Clinical Study on Surrounding Acupuncture for Herpes Zoster

Song Hai-yun, He Hua-qiong

1 Taihe Hospital Affiliated to Hubei Medical College, Shiyan 442000, China

2 Hubei Medical College, Shiyan 442000, China

Clinical Study on Surrounding Acupuncture for Herpes Zoster

Song Hai-yun1, He Hua-qiong2

1 Taihe Hospital Affiliated to Hubei Medical College, Shiyan 442000, China

2 Hubei Medical College, Shiyan 442000, China

Objective: To observe the clinical effects of the surrounding acupuncture for herpes zoster.

Methods: Sixty patients with herpes zoster were randomly divided into two groups, a treatment group and a control group, 30 cases in each. The cases in the treatment group were treated with surrounding acupuncture, intravenous infusion of Acyclovir and Ne-Ne laser radiation on the macular areas. While, those in the control group were treated with intravenous infusion of Acyclovir and topical application of Acyclovir ointment. The therapeutic effects were assessed in both groups after two courses of treatment.

Results: The treatment group was obviously better than the control group in the effective rate, relief of blister, drying up of blister, relief of pain and time of complete relief of pain (P＜0.05).

Conclusion: Surrounding acupuncture, combined with intravenous infusion of Acyclovir and He-Ne laser radiation, is remarkable in the therapeutic effects for herpes zoster and worthy of clinical application.

Herpes Zoster; Acupuncture Therapy; Laser Therapy

Herpes zoster is a commonly encountered dermal disease caused by varicella-zoster virus (VZV) and its incidence rate is about 1.4%-4.8%. In Western medicine, the anti-inflammatory and anti-viral treatments are often applied. Although it is effective, it is comparatively longer in the course of the treatment and is easy to induce post-herpetic neuralgia[1]. In Chinese medicine, it is termed ‘snake sores’ and acupuncture is commonly used for this disease[1-3]. In order to enhance the therapeutic effects, shorten the course and reduce complication of this disease, the patients with herpes zoster were treated in our clinic by comprehensive therapy with surrounding acupuncture in predominance. Now, the report is given as follows.

1 Clinical Materials

1.1 Diagnostic criteria

Based upon the diagnostic criteria of snake-like sores in theCriteria of Diagnosis and Therapeutic Effects of Diseases and Syndromes in Traditional Chinese Medicine[3], the diagnostic criteria were stipulated by prevailing tendency in the spring and autumn, susceptible in those with weakened immune system, and prodromal symptoms of fever, general discomfort and poor appetite in most patients, obvious subjective pain, severe pricking pain, burning pain, skin lesion with clutches of mung bean blisters, lined up likebelt along the nerves, and normal skin between blisters.

1.2 Inclusion criteria

In conformity with the above diagnostic criteria; with the duration within one week; without use of anti-virus medications; without severe diseases in the cardiac; cerebral and renal system; and signed informed consent.

1.3 Exclusion criteria

Those allergic to Acyclovir; those patients complicated with cardiac, hepatic and renal diseases; women in pregnancy and breast feeding; patients sick with administration of other medications in the recent two months; those unable to continue with this plan or accept other therapies influencing the observation of clinical effects.

1.4 General data

Sixty cases with herpes zoster in conformity with the inclusion criteria were the out-patients treated in the Acupuncture Department of our hospital from January of 2000 to January of 2013, and were randomized into a treatment group and a control group by their visit order, 30 cases in each. In the treatment group, the age was from 26 to 73 years old and the duration was from 1.5 d to 7 d. In the control group, the age was from 25 to 75 years old and the duration was from 1.2 d to 6.5 d. By statistical management of general data, the differences were not statistically significant between the two groups (P＞0.05), and so the two groups were comparable (table 1).

Table 1. Comparison of general data between the two groups

2 Therapeutic Methods

2.1 Treatment group

2.1.1 Intravenous infusion of Western medication

Intravenous infusion of Acyclovir, 0.25 mg each time, once a day.

2.1.2 Surrounding acupuncture

The filiform needles of 0.3 mm in diameter and 12-15 mm in length were used to puncture around herpes zoster, and the needles were inserted at about 1.5-2 cm away from the skin lesion by a 15°-30° angle between the needle body and skin, with the needle tip toward the center of skin lesion. By the size of the skin lesion, 5-10 needles were punctured. Then, G6805-II acupuncture apparatus was connected with continuous wave and frequency of 2.2-3.0 Hz, with the current intensity within the patient’s tolerance, for 30 min. For herpes zoster above the waist, Zhigou (TE 6), Quchi (LI 11), Waiguan (TE 5) and Hegu (LI 4) were added. For herpes zoster below the waist, Yanglingquan (GB 34), Zusanli (ST 36) and Xiaxi (GB 43) were added.

2.1.3 He-Ne laser radiation

After surrounding acupuncture, GG-3D-40 doubletube He-Ne laser apparatus was used, with power of 3.75 mW/cm2, by spot irradiation, to radiate each spot for 10 min.

2.2 Control group

Intravenous infusion of Western medication was as same as that of the treatment group. Additionally, Acyclovir ointment was applied on the local area, 3-5 times a day.

The patients in the two groups were all treated once a day, and seven days made one course. After rest for one day, the second course continued. After two courses, the therapeutic effects were assessed.

