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Wei X, Zhang C, Wei W, Yang C, Zheng J, Wang K. Thoracic paravertebral nerve block combined with acupuncture for the treatment of postherpetic neuralgia in the chest and abdomen: A prospective randomized controlled trial. Medicine (Baltimore) 2024; 103:e36823. [PMID: 38579055 PMCID: PMC10994496 DOI: 10.1097/md.0000000000036823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 12/08/2023] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND Postherpetic neuralgia (PHN) is the most common complication of varicella-zoster infection and tends to occur in older people. All patients treated with a single regimen have not achieved consistent success across all current study protocols, and multimodal combination regimens still need to be explored. METHODS A total of 111 patients with PHN were randomly divided into drug group (group A), thoracic paravertebral nerve block group (group B), thoracic paravertebral nerve block combined with acupuncture group (group C), with 37 cases in each group. Group A: received oral gabapentin capsules and external lidocaine gel plaster; group B: combined with thoracic paravertebral nerve block based on group A; group C: combined with acupuncture based on group B. The primary outcome was effective rate, and secondary outcomes included pain sensation score (numerical rating scale), SF-36 quality of life score, and sleep quality. RESULTS Before treatment, there were no significant differences in numerical rating scale value, SF-36 quality of life score, and sleep quality level among the 3 groups (P > .05). After 12 weeks of treatment, the total effective rate of treatment of patients in group C (91.43%) was higher than that in group B (77.14%), and significantly higher than that in group A (51.43%) (P < .05). CONCLUSION Based on drug treatment combined with thoracic paravertebral nerve block and acupuncture, the treatment of PHN in the elderly can quickly and effectively relieve pain, improve the quality of life of patients, and improve the quality of sleep.
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Affiliation(s)
- Xiang Wei
- Department of Anesthesiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Chi Zhang
- Department of Anesthesiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Wei Wei
- Department of Anesthesiology, Sports Hospital Affiliated to Chengdu University of Physical Education, Chengdu, China
| | - Caiqi Yang
- Department of Anesthesiology, Shenzhen Children’s Hospital, Shenzhen, China
| | - Junyi Zheng
- Department of Anesthesiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Kejia Wang
- Department of Anesthesiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
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Pu B, Lu X, Yu P, Wang C, Li J, Yang D, Wang J. Acupoint herbal patching for postherpetic neuralgia: A systematic review and meta-analysis. Medicine (Baltimore) 2024; 103:e37029. [PMID: 38277557 PMCID: PMC10817132 DOI: 10.1097/md.0000000000037029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 01/02/2024] [Indexed: 01/28/2024] Open
Abstract
BACKGROUND This study aimed to systematically evaluate the clinical effectiveness and safety of acupoint herbal patching in the treatment of postherpetic neuralgia. METHODS Eight databases including PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wan-Fang Database, China Biomedical Literature Service System, and Chongqing VIP Chinese Science were searched. The search time was set to October 2023. Two researchers independently screened the literature according to the inclusion and exclusion criteria; extracted the basic information, acupoints, Chinese herbal medicine, pain score, sleep score, depression score, and other information of the subjects, and independently assessed the risk of bias by 2 researchers. Meta-analysis of the included studies was performed using the StataMP 16 software. RESULTS Fifteen studies with 1362 participants were included in this meta-analysis. Ashi is the acupoint frequency at the forefront, and Borneol is the Chinese herbal medicine frequency at the forefront. The acupoint herbal patching group showed significant improvements in visual analog score (SMD: -2.09; 95% Cl: -2.77, -1.42; P < .001), sleep score (SMD: -1.58; 95% Cl: -2.11, -1.05; P < .001), depression score (SMD: -1.61; 95% Cl: -2.22, -0.99; P < .001), Chinese medicine syndrome score (SMD: -2.32; 95% Cl: -2.84, -1.80; P = .06), dermatology life quality index (weighted mean differences: -4.11; 95% Cl: -4.58, -3.63; P = .98), and related laboratory indicators compared to the control group, and the total effective rate was significantly higher (relative risk: 1.20; 95% confidence interval: 1.15, 1.26; P = .99) than the control group. Two studies reported adverse reactions, but the 2 groups were not statistically significant. CONCLUSIONS Acupoint herbal patching intervention in postherpetic neuralgia is effective in improving the pain, sleep, anxiety, depression, quality of life of patients, and related laboratory indicators.
