OBJECTIVE To assess the effi⁃cacy and safety of acupuncture-related treat⁃ments for postherpetic neuralgia(PHN),identify the most effective acupuncture and related treat⁃ments.METHODS PubMed,Cochrane Central Register ...OBJECTIVE To assess the effi⁃cacy and safety of acupuncture-related treat⁃ments for postherpetic neuralgia(PHN),identify the most effective acupuncture and related treat⁃ments.METHODS PubMed,Cochrane Central Register of Controlled Trials,Embase,Web of Science,and four Chinese databases,a clinical research registration platform,and grey literature were searched.We evaluated the risk of bias and quality in the included studies and per⁃formed a Bayesian multiple network meta-analysis.RESULTS We included 29 randomized controlled trials comprising 1973 patients,of which approximately 17.24%showed a high risk of bias.According to the Jadad scale,2,16,and 11 studies were high,medium,and low quality,respectively.The pairwise meta-analysis results revealed that the efficacy of all acupuncture-related treatments for pain relief related to PHN showed the difference was statistically significant com⁃pared with that of antiepileptics.The network meta-analysis results showed that pricking and cupping plus antiepileptics were the most effective,followed by electroacupuncture(EA)plus antiepileptics for pain relief in patients with PHN.EA plus antiepileptics ranked the best regarding reduced Pittsburgh Sleep Quality Index and Self-Rating Depression Scale scores in patients with PHN.No results were found regarding total response rate or quality of life among this study.Acupuncture-related treatments showed a lower incidence of adverse events than that of antiepi⁃leptics-related treatments.CONCLUSION Acu⁃puncture-related therapies may be potential treat⁃ment options for PHN and are relatively safe.Pricking and cupping plus antiepileptics are the most effective techniques for pain relief.EA plus antiepileptics is the best approach for improving insomnia and depression symptoms of PHN.展开更多
BACKGROUND Postherpetic neuralgia(PHN)is the most frequent and a difficult-to-treat complication of herpes zoster(HZ).Its symptoms include allodynia,hyperalgesia,burning,and an electric shock-like sensation stemming f...BACKGROUND Postherpetic neuralgia(PHN)is the most frequent and a difficult-to-treat complication of herpes zoster(HZ).Its symptoms include allodynia,hyperalgesia,burning,and an electric shock-like sensation stemming from the hyperexcitability of damaged neurons and varicella-zoster virus-mediated inflammatory tissue damage.HZ-related PHN has an incidence of 5%–30%,and in some patients,the pain is intolerable and can lead to insomnia or depression.In many cases,the pain is resistant to pain-relieving drugs,necessitating radical therapy.CASE SUMMARY We present the case of a patient with PHN whose pain was not cured by conventional treatments,such as analgesics,block injections,or Chinese medicines,but by bone marrow aspirate concentrate(BMAC)injection containing bone marrow mesenchymal stem cells.BMAC has already been used for joint pains.However,this is the first report on its use for PHN treatment.CONCLUSION This report reveals that bone marrow extract can be a radical therapy for PHN.展开更多
BACKGROUND Intractable postherpetic neuralgia(PHN)can be difficult to manage even with aggressive multimodal therapies.Patients who experience uncontrolled refractory cranial PHN despite conservative treatment may ben...BACKGROUND Intractable postherpetic neuralgia(PHN)can be difficult to manage even with aggressive multimodal therapies.Patients who experience uncontrolled refractory cranial PHN despite conservative treatment may benefit from an intrathecal drug delivery system(IDDS).For craniofacial neuropathic pain,the traditional approach has been to place the intrathecal catheter tip below the level of the cranial nerve root entry zones,which may lead to insufficient analgesia.CASE SUMMARY We describe a 69-year-old man with a 1-year history of PHN after developing a vesicular rash in the ophthalmic division of cranial nerve V(trigeminal nerve)distribution.The pain was rated 7-8 at rest and 9-10 at breakthrough pain(BTP)on a numeric rating scale.Despite receiving aggressive multimodal therapies including large doses of oral analgesics(gabapentin 150 mg q12 h,oxycodone 5 mg/acetaminophen 325 mg q6 h,and lidocaine 5%patch 700 mg q12 h)and sphenopalatine ganglion block,there was no relief of pain.Subsequently,the patient elected to have an implantable IDDS with the catheter tip placed at the interpeduncular cistern.The frequency of BTP episodes decreased.The patient’s continuous daily dose was adjusted to 0.032 mg/d after 3 mo of follow-up and stopped 5 mo later.He did not report pain or other discomfort at outpatient follow-up 6 mo and 1 year after stopping intracisternal hydromorphone.CONCLUSION The use of interpeduncular cistern intrathecal infusion with low-dose hydromorphone by IDDS may be effective for severe craniofacial PHN.展开更多
