A qualitative study of the psychological processes in patients with post-herpetic neuralgia

Objective:To understand the psychological process of patients with post-herpetic neuralgia(PHN)and provide references for the psychological management of PHN.Methods:The objective sampling method was used to conduct semi-structural in-depth interviews on 10 PHN patients,and Colaizzi’s phenomenological analysis method was used for data analysis.Results:According to the different pain durations of PHN patients,the patients were divided into three stages and five themes were extracted:the need for strong pain relief,the helpless tolerance of pain,the self-feeling burden,the need for health education,and the positive response to pain.Conclusions:PHN has complex psychological activities,so it is necessary to pay attention to the psychological process of patients and take effective psychological measures to intervene negative psychology so that patients can actively cope with the pain.

Correlation of p38MAPK,ERK1/2 and JNK expression in peripheral blood with the cytokines and pain mediators in patients with post-herpetic neuralgia

Objective: To study the correlation of p38MAPK, ERK1/2 and JNK expression in peripheral blood with the cytokines and pain mediators in patients with post-herpetic neuralgia (PHN). Methods: Patients who were diagnosed with herpes zoster for the first time in the Second Hospital of Hanbin District Ankang City between March 2015 and April 2016 were selected and divided into the PHN group who were combined with post-herpetic neuralgia and the pure HZ group who were without neuralgia, and the healthy volunteers who received physical examination in the Second Hospital of Hanbin District Ankang City during the same period were selected as control group. The peripheral blood was collected to determine the expression of MAPK signaling molecules, and serum was collected to determine the contents of cytokines and pain mediators. Results: p38MAPK, ERK1/2 and JNK mRNA expression in peripheral blood as well as 5-HT, CGRP, SP, NSE, S100B, IFN-γ, TNF-α and IL-17 levels in serum of PHN group and HZ group were significantly higher than those of control group while β-EP levels were significantly lower than that of control group;p38MAPK, ERK1/2 and JNK mRNA expression in peripheral blood as well as 5-HT, CGRP, SP, NSE, S100B, IFN-γ, TNF-α and IL-17 levels in serum of PHN group were significantly higher than those of HZ group while β-EP level was significantly lower than that of HZ group. p38MAPK, ERK1/2 and JNK expression in peripheral blood of PHN patients were positively correlated with CGRP, 5-HT, SP, NSE, S100B, IFN-γ, TNF-α and IL-17 levels in serum, and negatively correlated with β-EP level in serum. Conclusion: The high expression of p38MAPK, ERK1/2 and JNK in peripheral blood of PHN patients can increase the secretion of cytokines and algogenic mediators and decrease the secretion of analgesic mediators.

Correlation of serum inflammatory cytokine and immunoglobulin content with post-herpetic neuralgia in patients with acute herpes zoster

Objective:To study the correlation of serum inflammatory cytokine and immunoglobulin content with post-herpetic neuralgia in patients with acute herpes zoster.Methods:Patients diagnosed with herpes zoster in our hospital between May 2012 and October 2015 were selected and divided into herpes zoster-post-herpetic neuralgia group (VZV-PHN group) and herpes zoster-control group (VZV-Con group) according to the incidence of post-herpetic neuralgia (PHN);healthy volunteers receiving physical examination in our hospital during the same period were selected as normal control group (Con group).Results: Serumβ-EP, NT, IFN-γ and IL-2 levels of VZV-PHN group and VZV-Con group were significantly lower than those of Con group (P<0.05), while SP, VGF, CGRP, IL-4, IL-6, IL-17, IL-21, TNF-α, IL-10, TGF-β1, IgG, IgM and IgA levels were significantly higher than those of Con group (P<0.05);serumβ-EP, NT, IFN-γ, IL-2, IgG, IgM and IgA levels of VZV-PHN group were significantly lower than those of VZV-Con group (P<0.05) while SP, VGF, CGRP, IL-4, IL-6, IL-17, IL-21, TNF-α, IL-10 and TGF-β1 levels were significantly higher than those of VZV-Con group (P<0.05);β-EP and NT were positively correlated with IFN-γ, IL-2, IgG, IgM and IgA, and negatively correlated with IL-4, IL-6, IL-17, IL-21, TNF-α, IL-10 and TGF-β1;SP, VGF and CGRP were negatively correlated with IFN-γ, IL-2, IgG, IgM and IgA, and positively correlated with IL-4, IL-6, IL-17, IL-21, TNF-α, IL-10 and TGF-β1.Conclusions:Abnormal secretion of inflammatory cytokines and immunoglobulin caused by humoral immune and cellular immune response disorder is associated with the occurrence of post-herpetic neuralgia in patients with acute herpes zoster.