3 Therapeutic Effects

3.1 Criteria of therapeutic effects

Cured: Skin rashes disappear, and clinical signs and pain disappear.

Improvement: Skin rashes disappear by 30%, and pain is obviously relieved.

Failure: Skin rashes disappear by less than 30%, still painful.

3.2 Observed Indexes

3.2.1 Recovery of herpes

The herpes-stopping time, pain-starting time, herpesdrying up time, complete pain-stopping time and complete scab-falling time were respectively recorded in the patients of the two groups.

3.2.2 Assessment of pain degree

Jane Scott visual pain score scale (10 cm) was used to evaluate pain degree by referring to the reference[3].

3.3 Statistical methods

The CHISS software was used, and analysis of variance was used for comparison of materials.

3.4 Therapeutic results

3.4.1 Comparison of deflorescence situations in the two groups

The times of herpes-stopping and herpes-drying up and scabbing were obviously shorter in the treatment group than those in the control group, with statistical significance in the differences between the two groups (allP＜0.05), indicating that the triple therapy for herpes zoster is able to accelerate scabbing of herpes and shorten the duration (table 2).

Table 2. Comparison of herpes relief after treatment between the two groups (, day)

Table 2. Comparison of herpes relief after treatment between the two groups (, day)

Note: Compared with the control group, 1)P＜0.05

GroupsnHerpes-stopping time Drying up and scabbing time Treatment 30 2.112±0.5001)3.335±1.3301)Control 30 4.812±0.803 6.858±2.137

3.4.2 Comparison of pain after treatment between the two groups

The differences in the pain-stopping time and complete pain-stopping time after the treatment between the two groups were statistically significant (allP＜0.01), indicating that the triple therapy for herpes zoster is able to relieve pain swiftly (table 3).

Table 3. Comparison of pain situation after treatment between the two groups (, day)

Table 3. Comparison of pain situation after treatment between the two groups (, day)

Note: Compared with the control group, 1)P＜0.01

GroupsnPain-relieving time Complete pain-stopping time Treatment 30 1.171±0.4391)3.421±1.7121)Control 30 3.873±0.758 6.921±2.272

3.4.3 Comparison of clinical effects between the two groups

The total effective rate was 100% in the treatment group, versus 86.7% in the control group, and the difference between the two groups was statistically significant (P＜0.05), indicating that the therapeutic effect was better in the treatment group than that in the control group (table 4).

Table 4. Comparison of therapeutic effects between the two groups (case)

4 Discussion

Herpes zoster is described as ‘snake-like sores’,‘spider-like sores’ and ‘fire blisters around the waist’ in traditional Chinese medicine. Etiologically, it is mostly caused by emotional disorder, liver qi stagnation and accumulation of internal dampness and heat, affecting the muscle, skin and collaterals, which results in sores, so the meridians and collaterals are obstructed by pathogenic dampness and heat, leading to blockage of qi and blood, and hence pain due to obstruction[4]. It is believed in modern medicine that herpes zoster is caused by infection of VZV, and about 70% of the patients would present blisters and 30% of the patients are insidious infection. After infection, virus would exist in the neuron in a latent way. When the immune ability declines in the body, virus could spread to the skin via the sensory nerve fibers, causing clusters of blisters. Therefore, both the two types of the symptoms, herpes and pain, coexist in the body of the patients with herpes zoster[5]. In Western medicine, anti-viral treatment is often adopted by using Acyclovir. Acyclovir is the first generation of nucleoside antiviral drug. Acyclovir can selectively inhibit and deactivate the viral DNA polymerase, block the viral DNA synthesis, reduce acute pain, stop the pervasion of virus and reduce the complications of the internal organs, but it is ineffective for postherpetic neuralgia. If the prompt and effective therapy is not adopted for herpes zoster, postherpetic neuralgia would occur as high as 30%-50%[6]. In order to explore the best therapeutic method, and reduce the incidence rate of postherpetic neuralgia, we combine the surrounding acupuncture and He-Ne laser radiation on the local area, together with the anti-viral treatment. Surrounding acupuncture can clear away heat and dissolve toxin, regulate qi and blood, and also hinder the pervasion of pathogenic virus and effectively inhibit skin lesion. Surrounding acupuncture is also an effective method to stop pain by concentrated force, and can stimulate the human body to release dynorphin simultaneously, to enhance the analgesic effect and also enhance the immunity of the human body. He-Ne laser is a weak laser, also termed low energy laser[7]. By direct radiation of laser on the local areas, it is possible to improve local blood circulation, intensify the activity of intracellular enzymes of the local tissues, regulate the permeability of the vascular walls, reduce the exudation of inflammatory edema, promote the absorption and dispersion of inflammatory edema[8], promote the repair of the damaged nerves, regulate the immune functions of the body, so as to realize the astringent, anti-inflammatory, anti-infective and analgesic effect[9-10]. The cooperative function of three of them can greatly shorten the course and reduce the suffering of the patients and occurrence of complications. So, it is worthy of extensive clinical application.

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[9] Wang XQ, Sun YL. Observation of clinical effect of He-Ne laser treatment of skin ulceration. Linchuang Pifu Ke Zazhi, 2005, 34(8): 503.

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Translator: Huang Guo-qi

R246.7

A

Date: April 4, 2013

Author: Song Hai-yun, deputy chief physician

He Hua-qiong, technician.

E-mail: 2330320069@qq.com