Herpes zoster is an acute herpetic skin disease caused by the herpes virus, which can occur in any part of the body, but is more common in the lumbar region, and is more common along the intercostal nerves. The disease is similar to the “waist-wrapping sores” and “snake-string sores” recorded in the “Treatise on the Origin of Diseases”, and is called “retort sores”, “spider sores” in the “Surgery Qixuan”, and “waist-wrapping sores” in the “Medical Jinjian”. The disease is most common when it occurs unilaterally, and is characterized by clusters of small blisters arranged in a band, with severe pain.
Etiology]
The common cause of this disease is internal injury, liver and gallbladder fire or spleen loss of health, dampness and turbidity, resulting in the accumulation of damp-heat and poisonous evil.
Diagnostic points]
(a) Cluster of blisters along one side of the nerve distribution area, arranged in a band, with unilateral rash, mostly not exceeding the midline of the body surface.
(B) The lymph nodes nearby are enlarged.
(c) Pain is obvious and may occur before the rash or with the rash, and older patients often have prolonged neuralgia after the damage subsides.
Treatment]
(A) Liver and gallbladder fire type
Main evidence: This type is erythematous type, also called dry type. Before the onset of the disease, there is burning and pinching pain in the affected skin, mild fever, bitter mouth and drinking, irritability, yellow urine, red tongue, thin yellow or greasy coating, smooth or string pulse. The rash mostly occurs on one side of the body, such as the waist and ribs or chest (other areas such as the face and lower extremities may also appear). The rash is a red papular rash with a red base, tired as a string of pearls, band-like distribution, the herpetic fluid is initially transparent, followed by turbidity, more than ten days later, crusting, drying, shedding, most patients still pain for a period of time after the rash subsides.
Analysis of the disease mechanism: the liver is the main tendon, the nature of the liver and gallbladder, the liver and gallbladder are adjacent to each other, chest, ribs, femur are the distribution of liver and gallbladder parts. If anger and anger, internal injury, liver qi stagnation, heat and fire, resulting in liver and gallbladder fire, burning the skin, easy to violate the meridian parts, so the lumbar ribs, chest and other places to occur in a group of blisters such as band, local skin flushing, burning and pain, dry mouth, bitter thinking about drinking, irritable heart, urination red. The signs shown in the tongue and pulse are all signs of liver and gallbladder fire.
Treatment: Clearing heat from the liver and gallbladder, activating blood circulation and relieving dampness.
Prescription: Gentian and liver diarrhea soup with reduction
Examples of prescriptions: Gentiana 10g Radix Scutellariae 10g Radix Scutellariae 6g Gardenia 10g
Radix Rehmanniae 30g Radix Angelicae Sinensis 10g Neem 12g Yuanhu 12g
Plantago ovata decoction 12g Mouton 10g Da Qing Ye 15g
Addition and subtraction: If the fire is very toxic, add Panax notoginseng, dandelion, forsythia, etc. to clear heat and detoxify; if the local pain is severe, add peony, frankincense, myrrh, etc. to dredge the liver and relieve pain.
(II) Spleen-dampness type
Main symptoms: Cluster of blisters or large blisters on the skin, fusion and erosion, loose wall of blisters, flowing water after breaking, light pain and heavy itching, lack of appetite, fullness and stuffiness, pale color of urine, slightly light tongue, white greasy coating, sunken or slightly slippery pulse.
Treatment: Strengthening the spleen and eliminating dampness, accompanied by clearing heat.
Remedies: De-Dampness and Stomach Ling Tang plus reduction
Example of prescription: Atractylodes macrocephala 10g, Thicket 10g, Chen Pi 10g, Coix Seed 30g
Muxiang 6g, Poria 12g, Zelig 15g, Plantago 15g
Baicalin 10g
(C) Qi stagnation and blood stasis type
Main Evidence: Generally the rash is purple and dark in color, the herpes remains for a long time, the pain is prolonged, it is common in elderly patients, they are easily irritated, sleep is restless, the tongue is dark red or with petechiae, the moss is thin and white, the pulse is thin and astringent or thin and smooth.
Treatment: Diversify liver and qi, activate blood circulation to resolve blood stasis, promote blood circulation and relieve pain.
Treatment: Diversify the liver and Qi, invigorate blood circulation and resolve blood stasis, promote blood circulation and relieve pain.
Examples of prescriptions: Radix Rehmanniae 15g Radix Angelicae Sinensis 10g Radix Paeoniae Alba 10g Peach kernel 12g
Safflower 10g Bupleurum 10g Yujin 10g Neem 12g
Yuan Hu 12g Silkworm 6g Myrrh 3g
Addition and subtraction: If dry mouth and throat, irritable heart, palm fever, poor sleep at night, red tongue with less coating, liver and kidney yin deficiency, the above to remove peach kernel, yujin, loofah, add tortoise board (hot), salt cypress, Zhi Mu, Bai Wei, Yuan Shen, etc. to nourish yin and remove deficiency heat.
External treatment]
The dry type of liver and gallbladder fire, with “new Sanmyo San”; spleen dampness of the wet type, with “Qingdi San”; Qi stagnation, blood stasis, rash purple type, with “soft cream”.
Prevention and care
(a) Pay attention to rest, emotional stability, do not be anxious, build confidence to overcome the disease.
(2) Avoid eating fish, shrimp, chicken and duck and other hairy food and spicy stimulating food.
(c) Patients with severe and prolonged illness, especially the elderly, should be cautious, and internal organs examination is recommended to exclude other diseases.