BACKGROUND Primary trigeminal neuralgia can achieve satisfactory results through clinical treatment and intervention.The pathogenesis of neuralgia caused by varicellazoster virus infection of the trigeminal nerve is m...BACKGROUND Primary trigeminal neuralgia can achieve satisfactory results through clinical treatment and intervention.The pathogenesis of neuralgia caused by varicellazoster virus infection of the trigeminal nerve is more complex,and it is still difficult to relieve the pain in some patients simply by drug treatment or surgical intervention.CASE SUMMARY A 66-year-old woman was hospitalized with herpetic neuralgia after herpes zoster ophthalmicus(varicella-zoster virus infects the ophthalmic branch of the trigeminal nerve).On admission,the patient showed spontaneous,electric shocklike and acupuncture-like severe pain in the left frontal parietal region,and pain could be induced by touching the herpes area.The numerical rating scale(NRS)was 9.There was no significant pain relief after pulsed radiofrequency and thermocoagulation of the ophthalmic branch of the trigeminal nerve.Combined with patient-controlled intravenous analgesia(PCIA)with esketamine,neuralgia was significantly improved.The patient had no spontaneous pain or allodynia at discharge,and the NRS score decreased to 2 points.The results of follow-up 2 mo after discharge showed that the NRS score was≤3,and the Pittsburgh Sleep Quality Index score was 5 points.There were no adverse reactions.CONCLUSION Trigeminal extracranial thermocoagulation combined with esketamine PCIA may be a feasible method for the treatment of refractory herpetic neuralgia after herpes zoster ophthalmicus.展开更多
Objective:To systematically evaluate the safety and efficacy of acupuncture on patients with postherpetic neuralgia.Methods:Based on the heyword retrieval method,China National Knowledge Infrastructure(CNKI,1978-2020)...Objective:To systematically evaluate the safety and efficacy of acupuncture on patients with postherpetic neuralgia.Methods:Based on the heyword retrieval method,China National Knowledge Infrastructure(CNKI,1978-2020),China Biomedical Literature database(CBM,1979-2020),VIP database(WEIPU,1989-2020),Wanfang database(1989-2020),Cochrane Library,PubMed,and Embase were searched;randomized controlled trials of the use of acupuncture in the treatment of postherpetic neuralgia were screened out;the quality of the included literatures was evaluated based on the evaluation criteria in the Cochrane Handbook,and meta-analysis was performed using RevMan 5.3.Results:Twenty-six literatures that met the criteria,involving 2,174 patients,were included;the meta-analysis showed that compared with western medicine,the use of acupuncture can improve the overall effective rate(RR=1.24,95%CI[1.17,1.32],P<0.00001)and reduce the VAS score(MD=-1.43,95%CI[-1.97,-0.89],P<0.00001).Conclusion:The use of acupuncture can further improve the clinical effect of patients with postherpetic neuralgia.展开更多
Introduction:Postherpetic neuralgia(PHN)is a painful condition that occurs after herpes zoster skin lesions have subsided and that lasts for more than 1 month.PHN is usually difficult to treat.Case presentation:Patien...Introduction:Postherpetic neuralgia(PHN)is a painful condition that occurs after herpes zoster skin lesions have subsided and that lasts for more than 1 month.PHN is usually difficult to treat.Case presentation:Patient 1 was a 54-year-old woman who had PHN for 35 days.Patient 2 was a 74-year-old woman who had PHN for 65 days.Both patients were treated with an epidural block and found to have spinal metastasis from a malignant tumor.Discussion:The routinely used dermatological medications for the treatment of herpes zoster and PHN have slow and unsatisfactory analgesic effects.Epidural block treatment provides a new approach for patients who cannot tolerate or do not respond to these commonly used drugs.Physicians should pay special attention to patients who have a history of a malignant tumor or are suspected to have spinal disease.Computed tomography or magnetic resonance imaging of the spine is recommended for such patients,and epidural block treatment should be performed after a spinal tumor or other lesions have been excluded.Conclusion:Epidural block treatment provides a new approach for patients of herpes zoster or PHN,but the treatment should be performed after a spinal tumor or other spinal lesions have been excluded.展开更多
