Effects of bloodletting pricking, cupping and surrounding acupuncture on inflammation-related indices in peripheral and local blood in patients with acute herpes zoster.
To observe the effects of bloodletting pricking, cupping and surrounding acupuncture on blood inflammation-related indices in patients with acute herpes zoster (HZ), and to explore the mechanism of pain control and treatment.
A total of 60 patients were randomly divided into an observation group and a control group, 30 cases in each one. In the observation group, the patients were treated with bloodletting pricking at herpes, followed by cupping treatment; also the surrounding acupuncture was performed at injured skin. The treatment was given once a day and once every other day after the first 3 days; totally one-week treatment was given. In the control group, the patients were treated with intravenous drip of acyclovir and oral administration of vitamin B1 and B12, once a day for total one week. The visual analogue scale (VAS) and percentages of neutrophil, lymphocyte in peripheral and local blood were observed before and after treatment in the two groups.
After treatment, the score of VAS was significantly reduced in both groups (both P < 0.05); compared with the control group, the score of VAS and the time of pain relieve were significantly improved in the observation group (P < 0.01, P < 0.05). Compared before treatment, the percentages of lymphocyte in peripheral and local blood were reduced after treatment (both P < 0.05) and the percentages of neutrophil in local blood were increased (both P < 0.05). The lymphocyte in local blood was also reduced after treatment in the control group (P < 0.05); compared with peripheral blood in the observation group and local blood in the control group, the percentages of lymphocyte in local blood were reduced (both P < 0.05).
The efficacy of bloodletting pricking, cupping and surrounding acupuncture on acute herpes zoster is positive, and it can significantly lower the number of lymphocytes in the local blood and increase the number of neutrophil, which is likely to be one of the anti-virus mechanisms.
Comparison of therapeutic effects of different types of acupuncture interventions on herpes zoster in acute stage
To compare the therapeutic effects of different types of acupuncture therapy on herpes zoster (acute stage).
A total of 189 cases of acute herpes zoster outpatients and inpatients were recruited in the present multicenters (3 hospitals) randomized controlled clinical trials. They were divided into (computer-aided random allocation): basic acupuncture (n = 36), cotton moxibustion (n = 35), fire needle (n = 43), tapping-cupping (n = 39) and medication (n = 36) groups. Ashi-points (around the locus), Jiaji (EX-B 2), Zhigou (SJ 6) and Houxi (SI 3) were used in this study. For patients of the acupuncture group, the abovementioned acupoints were punctured with filiform needles (encircled needling around the affected loci) and also stimulated with electroacupuncture (EA). For patients of the cotton moxibustion group, thin defated dry cotton pieces put over the Ashi-point were ignited, 3 times altogether, followed by EA and encircled needling stimulation which were the same to those in the basic acupuncture group. Patients of the fire needle group were treated by pricking the herpes (3-5 in number) with a hot-red needle, followed by EA and encircled needling treatment. Patients of the tapping-cupping group were treated by tapping Ashi-points repeatedly with a percussopunctator and cupping over the pricked region, followed by EA and encircled needling treatment. Patients of the medication group were treated by oral administration of Valaciclovir Hydrochlordide (300 mg/time, twice a day) and vitamin B1 (10 mg/time, t. i.d.) for 10 days. The acupuncture-moxibustion treatment was given once daily for 10 days. The time of blister-occurrence cease, scab formation and decrustation was recorded, and pain degree was evaluated using visual analog scale (VAS). The therapeutic effect was assessed according to the related standards.
There were no significant differences among the 5 groups in the time of blister-occurrence cease, scab formation and decrustation, and in the therapeutic effect (P > 0.05). The VAS scores of the 5 groups were decreased gradually and apparently along with the treatment (P < 0.05), suggesting a pain relief after the treatment. In comparison with the medication group, the VAS scores of the basic acupuncture group, cotton moxibustion group, fire needle group and tapping-cupping group were significantly lower from the 7th day on following the treatment (P < 0.05).
Acupuncture plus encircled needling and acupuncture plus encircled needling combined with cotton-moxibustion, or with fire needle stimulation, or with tapping and cupping are effective in the treatment of herpes zoster at the acute stage, being comparable to the medication in the clinical curative effect and improvement of blisters, and better than medication in pain relief.
Acupuncture in acute herpes zoster pain therapy (ACUZoster) – design and protocol of a randomised controlled trial.
Acute herpes zoster is a prevalent condition. One of its major symptoms is pain, which can highly influence patient’s quality of life. Pain therapy is limited. Acupuncture is supposed to soften neuropathic pain conditions and might therefore act as a therapeutic alternative. Objective of the present study is to investigate whether a 4 week semi-standardised acupuncture is non-inferior to sham laser acupuncture and the anticonvulsive drug gabapentine in the treatment of pain associated with herpes zoster.
Three-armed, randomised, placebo-controlled trial with a total follow-up time of 6 months. Up to estimated 336 patients (interim analyses) with acute herpes zoster pain (VAS > 30 mm) will be randomised to one of three groups (a) semi-standardised acupuncture (168 patients); (b) gabapentine with individualised dosage between 900-3600 mg/d (84 patients); (c) sham laser acupuncture. Intervention takes place over 4 weeks, all patients will receive analgesic therapy (non-opioid analgesics: metamizol or paracetamol and opioids: tramadol or morphine). Therapy phase includes 4 weeks in which group (a) and (c) consist of 12 sessions per patient, (b) visits depend on patients needs. Main outcome measure is to assess the alteration of pain intensity before and 1 week after treatment sessions (visual analogue scale VAS 0-100 mm). Secondary outcome measure are: alteration of pain intensity and frequency of pain attacks; alteration of different aspects of pain evaluated by standardised pain questionnaires (NPI, PDI, SES); effects on quality of life (SF 36); analgesic demand; alteration of sensoric perception by systematic quantitative sensory testing (QST); incidence of postherpetic neuralgia; side effects and cost effectiveness. Credibility of treatments will be assessed.
This study is the first large-scale randomised placebo controlled trial to evaluate the efficacy of acupuncture compared to gabapentine and sham treatment and will provide valuable new information about the clinical and physiological effects of acupuncture and gabapentine in the treatment of acute herpes zoster pain. The study has been pragmatically designed to ensure that the study findings can be implemented into clinical practice if acupuncture can be shown to be an effective treatment strategy in acute herpes zoster pain.