Observation on the effect of fire needle combined with Linggui Bafa for post-herpetic neuralgia

Objective To observe the clinical effect of fire needle combined with Linggui Bafa for post-herpetic neuralgia （PHN）. Methods One hundred and twenty patients were randomly divided into an observation group and a control group with 60 cases each. For observation group, fire needle was applied to prick Zusanli （足三里 ST 36）, Yanglingquan （阳陵泉 GB 34）, Taichong （太冲 LR 3）, Sanyinjiao （三阴交 SP 6） and partial Ashi points around the lesion, and Linggui Bafa was combined to perform acupuncture therapy, once every other day, 10 times as a course of treatment; for the control group, only fire needle was applied. After 2 courses of treatment, the comparison of the value of visual analogue scale （VAS） and the total effective rate for the two groups were carried out. Results The VAS value of the observation group after treatment was obviously lower than that before treatment （2.28±2.08 vs 6.12±1.96） and that of the control group （2.28±2.08 vs 3.62±2.90）, there were significant differences （all P〈0.01）. The total effective rate of the observation group was obviously higher than that of the control group [93.3% （56/60） vs 76.7% （46/60）], the difference between the two groups was statistically significant （P〈0.05）. Conclusion The effect of fire needle combined with Linggui Ba.fa for PHN is obviously superior to that of single fire needle therapy.

Needle-embedding therapy for fifty cases of post-herpetic neuralgia

Objective To observe the clinical efficacy of needle-embedding therapy for the treatment of post-herpetic neuralgia. Method Fifty patients of post-herpetic neuralgia treated with needle-embedding therapy from January 2013 to June 2014 at Department of pain of the Second People＇s Hospital of Yibin City were selected. At each time of needle-embedding therapy, 4-8 points were selected. Patients were treated once a day, 5 times for a course of treatment and received a total of 1-3 courses of treatment. Meanwhile, the curative effect was analyzed in accordance with Criteria of Diagnosis and Therapeutic Effect of Diseases and Syndromes in Traditional Chinese Medicine. Result Among the 50 patients, the markedly effective rate was 84.0% （42/50）, the effective rate was 16.0% （8/50） and the total effective rate was 100.0%. Conclusion Needle-embedding therapy for the treatment of post-herpetic neuralgia offers a good curative effect.