OBJECTIVE:To investigate the effectiveness of electroacupuncture at Jiaji acupoints(EX-B 2)plus moxibustion and intermediate frequency on postherpetic neuralgia(PHN).METHODS:A total of 140 outpatients who satisfied th...OBJECTIVE:To investigate the effectiveness of electroacupuncture at Jiaji acupoints(EX-B 2)plus moxibustion and intermediate frequency on postherpetic neuralgia(PHN).METHODS:A total of 140 outpatients who satisfied the inclusion criteria and volunteered for this treatment were randomly divided into treatment(n=70)and control(n=70)groups.Both groups received a localized lesion area and electroacupuncture treatment combined with moxibustion and intermediate frequency.The treatment group(TG)increased acupuncture at Jiaji acupoints(EX-B 2)and electroacupuncture.Pain and anxiety were assessed before and after 5,10,15,and 20 treatments by using visual pain simulation score(VAS)and Hamilton anxiety scale(HAMA),respectively.Clinical efficacy was also evaluated.RESULTS:The baseline between the two groups did not significantly differ(P>0.05).The VAS and HAMA scores of the two groups after treatment significantly decreased compared with those of various treatment stages(P>0.05).The HAMA score(P<0.01)of TG was lower than that of the control group(CG).The VAS score of TG was lower than that of CG in the 5th and 10th treatments(P<0.01).In the 15 th and 10 th scores,CG was also superior to TG(P<0.05).CONCLUSION:The combined treatment of electroacupuncture at Jiaji acupoints(EX-B 2),moxibustion,and intermediate frequency can relieve the pain and anxiety symptoms of PHN.The efficacy of the combined treatment was superior to traditional acupuncture.展开更多
Objective: To observe the therapeutic efficacy of Fu's subcutaneous needling(FSN) with laser for postherpetic neuralgia and analyze its action mechanism. Methods: A total of 102 cases with postherpetic neuralgia w...Objective: To observe the therapeutic efficacy of Fu's subcutaneous needling(FSN) with laser for postherpetic neuralgia and analyze its action mechanism. Methods: A total of 102 cases with postherpetic neuralgia were randomly allocated into a treatment group and a control group, 51 in each group. FSN with laser was used for patients in the treatment group, whereas electroacupuncture was used for patients in the control group. After 6 months of treatment, the total effective rates, action time and cure courses in recovery cases were compared between the two groups. Three months after the treatment was completed, a follow-up was done to compare relapse rates between the two groups. Results: The recovery and total effective rates in the treatment group were 56.9% and 94.1% respectively, versus 35.3% and 68.6% in the control group, showing statistical differences(P<0.05); the action time and cure courses in the observation group were significantly shorter than those in the control group(P<0.05); the relapse rate in the treatment group was 6.9%, versus 44.4% in the control group, showing a statistical difference(P<0.05). Conclusion: FSN with laser can obtain better effect for postherpetic neuralgia than electroacupuncture and pose lower relapse risks.展开更多
BACKGROUND Varicella zoster virus(VZV)is a human neurotropic and double-stranded DNA alpha-herpes virus.Primary infection with VZV usually occurs during childhood,manifesting as chickenpox.Reactivation of latent VZV c...BACKGROUND Varicella zoster virus(VZV)is a human neurotropic and double-stranded DNA alpha-herpes virus.Primary infection with VZV usually occurs during childhood,manifesting as chickenpox.Reactivation of latent VZV can lead to various neurological complications,including transverse myelitis(TM);although cases of the latter are very rare,particularly in newly active VZV infection.CASE SUMMARY We report here an unusual case of TM in a middle-aged adult immunocompetent patient that developed concomitant to an active VZV infection.The 46-year-old male presented with painful vesicular eruption on his left chest that had steadily progressed to involvement of his back over a 3-d period.Cerebrospinal fluid testing was denied,but findings from magnetic resonance imaging and collective symptomology indicated TM.He was administered antiviral drugs and corticosteroids immediately but his symptom improvement waxed and waned,necessitating multiple hospital admissions.After about a month of repeated treatments,he was deemed sufficiently improved for hospital discharge to home.CONCLUSION VZV myelitis should be suspected when a patient visits the outpatient pain clinic with herpes zoster showing neurological symptoms.展开更多
