Surrounding Needling with Fire Needle and Filiform Needle Plus Moxibustion in the Treatment of Lower Limb Herpes Zoster:One Case Report

Introduction Herpes zoster is a skin disease caused by activation of the varicella zoster virus,which is latent in neurons.It can be accompanied by severe neuralgia.Some herpes zoster patients may have pain allergy,general discomfort,loss of appetite and other prodromal symptoms,typical clinical manifestation as a cluster of blisters distribution along unilateral peripheral nerve,often accompanied by obvious neuralgia[1].

火针围刺联合夹脊电针治疗急性期带状疱疹:随机对照试验

ObjectivesTo investigate the clinical efficacy of surrounding fire needling combined with electroacupuncture (EA) at Jiājĭ (夹脊EX-B2) on acute herpes zoster, and explore the potential mechanism of this combined treatment by measuring the changes of serum inflammatory cytokines and pain mediators.MethodsSixty patients with acute herpes zoster were randomly assigned to either acupuncture plus western medicine group or western medicine group. In the western medicine group, the patients took orally mecobalamin and ganciclovir for 14 consecutive days. In the acupuncture plus western medicine group, on the base of the western medicine, the surrounding fire needling (fire needling was operated swiftly toward the center of skin lesions.) combined with EA at EX-B2 was provided. Acupoints of EX-B2 were selected based on the nerve ganglion corresponding to the skin lesions, as well as two adjacent nerve ganglions(one level upwards and one downwards) to the lesions, and were stimulated with EA once daily for 14 days. The change of symptoms from the blister eruption to scabbing and decrustation were observed. The score of visual analogue scale (VAS), serum inflammatory cytokines (interleukin-1β, interleukin-6, tumor necrosis factor-α) and pain mediators (calcitonin gene related peptide, substance P) before and after treatment, the scores of Pittsburgh sleep quality index (PSQI) and Hamilton depression scale (HAMD) before and after treatment as well as at 1 month of follow-up, and the overall effective rate and the incidence of post-hepatic neuralgia at 1 month of follow-up were assessed and compared between two groups, respectively.ResultsAfter treatment completion, the time of blister relief, scabbing and decrustation in the acupuncture plus western medicine group was significantly shorter when compared with that of the western medicine group (all P < 0.05). After treatment, VAS score, PSQI score and HAMD score were all reduced significantly when compared with that before treatment within group (P < 0.05). These scores in the acupuncture plus western medicine were reduced significantly compared with the western medicine group at the same time point (all P < 0.05). After treatment, the incidence of post-hepatic neuralgia was 6.89%, lower than that in western medicine group (50.00%, P < 0.05). After treatment, the values of serum inflammatory cytokines (IL-1β, IL-6, TNT-a) and pain mediators (CGRP, SP) were reduced when compared with the those before treatment within group (P < 0.05), and the reduction in the acupuncture plus western medicine group was larger than that in the western medicine group (P < 0.05). The total effective rate was 96.67% in the acupuncture plus western medicine group, higher than western medicine group (86.67%, P < 0.05).ConclusionsSurrounding fire needling therapy combined with EA at EX-B2 on the base of western medicine obtained better therapeutic effect on acute herpes zoster when compared with western medicine. This combined treatment may effectively relieve pain and depressive emotions, improve sleep quality and reduce the incidence of post-hepatic neuralgia. The underlying mechanism may related to regulation of pain mediators and reduction of inflammatory cytokines.

刺络放血拔罐结合电针围刺治疗带状疱疹后神经痛临床观察

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.