[Abstract] Objective To observe the efficacy of acupoint injection of interferon in the treatment of herpes zoster. Methods Seventy-six patients with herpes zoster were randomly divided into 39 cases in the treatment group and 37 cases in the control group, and the treatment group was treated with acupoint injection of interferon and the control group was treated with intramuscular injection of interferon, and the clinical efficacy was compared and observed. Results Clinical observation, the efficiency of the treatment group was 92.3%; the efficiency of the control group was 70.2%. There was a significant difference (P<0.01) in the comparison of clinical observation of blistering, crusting and pain relief in the two groups. Conclusion Acupoint injection of interferon for herpes zoster can significantly reduce the pain, shorten the course of the disease and improve the cure rate.
Herpes zoster is an acute herpetic skin disease caused by varicella-zoster virus. The virus is neurophilic and causes clusters of herpes in bands along the innervated areas of the skin, accompanied by neuralgia. The onset of the disease is called “herpes zoster” because it follows the course of the nerve and is strip-like; it can also invade the head, face and ears and cause facial nerve paralysis called Ramsay Hunt syndrome. In recent years, the author used acupuncture point injection interferon to treat 39 cases of herpes zoster, and compared with the control group of 37 cases of intramuscular injection interferon treatment, is reported as follows.
1, clinical data
1.1 General data 76 patients were outpatients and inpatients of our hospital, clearly diagnosed according to herpes zoster diagnostic criteria [1]; herpes zoster lesions not more than 5 days; no serious organic diseases such as heart and kidney and autoimmune diseases such as diabetes, lupus erythematosus and dermatomyositis. Exclusion criteria: herpes zoster lesions for more than 5 days; pregnant and lactating women; severe cardiopulmonary disease; central nervous system comorbidities; local secondary infections (bacterial, fungal) of the lesions.
The 76 patients were divided into 2 groups according to the randomization principle: 39 patients in the treatment group, 21 males and 18 females; age (52±6.4) years; duration of disease (3.3±1.1) days; including 13 cases of Ramsay Hunt syndrome. In the control group, there were 37 cases, 21 males and 16 females; age (53±6.0) years; duration of illness (3.5±1.2) days; 11 cases of Ramsay Hunt syndrome. there were no significant differences in age, sex, duration of illness and condition between the two groups (P>0.05), which were comparable.
1.2 Treatment method
In the treatment group, two acupuncture points were selected according to the distribution of the rash. For herpes zoster on the chest and back, acupuncture points of the bladder meridian above and below the same nerve segment were taken according to the direction of the nerve under the distribution of the rash. If the rash is distributed from the dorsal band to the flat navel, which is the tenth segment of the thoracic nerve, take the “Liver and Gallbladder” point 1.5 inches below the spinous process of the ninth and tenth thoracic vertebrae, and so on for other parts of the lesion. Ramsay Hunt syndrome, “cataract” point, etc.
The acupuncture point should not have herpes distribution at the site of entry. The acupuncture points were strictly disinfected with 2.5% iodine and 75% alcohol, and a single-use sterile syringe was used to inject 1 million IU of recombinant human interferon α-2b (produced by Anhui Anke Biological Engineering Co., Ltd.) into each acupuncture point; 1 ml was injected once daily for 10 days.
In the control group, the same type and dose of interferon was injected intramuscularly once a day for 10 days.
For those with severe herpes lesions, topical application of 2% gentian violet was applied.
1.3 Observation items and indicators Subjective symptoms:including the time and degree of occurrence and disappearance of local pain, itching and burning sensation. Objective symptoms: number of blisters, crusting of blisters, color of erythema, and area of red shift. The time of stopping the appearance of new blisters, the time of starting to reduce and recede of blisters, the time of starting to crust and the time of all crusts falling off were also observed according to the four-level scoring method. The scoring was performed with reference to the criteria in Table 1, and observations were made before treatment, and on the 3rd, 7th and 14th days after starting treatment.
The efficacy was classified into four levels: cured, effective, efficient and ineffective. Cured: the efficacy index was 100%; effective: the treatment index decreased by 60% to 99%; effective: the treatment index decreased by 30% to 59%; ineffective: the treatment index decreased by <30%. Therapeutic index = (pre-treatment points - post-treatment points)/pre-treatment points × 100%. The total effective rate includes both cured and apparent cases.