This article introduces the clinical experience of Professor Jian-qiao FANG in treatment of postherpetic neuralgia(PHN)with acupuncture and moxibustion.Jian-qiao FANG believes that PHN is characterized by“stagnation...This article introduces the clinical experience of Professor Jian-qiao FANG in treatment of postherpetic neuralgia(PHN)with acupuncture and moxibustion.Jian-qiao FANG believes that PHN is characterized by“stagnation”and“deficiency”in pathogenesis and it is treated by“resolving stasis”and“replenishing for deficiency”.Electroacupuncture is predominated in treatment and the combined regimen of various techniques of acupuncture and moxibustion is adopted in therapeutic strategy.According to the pain characteristics of patients,the acupuncture and moxibustion prescription is drafted for resolving stasis and masses,replenishing for deficiency and regulating the mind.The acupoints include Ashi points,Jiaji(EX-B2),Hegu(LI4),Waiguan(TE5),Zusanli(ST36),Sanyinjiao(SP6),Shenting(GV24),Baihui(GV20)and Sishencong(EX-HN1).In treatment with electroacupuncture,the stimulation parameters are selected flexibly according to different pain characteristics.The frequency of 2/100 Hz is the first option,100 Hz is used for the acute seizure and 2 Hz is for mild pain.After electric stimulation,the treatment with roller type of dermal needle and moxibustion can be applied to ensure clinical efficacy.展开更多
Objective:To summarize the available evidence of acupuncture for pain relief in the patients with postherpetic neuralgia(PHN)using a scoping review.Methods:Seven electronic databases of the original studies of acupunc...Objective:To summarize the available evidence of acupuncture for pain relief in the patients with postherpetic neuralgia(PHN)using a scoping review.Methods:Seven electronic databases of the original studies of acupuncture on PHN were retrieved.The search time was from the inception to May 1,2021.Two researchers screened the title,abstract and full text of each article independently.The original studies that was met the inclusion criteria were collected and analyzed,and finally presented with a qualitative description.Results:A total of 216 original studies were eligible and all of them were randomized controlled trials.The acupuncture therapies with the highest use frequency included manual acupuncture,pricking and cupping and electroacupuncture.Acupuncture therapies were mostly combined with other interventions in studies.There were large differences in acupoint selection,time duration for single treatment and the total treatment times.It was believed in all of the included studies that acupuncture was effective of pain relief in PHN and 85.65%of the studies obtained the minimum clinical importance difference(MCID),suggesting the clinical effectiveness.The adverse reaction of acupuncture was low in its incidence,and mostly transient in occurrence.Conclusion:The study type of acupuncture for PHN is relatively simple.Most studies show the advantages of acupuncture in pain relief of PHN.The quality of study needs to be improved.展开更多
基金National Key Research and Development plan for the Modernization of Traditional Chinese Medicine (2018YFC1707700)National Key Research and Development plan for the Modernization of Traditional Chinese Medicine (2018YFC1707706)National Administration of Traditional Chinese Medicine Evidencebased Capacity Building Project (2019XZZXZJ005)
文摘OBJECTIVE To assess the effi⁃cacy and safety of acupuncture-related treat⁃ments for postherpetic neuralgia(PHN),identify the most effective acupuncture and related treat⁃ments.METHODS PubMed,Cochrane Central Register of Controlled Trials,Embase,Web of Science,and four Chinese databases,a clinical research registration platform,and grey literature were searched.We evaluated the risk of bias and quality in the included studies and per⁃formed a Bayesian multiple network meta-analysis.RESULTS We included 29 randomized controlled trials comprising 1973 patients,of which approximately 17.24%showed a high risk of bias.According to the Jadad scale,2,16,and 11 studies were high,medium,and low quality,respectively.The pairwise meta-analysis results revealed that the efficacy of all acupuncture-related treatments for pain relief related to PHN showed the difference was statistically significant com⁃pared with that of antiepileptics.The network meta-analysis results showed that pricking and cupping plus antiepileptics were the most effective,followed by electroacupuncture(EA)plus antiepileptics for pain relief in patients with PHN.EA plus antiepileptics ranked the best regarding reduced Pittsburgh Sleep Quality Index and Self-Rating Depression Scale scores in patients with PHN.No results were found regarding total response rate or quality of life among this study.Acupuncture-related treatments showed a lower incidence of adverse events than that of antiepi⁃leptics-related treatments.CONCLUSION Acu⁃puncture-related therapies may be potential treat⁃ment options for PHN and are relatively safe.Pricking and cupping plus antiepileptics are the most effective techniques for pain relief.EA plus antiepileptics is the best approach for improving insomnia and depression symptoms of PHN.