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Affiliation(s)
- Bingyu Pu
- College of Acupuncture-Moxibustion and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Xiaoxue Lu
- College of Acupuncture-Moxibustion and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Peilin Yu
- College of Acupuncture-Moxibustion and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Chengjie Wang
- College of Acupuncture-Moxibustion and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Juan Li
- College of Acupuncture-Moxibustion and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Dianhui Yang
- College of Acupuncture-Moxibustion and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
- The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Jian Wang
- College of Acupuncture-Moxibustion and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
- The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
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He Y, Miao F, Fan Y, Zhang F, Yang P, Zhao X, Wang M, He C, He J. Acupuncture Methods for Piriformis Syndrome: A Protocol for Systematic Review and Network Meta-Analysis. J Pain Res 2023; 16:2357-2364. [PMID: 37465718 PMCID: PMC10350400 DOI: 10.2147/jpr.s417211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 06/24/2023] [Indexed: 07/20/2023] Open
Abstract
Background Piriformis syndrome (PS) is a common disease that is difficult to clinically treat, which seriously affects people's health and living quality. Multiple clinical studies have demonstrated that acupuncture therapy is an effective treatment for PS, but the optimal method of various acupuncture methods has remained unknown. The aim of this study protocol is to compare the efficacy and the safety of different acupuncture methods for PS. Methods We will search seven electronic bibliographic databases (PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, Wanfang Database, Chinese Biomedical Literature Database, and Chongqing VIP Database) from inception to June 2023. Randomized controlled trials (RCTs) will be selected for assessing the effectiveness of acupuncture therapy on PS. Primary outcome measure for this study is pain intensity, and the secondary outcomes are clinical symptoms and signs, physical activity, effective rate, and adverse events. Study selection, data extraction, and risk of bias assessment will be independently completed by at least two reviewers. Then, standard pairwise meta-analysis and network meta-analysis will be conducted using Revman 5.3, Stata V.15.1 and OpenBUGS V.3.2.3. The heterogeneity will be explored by subgroup, meta-regression, and sensitivity analysis, if applicable. Finally, Grading of Recommendations, Assessment, Development and Evaluation (GRADE) pro system will be used to evaluate the quality of evidence. Results Our systematic review and network meta-analysis will identify the best acupuncture treatment method for PS patients. Conclusion The results of our review will help decision-makers make educated choices regarding evidence-based acupuncture management options for PS. Prospero Registration Number No. CRD42022335028.
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Affiliation(s)
- Yujun He
- Faculty of Acupuncture, Moxibustion and Tui Na of Guangxi University of Chinese Medicine, Nanning, 530001, People’s Republic of China
| | - Furui Miao
- Faculty of Acupuncture, Moxibustion and Tui Na of Guangxi University of Chinese Medicine, Nanning, 530001, People’s Republic of China
| | - Yushan Fan
- Faculty of Acupuncture, Moxibustion and Tui Na of Guangxi University of Chinese Medicine, Nanning, 530001, People’s Republic of China
| | - Fangzhi Zhang
- Faculty of Acupuncture, Moxibustion and Tui Na of Guangxi University of Chinese Medicine, Nanning, 530001, People’s Republic of China
| | - Pu Yang
- Graduate School of Guangxi University of Traditional Chinese Medicine, Nanning, 530200, People’s Republic of China
| | - Xinyi Zhao
- Guangxi Zhuang Yao Medicine Center of Engineering and Technology, Guangxi University of Chinese Medicine, Nanning, 530200, People’s Republic of China
| | - Miaodong Wang
- Graduate School of Guangxi University of Traditional Chinese Medicine, Nanning, 530200, People’s Republic of China
| | - Cai He
- Faculty of Acupuncture, Moxibustion and Tui Na of Guangxi University of Chinese Medicine, Nanning, 530001, People’s Republic of China
| | - Jiujie He
- Faculty of Acupuncture, Moxibustion and Tui Na of Guangxi University of Chinese Medicine, Nanning, 530001, People’s Republic of China
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Peng F, He H, Xia T, Lv S. Comparison of a One- versus Two-Week Treatment with Famciclovir Upon Reductions in Pain and Occurrence of Postherpetic Neuralgia in Herpes Zoster: A Randomized Open-Label Trial. Infect Drug Resist 2023; 16:721-726. [PMID: 36756610 PMCID: PMC9901438 DOI: 10.2147/idr.s385442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 01/16/2023] [Indexed: 02/04/2023] Open
Abstract