Table 1 Scoring criteria for subjective and objective symptoms of herpes zoster
Symptoms and signs 0 points 1 point 2 points 3 points
Subjective symptoms Pain Vaguely felt symptoms Mild, often felt symptoms, Moderate, often felt symptoms
Itching No symptoms Tolerable, does not affect daily life Tolerable, but affects daily life
Burning sensation
Objective symptoms Number of blisters (pcs) 0 <25 26~50 >50
Blister changes Few dry crusts or blisters dry crusts dry blisters broken crusts cloudy vesicles or broken light exudation
Hyperpigmentation and hypochromia
Erythema color None Pale red Flushed red Flushed with swelling
Erythema area(cm2) None <10 10~20 >30
2. Results
2.1 Comparison of the time of regression of symptoms and signs between the two groups See Table 2
Group Time to stop blistering Time to stop scabbing Time to stop pain Time to heal skin lesion
Treatment group 1.31±0.58 6.24±3.52 3.45±2.12 11.9±3.21
Control group 2.12±0.68 8.59±4.29 7.68±3.82 13.87±3.64
t 5.57 2.06 5.93 2.50
P <0.001 <0.01 <0.001 <0.01
2.2 Comparison of the efficacy of the two groups See Table 3
Group n Cured Effective Improved Ineffective Total effective rate %
Treatment group 39 29 7 2 1 92.31)
Control group 37 17 9 7 4 70.2
Note: Comparison with the control group 1) X2=4.61 P<0.05
2.3 Adverse reactions Twenty-nine patients in the treatment group and 26 patients in the control group had transient hypothermia (temperature <38.5OC) with aching limbs on the day after injection, which mostly disappeared on its own the next day, and 24 cases only took "anti-inflammatory pain" tablets orally once.
3. Discussion
The herpes zoster disease is called “string waist dragon” and “tangled waist fire dan” in Chinese medicine, which is thought to be caused by the fire of liver and gallbladder and the stagnation of spleen dampness for a long time, and the external poisonous evil. Modern research shows that when the body’s immunity decreases, the virus latent in the nerve cells will multiply, causing inflammation and necrosis of the ganglion, resulting in clusters of herpes arranged in bands along the innervated skin area, accompanied by neuralgia. The virus has a neurophilic character and most of the attacks always follow the course of the nerves in a strip-like pattern, hence the name “herpes zoster”.
Interferon has a broad-spectrum antiviral effect, but it does not directly inactivate the virus, but inhibits its replication. Interferon has been used to treat herpes zoster in China [3], with similar efficacy to the control group (intramuscular injection) in this paper.
Because the pharmacokinetics of interferon is different from that of antibiotics,interferon has a short half-life when injected intravenously; a relatively long half-life when injected intramuscularly; and a better effect when administered topically (local injection), the application of topical interferon topical therapy has gradually increased in recent years [4].
Acupoint injection therapy is a new therapy formed by combining the drug injection method commonly used in modern Western medicine with the acupuncture method in Chinese medicine.
It is based on the therapeutic effect of acupuncture points and the pharmacological effect of drugs, the corresponding meridian-acupuncture points and the pharmacological effect of drugs are selected, and the appropriate amount of drug solution is injected into the acupuncture points to stimulate the meridian points through the dual action of acupuncture and drugs, giving full play to the comprehensive effect of meridian-acupuncture points and drugs on diseases and the human body, and then adjusting and improving the pathological state of the body functions and disease tissues, so that the body’s qi and blood flow smoothly This treatment uses interferon in combination with acupuncture and moxibustion.
The good efficacy of this treatment with interferon combined with acupuncture point injection method confirms the main characteristics of interferon pharmacokinetics. This method is suitable for the treatment of typical cutaneous herpes zoster and the acute phase of Ramsay-Hunt syndrome. Compared with the intramuscular injection treatment method, the onset of action is early, the symptoms and signs disappear quickly, and the cure time is shortened, indicating superiority over the conventional intramuscular injection treatment method, which is worthy of clinical promotion.