Herpes zoster is an acute inflammatory skin disease caused by the varicella zoster virus, which is known in Chinese medicine as “tangle waist fire dragon” and “tangle waist fire dan”. It is also commonly known as “snake sores” and “spider sores”.
It is characterized by clustered blisters that are distributed in clusters along one side of the peripheral nerve, often accompanied by significant neuralgia.
It is latent in the posterior spinal ganglion or cranial ganglion, and a weakened immune system can trigger the reemergence of varicella zoster virus, which grows and multiplies and spreads to the skin along the peripheral nerves, resulting in herpes zoster. Patients with herpes zoster generally have lifelong immunity to the virus. However, there are recurrent episodes.
I. Etiology.
VZV is now named human herpesvirus type 3 (HHV-3), a brick-shaped virus with a three-dimensional symmetrical capsid containing a double-stranded DNA molecule that is less resistant to the in vitro environment and loses its activity quickly in a dry scab. Children who are immune to this virus are infected and develop chickenpox. Some patients are infected and become carriers of the virus without developing symptoms. Because the virus is neurophilic, it can be latent in the neurons of the posterior root ganglion of the spinal nerve for a long time after infection. When the resistance is low or when there is exertion, infection, cold and fever, anger and fire, the virus can grow and multiply again and move along the nerve fibers to the skin, causing intense inflammation of the invaded nerve and skin. The rash is usually unilateral and distributed by nerve segments, consisting of clusters of herpes and accompanied by pain. The older the person, the more severe the neuralgia. The disease is known as herpes zoster in modern medicine and as snake bile sores, tangled dragons, and flying snakes in folklore.
Second, the characteristics.
Herpes zoster, also known as acute herpes zoster (AHZ), is a kind of varicella-zoster virus (VZV).
Third, the acute herpetic skin disease caused by herpes zoster in the lumbar region.
The pathological mechanism by which this disease occurs is that it causes primary infection in humans with no or low immunity (e.g., children), and the pathogenic VZV virus enters the bloodstream primarily through the respiratory mucosa to form a viremia, or chickenpox. After the symptoms of chickenpox disappear, the infected virus exists in the nerve cells of the spinal nerve or cranial nerve in latent form for a long time. The recurrent infection is herpes zoster. Most people carry the virus for life without recurrent infection. In patients with herpes zoster, antibodies are produced after the disappearance of clinical symptoms and lifelong immunity, and there will be some patients who turn to posterior neuralgia. In case of pancytopenia, one should be alert to the possibility of an underlying immunodeficiency disease or malignancy. We found two cases of consecutive patients with herpes zoster in our consultations, which were recommended to be examined and found to have pancreatic cancer. The earlier the disease is treated properly, the easier it is to cure. On the contrary, the disease will worsen and pain will increase, leaving neuralgia in mild cases and accidents in severe cases.
After the primary infection of this disease, the virus hides in the ganglion and there is no way to remove it yet, and there is no way to predict the time of recurrence, so there is no way to prevent it. However, it has been found that recurrent infection for herpes zoster is closely related to the immune function of the body, such as the elderly, after local trauma, systemic lupus erythematosus, lymphoma, leukemia, AIDS and patients receiving long-term skin hormones, radiation therapy and immunosuppressive drugs are most susceptible to infection, and the duration of the disease is long and heavy, with more prominent posterior neuralgia.
Fourth, the main characteristics of herpes zoster.
1. The disease can develop in both young and old, and is more common in adults with more severe symptoms.
2. The disease can develop in all seasons, with spring and autumn and humid days being the most common.
3. Herpes can appear on any part of the body, with the trunk and face being the most common.
4. The onset of herpes is accompanied by pain, and some patients will continue to have pain after the herpes has crusted over.
5. The blisters and lesions are mostly distributed along a certain peripheral nerve and arranged in bands occurring on one side of the body, not exceeding the midline of the torso.
V. Common treatments.
(A) economic treatment methods for herpes zoster.