针灸疗法对带状疱疹后遗神经痛患者血清细胞因子和疼痛因子水平的影响

【目的】观察针灸治疗带状疱疹后遗神经痛的临床疗效,并探讨其可能的作用机制。【方法】将120例带状疱疹后遗神经痛患者随机分为观察组和对照组,每组各60例,对照组给予常规西药治疗,观察组在对照组基础上,同时给予针灸治疗。连续治疗4周。治疗4周后,比较2组患者治疗前后的疼痛视觉模拟评分(VAS)、白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)、白细胞介素1β(IL-1β)、白细胞介素10(IL-10)、5羟色胺(5-HT)以及P物质水平的变化情况,并评价2组的临床疗效。【结果】(1)治疗2周和4周后,2组患者的VAS评分明显改善(P<0.05),且观察组在改善VAS评分方面明显优于对照组,差异有统计学意义(P<0.05)。(2)治疗后,2组患者的血清TNF-α、IL-6、IL-1β、IL-10水平明显改善(P<0.05),且观察组在改善血清TNF-α、IL-6、IL-1β、IL-10水平方面均明显优于对照组,差异有统计学意义(P<0.05)。(3)治疗后,2组患者的5-HT、P物质水平均明显改善(P<0.05),且观察组在改善5-HT、P物质水平方面均明显优于对照组,差异有统计学意义(P<0.05)。(4)观察组总有效率为96.67%(58/60),对照组为91.67%(55/60)。观察组疗效优于对照组,差异有统计学意义(P<0.05)。【结论】针灸治疗带状疱疹后遗神经痛,能明显改善患者的疼痛症状,进一步降低疼痛相关细胞因子、疼痛因子的水平,临床疗效显著。

Collateral-pricking and blood-letting cupping combined with electroacupuncture for post-herpetic neuralgia

Objective:To explore the clinical efficacy of collateral-pricking and blood-letting cupping combined with surrounding needling technique electroacupuncture in the treatment of post-herpetic neuralgia(PHN).Methods:Seventy-two patients with post-herpetic neuralgia were randomized into observation group and control group.Of the 72 cases,12 cases fell off,so finally 30 cases in each group.The observation group was treated with collateral-pricking and blood-letting cupping combined with surrounding needling technique electroacupuncture,while the control group was treated simply with pregabalin capsules for 20 consecutive days.On the basis of the western medication pregabalin capsules,the same as that of the control group,collateral-pricking and blood-letting cupping combined with electroacupuncture in a surrounding needling technique,was adopted for the observation group,once every two days,ten days as one course of treatment,a total of two courses.The immediate visual analogue scale(VAS)before and after treatment were observed in the two groups,and their clinical effects were compared.Results:The VAS scores of PHN patients in the two groups after treatment were lower than those before treatment(both P<0.01),and the scores of observation group were lower than those of control group(P<0.05).The total effective rate of the observation group was 86.7%,higher than 73.3% of the control group.Conclusion:The clinical effect of collateral-pricking and blood-letting cupping combined with electroacupuncture is relatively satisfactory in the treatment of post-herpetic neuralgia.

灸法治疗带状疱疹后遗神经痛的系统评价与Meta分析

目的:运用系统评价与Meta分析评价灸法治疗带状疱疹后遗神经痛的疗效。方法:全面检索国内四大数据库,中国知网(CNKI,1978年-2015年)、中国生物医学文献数据库(CBM,1979年-2015年)、维普中文期刊全文数据库(VIP,1989年-2015年)、万方数字化期刊群(WF,1989年-2015年)。收集灸法治疗带状疱疹后遗神经痛的RCT文献,经阅读、筛选、提取有效信息后,采用Cochrane Review Handbook 5.1.0对纳入文献进行质量评估,结果采用Cochrane协作网提供的Rev Man 5.3.3软件进行核实。结果:共纳入合格文献21篇,文献质量普遍偏低。Meta分析:灸法vs西药,RR=1.46,95%CI[1.29,1.66](P<0.00001);灸法+西药vs西药总有效率,RR=1.31,95%CI[1.16,1.47](P<0.0001);灸法vs针刺,RR=1.18,95%CI[0.81,1.72](P>0.05);灸法+针刺vs针刺,RR=1.18,95%CI[1.09,1.28](P<0.0001);灸法vs物理疗法总有效率,RR=1.68,95%CI[1.28,2.22](P<0.05)。结论:灸法相对西药、物理疗法有疗效优势,结合西药有增强疗效的作用,灸法相对针刺和结合针刺方面,尚未显示出比较确定的疗效优势,还需今后临床进一步拓展验证。

Two proved cases of treating herpes zoster pain by needling wei

Two cases of herpes zoster neuralgia treated by shallow needling combined with electroacupuncture were introduced. The literature basis and possible mechanisms were discussed.