomly divided into a needle group and a medicine group, 50 cases in each one. In the needle group, pricking method of fire filiform needle was given at the Ashi points, and then mild moxibustion was applied for 15 min. In the medicine group, the oral administration of gabapentin capsule and sham acupuncture at non-acupoints in the distal end of lesions were applied. The treatment was required for 21 days in both groups. The visual analogue score (VAS) was recorded before treatment and on the 1st day, 2nd day, 3rd day, 6th day, 9th day and 12th day of treatment. The most severity of pain within last 24 h, preset severity of pain, immediate analgesia effect and starting time of pain relief were observed, also the efficacy was assessed and improvement of symptoms was observed in the follow-up visit.

RESULTSThe total effective rate was 94.0% (47/50) in the fire filiform needle group, which was superior to 86.0% (43/50) in the medicine group (P < 0.05). Compared with medicine group, the VAS of the most severity of pain within last 24 h was obviously reduced after the 2nd treatment in the fire filiform needle group while that of present severity of pain was relieved after the 1st treatment (both P < 0.05). The immediate analgesia effect in the fire filiform needle group was obviously superior to that in the medicine group in the first three times of treatment (all P < 0.05). The average time of pain relief was (3.91 +/- 0.82) days in the fire filiform needle group, which was significantly earlier to (6.53 +/- 1.13) days in the medicine group (P < 0.05). 26 cases were cured in the fire filiform needle group in the follow-up visit, which was superior to 2 cases in the medicine group (P < 0.05). The improvement of VAS, pain range and sleep quality in the needle group were also superior to those in the medicine group (all P < 0.05). The direct medical cost in the fire filiform needle group was (232.32 +/- 48.108) yuan, which was significantly lower than (466.00 +/- 41.09) yuan in the medicine group (P < 0.05). There was only one case of adverse effect in the medicine group during the treatment.

CONCLUSIONThe fire filiform needle combined with mild moxibustion could obviously relieve the pain in PHN patients, which has superior immediate analgesia effect and pain relieving time compared with gabapentin, which also has less adverse effects and cheap cost.

Acupuncture Points ; Acupuncture Therapy ; Aged ; Combined Modality Therapy ; Female ; Humans ; Male ; Middle Aged ; Moxibustion ; Neuralgia, Postherpetic ; therapy ; Pain Measurement ; Treatment Outcome

OBJECTIVE: To determine the short and mid-term effect of paravertebral adriamycin injection under CT guidance on intractable postherpetic neuralgia (PHN). METHODS: From January 2010 to May 2012, 68 patients with intractable PHN receiving paravertebral adriamycin injection under CT guidance were enrolled. The outcome included the Quality of Life Score (QLS), Visual Analogue Score (VAS) (average, the worst and the least VAS), pain relief rate at the time before and after the injection, and 1 year after discharge. RESULTS: Lower VAS was observed after the injection than that before the injection [(3.5 ± 1.5) vs (7.9 ± 1.3) on average; (2.1 ± 0.9) vs (6.5 ± 1.7) at least and (4.5 ± 1.4) vs (9.2 ± 1.1) at worst, P<0.05]. Lower VAS at 1 year after discharge was found than that before the injection [(2.2 ± 1.8) vs (7.9 ± 1.3) on average; (1.5 ± 0.8) vs (6.5 ± 1.7) at least; (3.2 ± 1.6) vs (9.2 ± 1.1) at worst ] and that after the injection [(3.5 ± 1.5) vs (2.2 ± 1.8) on average; (1.5 ± 0.8) vs (2.1 ± 0.9) at least and (3.2 ± 1.6) vs (4.5 ± 1.4) at worst, P<0.05]. The pain relief rate after the injection was (68 ± 23)%. The pain relief rate at 1 year after discharge (81 ± 22)% was higher than that at discharge (68 ± 23)% (P<0.05). The quality of life evaluation index scale after the injection (daily life, diet, general activities, sleep, work and social activities) was significantly improved than that before the injection [(10.1 ± 2.2) vs (14.2 ± 1.9), P<0.05]. The quality of life evaluation index scale at 1 year after discharge was significantly improved than that before the injection [(7.0 ± 2.1) vs (14.2 ± 1.9)] and that after the injection [(7.0 ± 2.1) vs (10.1 ± 2.2), P<0.05]. No complication was observed when the patients were discharged and 1 year after discharge. CONCLUSION Paravertebral adriamycin injection under CT guidance for intractable PHN can effectively relieve the patient's pain, improve the quality of sleep and life without obvious complications. It is safe and effective for intractable PHN.
Doxorubicin ; administration & dosage ; therapeutic use ; Humans ; Neuralgia, Postherpetic ; drug therapy ; Pain Measurement ; Quality of Life