文摘BACKGROUND Postherpetic neuralgia(PHN)is the most frequent and a difficult-to-treat complication of herpes zoster(HZ).Its symptoms include allodynia,hyperalgesia,burning,and an electric shock-like sensation stemming from the hyperexcitability of damaged neurons and varicella-zoster virus-mediated inflammatory tissue damage.HZ-related PHN has an incidence of 5%–30%,and in some patients,the pain is intolerable and can lead to insomnia or depression.In many cases,the pain is resistant to pain-relieving drugs,necessitating radical therapy.CASE SUMMARY We present the case of a patient with PHN whose pain was not cured by conventional treatments,such as analgesics,block injections,or Chinese medicines,but by bone marrow aspirate concentrate(BMAC)injection containing bone marrow mesenchymal stem cells.BMAC has already been used for joint pains.However,this is the first report on its use for PHN treatment.CONCLUSION This report reveals that bone marrow extract can be a radical therapy for PHN.
基金Supported by National Natural Science Foundation of China,No.81891004Tianjin Natural Science Foundation of China,No.21JCQNJC01140.
文摘BACKGROUND Intractable postherpetic neuralgia(PHN)can be difficult to manage even with aggressive multimodal therapies.Patients who experience uncontrolled refractory cranial PHN despite conservative treatment may benefit from an intrathecal drug delivery system(IDDS).For craniofacial neuropathic pain,the traditional approach has been to place the intrathecal catheter tip below the level of the cranial nerve root entry zones,which may lead to insufficient analgesia.CASE SUMMARY We describe a 69-year-old man with a 1-year history of PHN after developing a vesicular rash in the ophthalmic division of cranial nerve V(trigeminal nerve)distribution.The pain was rated 7-8 at rest and 9-10 at breakthrough pain(BTP)on a numeric rating scale.Despite receiving aggressive multimodal therapies including large doses of oral analgesics(gabapentin 150 mg q12 h,oxycodone 5 mg/acetaminophen 325 mg q6 h,and lidocaine 5%patch 700 mg q12 h)and sphenopalatine ganglion block,there was no relief of pain.Subsequently,the patient elected to have an implantable IDDS with the catheter tip placed at the interpeduncular cistern.The frequency of BTP episodes decreased.The patient’s continuous daily dose was adjusted to 0.032 mg/d after 3 mo of follow-up and stopped 5 mo later.He did not report pain or other discomfort at outpatient follow-up 6 mo and 1 year after stopping intracisternal hydromorphone.CONCLUSION The use of interpeduncular cistern intrathecal infusion with low-dose hydromorphone by IDDS may be effective for severe craniofacial PHN.
文摘BACKGROUND Primary trigeminal neuralgia can achieve satisfactory results through clinical treatment and intervention.The pathogenesis of neuralgia caused by varicellazoster virus infection of the trigeminal nerve is more complex,and it is still difficult to relieve the pain in some patients simply by drug treatment or surgical intervention.CASE SUMMARY A 66-year-old woman was hospitalized with herpetic neuralgia after herpes zoster ophthalmicus(varicella-zoster virus infects the ophthalmic branch of the trigeminal nerve).On admission,the patient showed spontaneous,electric shocklike and acupuncture-like severe pain in the left frontal parietal region,and pain could be induced by touching the herpes area.The numerical rating scale(NRS)was 9.There was no significant pain relief after pulsed radiofrequency and thermocoagulation of the ophthalmic branch of the trigeminal nerve.Combined with patient-controlled intravenous analgesia(PCIA)with esketamine,neuralgia was significantly improved.The patient had no spontaneous pain or allodynia at discharge,and the NRS score decreased to 2 points.The results of follow-up 2 mo after discharge showed that the NRS score was≤3,and the Pittsburgh Sleep Quality Index score was 5 points.There were no adverse reactions.CONCLUSION Trigeminal extracranial thermocoagulation combined with esketamine PCIA may be a feasible method for the treatment of refractory herpetic neuralgia after herpes zoster ophthalmicus.