1, nerve nutrition oral or intramuscular injection of B vitamins, such as B1: 100mg, B12: 250vg, or B1, methylcobalamin 0.5tid, etc.
2, Antiviral: Famciclovir tablets 500mg. orally, once in 8 hours. Vanaciclovir, 300 mg,orally, 2 times/day. Acyclic guanosine, 200 mg, orally, 5 times/day. Polymyxin 2 mg, intramuscularly, every other day. Interferon, 3 million U, intramuscular injection, 1 time/day.
3.Analgesia: Oral analgesic tablets such as depot pain tablets. Ibuprofen (fenpropathrin) 300 mg orally 2 times/day. Paraspinal ganglion closure therapy, etc.
4. Combination: Triazolyl nucleoside (virazole) 10 mg/kg added to 5% glucose 500 ml IV once a day for 8 times. Auxiliary, while topical rehabilitation new liquid rubbing, severe rupture to rehabilitation new liquid wet compress, a total of 8 d. The efficacy is remarkable.
(B) Herpes zoster home treatment methods.
Keep the infected area clean, dry and exposed to the air as much as possible (without covering with clothing). Do not scratch or break the blisters. If you can’t sleep because of pain, try binding the area with a neat, clean elastic bandage.
Try a cold compress of ice for about 10 minutes every few hours for the first 3 or 4 days. Next, soak a cold moist compress in aluminum acetate, an over-the-counter medication that is available as an astringent solution, or as a powder or tablet.
To alleviate the neurological effects, crush two aspirin tablets, mix them in two tablespoons of antiseptic alcohol, and then apply this paste to the surface of the blister three times a day.
To relieve the itching, ask your pharmacist to mix 78% glyburide lotion, 20% antiseptic alcohol, 1% phenol and 1% menthol. You can apply this mixture continuously until the blisters crust over.
Other treatments for itching include taking vitamin E regularly, or applying a hot bath of colloidal oatmeal to relieve pain.
VI. Prevention.
1. Strengthen physical fitness and improve resistance to disease. The elderly should adhere to appropriate outdoor activities or participate in sports to enhance physical fitness and improve the body’s ability to resist disease.
2.Prevent infection. Infection is one of the causes of this disease. Elderly patients should prevent infection from various diseases, especially in the autumn season, cold and warm, to increase and decrease clothing at the right time, to avoid the cold caused by upper respiratory infection. In addition, inflammation of the oral cavity and nasal cavity should be actively given treatment.
3, prevent trauma. Trauma can easily reduce the body’s ability to resist disease, which can easily lead to the occurrence of this disease. Therefore, elderly patients should pay attention to avoid trauma.
4.Avoid contact with toxic substances. Avoid contact with chemicals and toxic drugs as much as possible to prevent injury to the skin, affect the health of the body and reduce the resistance of the organism.
5.Improve nutrition. The elderly should pay attention to the nutrition of the diet, eat more soy products, fish, eggs, lean meat and other protein-rich treasures and fresh fruits and vegetables, so as to make the body strong and prevent the occurrence of various diseases directly or indirectly related to the disease.
Seven, precautions.
1, do not be overly nervous. Some patients may have large blisters, bloody blisters, or even erosion on the skin, but please do not be nervous, if treated properly it can be cured in about 10 days, and will not usually recur after cure.
2. Take plenty of rest and give an easily digestible diet and plenty of water.
3. In terms of diet avoid eating greasy food, seafood and eggs, poultry also try not to eat, eat some light food.
4. Prevent secondary bacterial infection. Do not rub the affected area to avoid blister rupture. You can use topical Chinese herbs or Revnur wet compresses to promote blister drying and crusting.
5, elderly patients with severe disease, especially in the head and face of herpes zoster, it is best to hospitalization to prevent complications.
6, suffering from “shingles” suggests that the patient’s body immunity is in a low state, should take appropriate measures in a timely manner.
7, some patients still have neuralgia after the lesions have completely disappeared, so acupuncture and physiotherapy can be used to relieve the pain.