Background Herpes zoster (HZ) is an acute herpetic skin disease resulting from the varicella-zoster virus. Typically, this condition is treated with a one-week administration of antiviral drugs, including famciclovir, which can effectively control the symptoms during the acute phase and prevent the occurrence of postherpetic neuralgia (PHN). Objective To investigate whether a longer, two-week, regimen would enhance the capacity for famciclovir to reduce pain and prevent the occurrence of postherpetic neuralgia. Methods HZ patients were randomly divided into two groups who were treated with famciclovir for either a one- or two-week period. Following their respective famciclovir treatments, patients were assessed for potential differences in pain intensity as evaluated at 1, 2, 4, 8 and 12 weeks post-treatment. In addition, the occurrence of postherpetic neuralgia at three months after treatment was compared between the two groups. Results Of the 86 patients initially enrolled, 80 completed the study with N=40 randomly assigned to each of the two groups. Pain scores decreased significantly at 1, 2, 4, 8 and 12 weeks after famciclovir treatments. There were no significant differences in pain scores, and the incidence of postherpetic neuralgia occurrence between the two groups. There were no statistically significant differences in reducing pain intensity or frequency of postherpetic neuralgia between the one-week and two-week treatment protocols. Conclusion It suggests that longer administration of famciclovir has no further benefit in the treatment of herpes zoster in our study.
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Affiliation(s)
- Fen Peng
- Department of Dermatology, Peking University Third Hospital, Beijing, People’s Republic of China
| | - Haiyang He
- Department of Dermatology, Special Medical Center of Strategic Support Force of PLA, Beijing, People’s Republic of China
| | - Tianbao Xia
- Department of Dermatology, Special Medical Center of Strategic Support Force of PLA, Beijing, People’s Republic of China,Correspondence: Tianbao Xia; Shichao Lv, Department of Dermatology, Special Medical Center of Strategic Support Force of PLA, No. 9 Anxiang Beili Road, Chaoyang District, Beijing, 100101, People’s Republic of China, Email ;
| | - Shichao Lv
- Department of Dermatology, Special Medical Center of Strategic Support Force of PLA, Beijing, People’s Republic of China
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Cui Y, Zhou X, Li Q, Wang D, Zhu J, Zeng X, Han Q, Yang R, Xu S, Zhang D, Meng X, Zhang S, Sun Z, Yin H. Efficacy of different acupuncture therapies on postherpetic neuralgia: A Bayesian network meta-analysis. Front Neurosci 2023; 16:1056102. [PMID: 36704010 PMCID: PMC9871906 DOI: 10.3389/fnins.2022.1056102] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 12/16/2022] [Indexed: 01/11/2023] Open
Abstract
Background Postherpetic neuralgia (PHN) is a common, complex, and refractory type of neuropathic pain. Several systematic reviews support the efficacy of acupuncture and related treatments for PHN. Nevertheless, the efficacy of various acupuncture-related treatments for PHN remains debatable. Objective We aimed to assess the efficacy and safety of acupuncture-related treatments for PHN, identify the most effective acupuncture-related treatments, and expound on the current inadequacies and prospects in the applications of acupuncture-related therapies. Methods We searched PubMed, Cochrane Central Register of Controlled Trials, Embase, Web of Science, Google Scholar, four Chinese databases (China National Knowledge Infrastructure, China Biomedical, Chongqing VIP, and Wan Fang databases), clinical research registration platform (World Health Organization International Clinical Trial Registration platform, China Clinical Trial Registration Center) for relevant studies. We also examined previous meta-analyses; gray literature; and reference lists of the selected studies. We then evaluated the risk of bias in the included studies and performed a Bayesian multiple network meta-analysis. Results We included 29 randomized controlled trials comprising 1,973 patients, of which five studies showed a high risk of bias. The pairwise meta-analysis results revealed that the efficacy of all acupuncture-related treatments for pain relief related to PHN was significantly better than antiepileptics. The network meta-analysis results showed that pricking and cupping plus antiepileptics were the most effective treatment, followed by electroacupuncture (EA) plus antiepileptics for pain relief in patients with PHN. EA plus antiepileptics ranked the best regarding reduced Pittsburgh Sleep Quality Index (PSQI) and Self-Rating Depression Scale (SDS) scores in patients with PHN. No results were found regarding the total response rate or quality of life in this study. Acupuncture-related treatments showed a lower incidence of adverse events than that of antiepileptics. Conclusion Acupuncture-related therapies are potential treatment options for PHN and are safe. Pricking and cupping plus antiepileptics, are the most effective acupuncture-related techniques for pain relief, while EA plus antiepileptics is the best acupuncture-related technique for improving PHN-related insomnia and depression symptoms. However, owing to the limitations of this study, these conclusions should be cautiously interpreted, and future high-quality studies are needed. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021226422, identifier CRD42021226422.