文摘Objective:To systematically evaluate the safety and efficacy of acupuncture on patients with postherpetic neuralgia.Methods:Based on the heyword retrieval method,China National Knowledge Infrastructure(CNKI,1978-2020),China Biomedical Literature database(CBM,1979-2020),VIP database(WEIPU,1989-2020),Wanfang database(1989-2020),Cochrane Library,PubMed,and Embase were searched;randomized controlled trials of the use of acupuncture in the treatment of postherpetic neuralgia were screened out;the quality of the included literatures was evaluated based on the evaluation criteria in the Cochrane Handbook,and meta-analysis was performed using RevMan 5.3.Results:Twenty-six literatures that met the criteria,involving 2,174 patients,were included;the meta-analysis showed that compared with western medicine,the use of acupuncture can improve the overall effective rate(RR=1.24,95%CI[1.17,1.32],P<0.00001)and reduce the VAS score(MD=-1.43,95%CI[-1.97,-0.89],P<0.00001).Conclusion:The use of acupuncture can further improve the clinical effect of patients with postherpetic neuralgia.
基金funded by the National Natural Science Fund of China(No.81872216)the PUMC Postgraduate Education and Teaching Reform Project in 2018(No.10023201801701).
文摘Introduction:Postherpetic neuralgia(PHN)is a painful condition that occurs after herpes zoster skin lesions have subsided and that lasts for more than 1 month.PHN is usually difficult to treat.Case presentation:Patient 1 was a 54-year-old woman who had PHN for 35 days.Patient 2 was a 74-year-old woman who had PHN for 65 days.Both patients were treated with an epidural block and found to have spinal metastasis from a malignant tumor.Discussion:The routinely used dermatological medications for the treatment of herpes zoster and PHN have slow and unsatisfactory analgesic effects.Epidural block treatment provides a new approach for patients who cannot tolerate or do not respond to these commonly used drugs.Physicians should pay special attention to patients who have a history of a malignant tumor or are suspected to have spinal disease.Computed tomography or magnetic resonance imaging of the spine is recommended for such patients,and epidural block treatment should be performed after a spinal tumor or other lesions have been excluded.Conclusion:Epidural block treatment provides a new approach for patients of herpes zoster or PHN,but the treatment should be performed after a spinal tumor or other spinal lesions have been excluded.
文摘OBJECTIVE:To investigate the effectiveness of electroacupuncture at Jiaji acupoints(EX-B 2)plus moxibustion and intermediate frequency on postherpetic neuralgia(PHN).METHODS:A total of 140 outpatients who satisfied the inclusion criteria and volunteered for this treatment were randomly divided into treatment(n=70)and control(n=70)groups.Both groups received a localized lesion area and electroacupuncture treatment combined with moxibustion and intermediate frequency.The treatment group(TG)increased acupuncture at Jiaji acupoints(EX-B 2)and electroacupuncture.Pain and anxiety were assessed before and after 5,10,15,and 20 treatments by using visual pain simulation score(VAS)and Hamilton anxiety scale(HAMA),respectively.Clinical efficacy was also evaluated.RESULTS:The baseline between the two groups did not significantly differ(P>0.05).The VAS and HAMA scores of the two groups after treatment significantly decreased compared with those of various treatment stages(P>0.05).The HAMA score(P<0.01)of TG was lower than that of the control group(CG).The VAS score of TG was lower than that of CG in the 5th and 10th treatments(P<0.01).In the 15 th and 10 th scores,CG was also superior to TG(P<0.05).CONCLUSION:The combined treatment of electroacupuncture at Jiaji acupoints(EX-B 2),moxibustion,and intermediate frequency can relieve the pain and anxiety symptoms of PHN.The efficacy of the combined treatment was superior to traditional acupuncture.
基金supported by Taihe Hospital, Hubei University of Medicine
文摘Objective: To observe the therapeutic efficacy of Fu's subcutaneous needling(FSN) with laser for postherpetic neuralgia and analyze its action mechanism. Methods: A total of 102 cases with postherpetic neuralgia were randomly allocated into a treatment group and a control group, 51 in each group. FSN with laser was used for patients in the treatment group, whereas electroacupuncture was used for patients in the control group. After 6 months of treatment, the total effective rates, action time and cure courses in recovery cases were compared between the two groups. Three months after the treatment was completed, a follow-up was done to compare relapse rates between the two groups. Results: The recovery and total effective rates in the treatment group were 56.9% and 94.1% respectively, versus 35.3% and 68.6% in the control group, showing statistical differences(P<0.05); the action time and cure courses in the observation group were significantly shorter than those in the control group(P<0.05); the relapse rate in the treatment group was 6.9%, versus 44.4% in the control group, showing a statistical difference(P<0.05). Conclusion: FSN with laser can obtain better effect for postherpetic neuralgia than electroacupuncture and pose lower relapse risks.
