How does Traditional Chinese Medicine treat postherpetic neuralgia?

Shingles is an acute skin and mucosal disease that is contagious and often occurs suddenly. It is common among elderly people with weakened immunity and is also very painful. It can be treated with traditional Chinese medicine and is unlikely to recur once cured.

(1) Syndrome differentiation and medication

① Liver and gallbladder heat type

【Treatment method】The method should be to clear away heat and dampness, detoxify and relieve pain.

[Prescription] Longdan Xiegan Decoction with modifications: gentian, scutellaria, gardenia, isatis root, isatis leaf, oriental rhizome, plantain seed, corydalis, red peony root, raw licorice. If the rash appears on the head and face, add chrysanthemum; if it appears on the upper limbs, add mulberry branch and turmeric slices; if it appears on the lower limbs, add Achyranthes bidentata; if it appears on blood blisters, add moutan bark and white imperata root; if it appears on dry mouth, add gypsum and anemarrhena; if it appears on dry stool, add rhubarb; if it appears on rash with secondary bacterial infection, add schizonepeta tenuifolia and dandelion; if it appears on the elderly and infirm, add astragalus.

② Spleen dampness and lung heat type

[Treatment method] The method should be to strengthen the spleen and eliminate dampness, detoxify and relieve pain.

[Prescription] Modified Chushi Weiling Decoction: Poria, raw Atractylodes macrocephala, dried tangerine peel, Magnolia officinalis, Isatis indigotica, raw Coix seeds, Alisma orientalis, Corydalis yanhusuo, Plantago seed, raw licorice.

③Qi stagnation and blood stasis type

[Treatment method] The method should be to promote blood circulation and remove blood stasis, promote qi circulation and relieve pain, and clear away residual toxins.

[Prescription] Modified Huoxue Sanyu Decoction: peach kernel, safflower, Millettia reticulata, Phellodendron chinense, Corydalis yanhusuo, Toosendan fruit, earthworm, costus root, tangerine peel, and Caulis biflori. For those with strong vital energy, add Chuanjun to break up the blood stasis; for the elderly and weak, add raw Astragalus and Codonopsis pilosula to strengthen the vital energy.

(2) External treatment: For erythema and small blisters, Realgar Detoxification Powder can be used. Mix the Realgar Detoxification Powder with water for application, or mash fresh purslane or cabbage stalks and mix them for application. For erosion and ulceration, use boric acid and Shuanghuanglian solution (3% boric acid solution 2000ml plus Shuanghuanglian 0.6g) for cleaning, wet compress, or apply with water gauze strips. For scabs, use Huadusan ointment or Huanglian ointment. For postherpetic neuralgia, use a black ointment-pulling stick or a decolorized ointment-pulling stick and moisturize it.

(3) Single prescription medicines : In the acute stage, Longdan Xiegan Pills plus Isatis Root Granules can be used, or Chushi Pills plus Shugan Pills can be used. In the case of postherpetic neuralgia, Jianpi Shugan Pills plus Huoxue Xiaoyan Pills can be used.

The main treatments are antiviral, anti-inflammatory, analgesic and local symptomatic treatments.