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Affiliation(s)
- Yang Cui
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Xinyu Zhou
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Quan Li
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Delong Wang
- The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China
| | - Jiamin Zhu
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Xiangxin Zeng
- The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China
| | - Qichen Han
- The First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China
| | - Rui Yang
- The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China
| | - Siyu Xu
- The First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China
| | - Dongxu Zhang
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Xiangyue Meng
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Shuo Zhang
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Zhongren Sun
- Heilongjiang University of Chinese Medicine, Harbin, China,The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China,Zhongren Sun,
| | - Hongna Yin
- The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China,*Correspondence: Hongna Yin,
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Wang H, Wan R, Chen S, Qin H, Cao W, Sun L, Shi Y, Zheng Q, Li Y. Comparison of Efficacy of Acupuncture-Related Therapy in the Treatment of Postherpetic Neuralgia: A Network Meta-Analysis of Randomized Controlled Trials. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2022; 2022:3975389. [PMID: 36276855 PMCID: PMC9586726 DOI: 10.1155/2022/3975389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 09/03/2022] [Accepted: 09/26/2022] [Indexed: 11/05/2022]
Abstract
Background Postherpetic neuralgia (PHN) is the most common sequela of herpes zoster, and the efficacy of the treatment regimens recommended in the guidelines is not entirely reliable. Acupuncture and moxibustion are widely used complementary alternative therapies that have a positive effect on the treatment of PHN. However, there are various forms of acupuncture and moxibustion, and there are differences in efficacy between the different forms. Methods The retrieval work of randomised controlled trials (RCTs) of acupuncture for PHN in English databases (including PubMed, Cochrane Library, Embase, Web of Science) and Chinese databases (including China National Knowledge Infrastructure (CNKI), WeiPu database, WanFang database, and China Biomedical Literature Database) were conducted from the time of database creation to June 2022. Literature screening, data extraction, and evaluation of risk of bias for the included studies were carried out independently by two researchers, and data analysis was performed using Stata 14.2 software. Results A total of 30 RCTs including 2138 patients with PHN were included. In terms of pain improvement, acupoint embedding + Western medicine group, bloodletting-cupping group, and bloodletting-cupping + Western medicine group ranked top. In terms of total efficiency, acupuncture + Western medicine group, bloodletting-cupping + Western medicine group, and acupoint embedding group ranked top. There were no statistically significant differences in the incidence of adverse events between treatment regimens. Conclusions In a comprehensive comparison of the outcome indicators of 14 different treatment regimens, we considered acupoint injection + Western medicine and bloodletting-cupping + Western medicine to be the best combinations for the treatment of PHN. Due to the limitations of the study, the above conclusions still need to be validated in further multi-centre, large-sample prospective randomised controlled clinical trials.
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Affiliation(s)
- Haiyan Wang
- School of Acupuncture-Moxibustion and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China
| | - Renhong Wan
- Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Shuai Chen
- School of Acupuncture-Moxibustion and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China
| | - Haiyan Qin
- School of Acupuncture-Moxibustion and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China
| | - Wei Cao
- School of Acupuncture-Moxibustion and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China
| | - Luqiang Sun
- School of Acupuncture-Moxibustion and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China
| | - Yunzhou Shi
- School of Acupuncture-Moxibustion and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China
| | - Qianhua Zheng
- School of Acupuncture-Moxibustion and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China
| | - Ying Li
- School of Acupuncture-Moxibustion and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China
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