文摘BACKGROUND Varicella zoster virus(VZV)is a human neurotropic and double-stranded DNA alpha-herpes virus.Primary infection with VZV usually occurs during childhood,manifesting as chickenpox.Reactivation of latent VZV can lead to various neurological complications,including transverse myelitis(TM);although cases of the latter are very rare,particularly in newly active VZV infection.CASE SUMMARY We report here an unusual case of TM in a middle-aged adult immunocompetent patient that developed concomitant to an active VZV infection.The 46-year-old male presented with painful vesicular eruption on his left chest that had steadily progressed to involvement of his back over a 3-d period.Cerebrospinal fluid testing was denied,but findings from magnetic resonance imaging and collective symptomology indicated TM.He was administered antiviral drugs and corticosteroids immediately but his symptom improvement waxed and waned,necessitating multiple hospital admissions.After about a month of repeated treatments,he was deemed sufficiently improved for hospital discharge to home.CONCLUSION VZV myelitis should be suspected when a patient visits the outpatient pain clinic with herpes zoster showing neurological symptoms.
基金Supported by the Academic Experience Inheritance of the Seventh Batch of National Senior TCM Experts:2021-272The seventh batch of national academic experience inheritance work construction project of veteran traditional Chinese medicine experts:2022-76Zhejiang TCM Science and Technology Program:2023ZR030。
文摘This article introduces the clinical experience of Professor Jian-qiao FANG in treatment of postherpetic neuralgia(PHN)with acupuncture and moxibustion.Jian-qiao FANG believes that PHN is characterized by“stagnation”and“deficiency”in pathogenesis and it is treated by“resolving stasis”and“replenishing for deficiency”.Electroacupuncture is predominated in treatment and the combined regimen of various techniques of acupuncture and moxibustion is adopted in therapeutic strategy.According to the pain characteristics of patients,the acupuncture and moxibustion prescription is drafted for resolving stasis and masses,replenishing for deficiency and regulating the mind.The acupoints include Ashi points,Jiaji(EX-B2),Hegu(LI4),Waiguan(TE5),Zusanli(ST36),Sanyinjiao(SP6),Shenting(GV24),Baihui(GV20)and Sishencong(EX-HN1).In treatment with electroacupuncture,the stimulation parameters are selected flexibly according to different pain characteristics.The frequency of 2/100 Hz is the first option,100 Hz is used for the acute seizure and 2 Hz is for mild pain.After electric stimulation,the treatment with roller type of dermal needle and moxibustion can be applied to ensure clinical efficacy.
基金Supported by Innovation Fund of China Academy of Chinese Medical Sciences:CI2021A03503Fundamental Research Funds for the Central Public Welfare Research Institutes:ZZ13-024-9+1 种基金"The Belt and Road"TCM Cooperation Project of China Academy of Chinese Medical Sciences:GH201901China Center for Evidence Based Traditional Chinese Medicine:2020YJSZX-1。
文摘Objective:To summarize the available evidence of acupuncture for pain relief in the patients with postherpetic neuralgia(PHN)using a scoping review.Methods:Seven electronic databases of the original studies of acupuncture on PHN were retrieved.The search time was from the inception to May 1,2021.Two researchers screened the title,abstract and full text of each article independently.The original studies that was met the inclusion criteria were collected and analyzed,and finally presented with a qualitative description.Results:A total of 216 original studies were eligible and all of them were randomized controlled trials.The acupuncture therapies with the highest use frequency included manual acupuncture,pricking and cupping and electroacupuncture.Acupuncture therapies were mostly combined with other interventions in studies.There were large differences in acupoint selection,time duration for single treatment and the total treatment times.It was believed in all of the included studies that acupuncture was effective of pain relief in PHN and 85.65%of the studies obtained the minimum clinical importance difference(MCID),suggesting the clinical effectiveness.The adverse reaction of acupuncture was low in its incidence,and mostly transient in occurrence.Conclusion:The study type of acupuncture for PHN is relatively simple.Most studies show the advantages of acupuncture in pain relief of PHN.The quality of study needs to be improved.
