Serpentine sores (shingles)
Herpes zoster, also known as herpes zoster, is a viral infection. The disease is mostly caused by emotional disorders and dietary disorders, resulting in loss of spleen health, internal stagnation of dampness and heat, and the onset of dampness and heat and poisonous evil.
I. Diagnosis
For diagnosis in Chinese medicine, please refer to the “Chinese Medicine Treatment Guide for Common Diseases in Dermatology”.
Western medicine diagnosis refers to the Clinical Diagnosis and Treatment Guide-Dermatology and Venereal Diseases (edited by the Chinese Medical Association, People’s Health Publishing House) and the Clinical Technical Practice Guidelines-Dermatology and Venereal Diseases (edited by the Chinese Medical Association, People’s Military Medical Publishing House).
Second, the Chinese medicine treatment plan
(I) Heat-rich type.
Main evidence: local lesions are bright red, the walls of the blisters are tense, burning and stinging. Feeling of bitterness and dryness of the mouth, thirst, irritability, poor appetite. Urine is red, stool is dry or unpleasant. The tongue is red, with thin yellow or thick yellow tongue coating and a smooth, slightly counted pulse.
Treatment: Clear damp-heat, detoxify and relieve pain.
Remedy: Gentian and liver diarrhea soup with addition and subtraction.
Gentiana 10g, Scutellaria 10g, Gardenia 10g, Panax quinquefolium 15g, Daphyllium 15g, Zeligia 10g, Plantago 15g, Yuanhu 10g, Radix Paeonia 10g, Radix Glycyrrhiza 10g.
Add chrysanthemum if it occurs on the head and face; add mulberry branch and ginger yellow if it occurs on the upper extremities; add hyssop if it occurs on the lower extremities; add dandruff and white foxglove if it occurs in blood blisters; add raw gypsum and Zhi Mu if the mouth is dry and thirsty; add rhubarb if the stool is dry; add double flower and gong ying if the rash is secondary to bacterial infection; add astragalus if the body is old and weak.
Chinese patent medicine: available gentian diarrhea liver pill plus plate blue root punch.
Topical treatment: when erythema, small blisters can be used 30g of Xionghuang Detoxification San, 3g of Chemical Poison San mixed with water or fresh amaranth or cabbage gang pounded and mixed with dressing. When the vesicles are broken, use boric acid and double yellow lian liquid (3% boric acid liquid 2000m1 plus double yellow lian 0.6g) to clean up and wet compress, and water gauze to apply. When scabbing, use the ointment of chemotoxin and Huanglian.
(B) Dampness type
Main evidence: lighter skin color, relaxed herpes wall, slightly light pain, no thirst or thirst without desire to drink, not thinking about eating and drinking, abdominal distension after eating, end of stool, leucorrhea is common in female patients. The tongue is light and fat, the tongue coating is white and thick or white and greasy, the pulse is sluggish or slippery.
Treatment: Strengthening the spleen and relieving dampness, with detoxification.
Formula: Fu Ling 15g, Atractylodes Macrocephalae 10g, Chen Pi 10g, Hou Pu 10g, Da Qing Ye 15g, Sheng Cai 30g, Ze Di 10g, Yuan Hu 10g, Che Qian Zi 15g, Sheng Gan Cao 10g.
(C) Qi stagnation and blood stasis type.
Main Evidence: Local pain persists after the rash subsides. Dark tongue, white fur, thin pulse.
Treatment: Promote blood circulation to resolve blood stasis, promote qi circulation to relieve pain and clear residual toxins.
Treatment: Promoting Blood circulation and dispersing blood stasis with addition and subtraction.
Peach kernel 10g, safflower 10g, chicken blood vine 15g, ghost arrow feather 15g, yuan hu 10g, neem 10g, ground dragon 10g, mullein 6g, Chen Pi 10g, double flower vine 15g.
For those who still have strong positive energy, Chuanjun is added to break the stasis; for those who are old and weak, raw Astragalus and Radix Codonopsis are added to support positive energy.
III. Effect of TCM treatment
(A) Improve clinical symptoms, shorten the course of the disease, and reduce posterior neuralgia.
(2) Reduce the dosage of western medicine and reduce the side effects of western medicine.
IV. Difficulties in Chinese medicine treatment
Some patients have severe neuralgia, and although modern medicine has non-steroidal anti-inflammatory drugs, tricyclic antidepressants, carbamazepine, tramadol, gabapentin, etc., which are used to relieve pain, their gastrointestinal reactions and other side effects are common.
V. Response ideas of Chinese medicine treatment for the difficulties
Chinese medicine has certain advantages in treating herpes zoster neuralgia and post-herpetic neuralgia, which should be actively explored.
Characteristic therapies of Chinese medicine
(1) Acupuncture method
Acupuncture can effectively raise the patient’s pain threshold, improve local circulation, and be antibacterial and anti-inflammatory. For the treatment of herpes zoster, acupuncture points of the back and Hua Tuo are selected for the trunk, Qu Chi, Hand San Li, Foot San Li, Yang Ling Quan, Blood Sea, and San Yin Jiao for the extremities, and Bai Hui and Feng Chi for the head. The needles were kept for 15 min each time and performed once at an interval of 5 min. Acupuncture once a day, 7 times for a course of treatment.
(2) Moxibustion method
Use 2 moxa sticks for extensive circular moxibustion on the lesion and its surrounding skin at the same time.
(3) Acupoint injection
The points are selected from the normal skin between the clusters of blisters at the lesion site for injection. (1) for hepatobiliary type, then select Yanglingquan, Xingma, Manxi, Taichong, Waiguan, and Shimen of foot Shaoyang and Conjugate Yin meridians for injection to drain the depressed fire of liver and gallbladder; (2) for spleen and stomach type, select Yinlingquan, Sanyinjiao, Foot Sanli, and Quchi of foot Taiyin and Yangming meridians for injection to clear heat and promote dampness. Treatment: Extract vitamin B12ml, vitamin B121ml, 2% lidocaine 2ml mixed and inject around 2-3 places around the herpes. At the same time, select 2-3 meridian points according to the evidence for acupoint injection, 1ml per point, 1 time per day.
10 times for a course of treatment.