top of page
  • Writer's pictureAku Energija

Akupunktura in TKM za zdravljenje postherpetične nevralgije (dolgotrajne bolečine zaradi pasovca)

Updated: Mar 5, 2023

Postherpetična nevralgija (PHN) je najpogostejši zaplet in posledica herpesa zostra (HZ), ki močno vpliva na življenje in čustveno doživljanje bolnikov. Zdravila ni, vendar lahko zdravljenje olajša simptome. Pri večini ljudi se postherpetična nevralgija sčasoma izboljša. Terapija z akupunkturo je bila potrjena kot učinkovito in varno zdravljenje PHN.

Kaj je postherpetična nevralgija (PHN) - dolgotrajna bolečina zaradi pasovca?

Postherpetična nevralgija (PHN) je najpogostejši zaplet pasovca. Ko oseba enkrat preboli norice, virus ostane v telesu. Včasih se virus ponovno aktivira in povzroči pasovca, ki mu sledi PHN. PHN prizadene živčna vlakna in kožo ter povzroča pekočo bolečino, ki traja še dolgo po tem, ko izpuščaj in mehurji pri pasovcu izginejo. Tveganje za postherpetično nevralgijo narašča s starostjo, predvsem pa prizadene ljudi, starejše od 50 let. Približno eden od petih bolnikov s pasovcem bo zbolel za postherpetično nevralgijo. Veliko ljudi s postherpetično nevralgijo v enem letu popolnoma okreva. Vendar simptomi občasno trajajo več let ali pa so lahko tudi trajni.

Simptomi postherpetične nevralgije (PHN)

Znaki in simptomi postherpetične nevralgije so običajno omejeni na področje kože, kjer je prišlo do prvega izbruha pasavca - najpogosteje na predelu okoli trupa, običajno na eni strani telesa.

Znaki in simptomi so lahko naslednji:

  • bolečine, ki trajajo tri mesece ali dlje po zacelitvi izpuščaja pasovca. Bolečina je opisana kot pekoča, ostra in zbadajoča ali globoka in boleča.

  • Občutljivost na lahek dotik. Osebe s to boleznijo pogosto ne prenesejo niti dotika oblačil na prizadeti koži (alodinija).

  • Srbenje in odrevenelost. Redkeje lahko postherpetična nevralgija povzroči občutek srbenja ali otrplosti.

Dejavniki tveganja

Če imate pasovca, je tveganje za nastanek postherpetične nevralgije večje zaradi:

  • starosti. Če ste starejši od 50 let.

  • Resnosti pasovca. Če ste imeli hud izpuščaj in hude bolečine.

  • Druge bolezni. Če imate kronično bolezen, na primer sladkorno bolezen.

  • Lokacije pasovca. Če ste imeli pasovca na obrazu ali trupu.

Zapleti

Glede na to, kako dolgo traja postherpetična nevralgija in kako boleča je, se lahko pri osebah s to boleznijo pojavijo drugi simptomi, ki so značilni za kronično bolečino, kot so:

Kako dolgo traja postherpetična nevralgija (PHN)?

Postherpetična nevralgija (PHN) lahko traja tedne, mesece, pri nekaterih ljudeh pa tudi več let po tem, ko izpuščaj pasovca izgine. Pri večini ljudi bolečine pasovca izginejo v enem do treh mesecih. Pri enem od petih ljudi pa bolečine trajajo več kot eno leto.

Bolečina zaradi PHN je lahko pri nekaterih ljudeh tako huda, da jim moti vsakdanje življenje. Raziskovalci ne vedo, zakaj imajo nekateri ljudje hude ali dolgotrajne bolečine, drugi pa ne.

Razumevanje tradicionalne kitajske medicine o pasovcu

Akupunktura in zelišča se že več kot tisoč let uporabljajo za zdravljenje bolezni, ki jo poznamo pod imenom pasovec. Filozofija TKM meni, da je pasovec povezan predvsem z vročino in vlago. Kot akupunkturisti vidimo, da se pasovec na splošno kaže na enega od treh načinov:

Akupunktura in zelišča zaustavijo bolečino pri pasovcu ter so uspešnejša od zdravil

Akupunktura in zelišča so učinkovita pri zdravljenju pasovca. Raziskovalci treh neodvisnih študij [1-3] so ugotovili, da akupunktura in zeliščna medicina bistveno lajšata izpuščaje in bolečine, povezane z virusom herpes zoster (pasovec). Kar je pomembno je, da akupunktura in zeliščna medicina presegata učinkovitost protivirusnih in protivnetnih zdravil, kar kaže na to, da so običajni protokoli oskrbe brez vključitve akupunkture in zeliščne medicine suboptimalni. - Povzeto po healthcmi.com

Kako lahko akupunktura pomaga pri postherpetični nevralgiji (PHN)

Akupunkturna terapija, vključno z: akupunkturo, elektroakupunkturo, moksibustijo, ventuzami, puščanjem krvi itd., se pogosto uporablja pri različnih bolečinah. Študije so pokazale, da akupunktura ugodno vpliva na nevropatsko bolečino.[4-6] Potrjeno je bilo, da je terapija z akupunkturo že učinkovita pri zdravljenju PHN, ne le pri lajšanju občutka bolečine, temveč tudi pri izboljšanju kakovosti življenja, tesnobe in depresije.[7-10] Akupunktura in zelišča se lahko varno uporabljajo posamično ali kot dodatna terapija za lajšanje izpuščaja herpes zoster ter za preprečevanje dolgotrajnih poškodb živcev in bolečin zaradi nevralgije. Zdravljenje s TKM deluje tudi celostno, pri čemer druge simptome pasovca, kot sta glavobol in želodčne motnje, prav tako upošteva pri rednem zdravljenju brez potrebe po dodatnih zdravilih. Na dolgi rok lahko TKM okrepi imunski sistem in prepreči kronične bolezni.


Viri

  1. Cao Bo (2018) “Clinical Study of Longdan Xiegan decoction Combined with Acupuncture and Moxibustion for Herpes Zoster” Guide of China Medicine Vol.16(25) pp. 174-175.

  2. Zhang Qin, Ding Yujie (2018) “Study on the Effect of Dialectical Treatment with Chinese Medicine and Acupuncture on Clinical Symptoms of Herpes Zoster Neuralgia” Cardiovascular Disease Journal of Integrated Traditional Chinese and Western Medicine Vol.6(25) pp. 134.

  3. Zhao Yun (2018) “Observation on the Effect of Combined Chinese Medicine and Cupping Method on 36 Patients with Herpes Zoster” Traditional Chinese Medicine Vol.16(16) pp.172-174.

  4. Ursini T, Tontodonati M, Manzoli L, et al. Acupuncture for the treatment of severe acute pain in herpes zoster: results of a nested, open-label, randomized trial in the VZV Pain Study. BMC Complement Altern Med 2011;11:46.

  5. Estores I, Chen K, Jackson B, et al. Auricular acupuncture for spinal cord injury related neuropathic pain: a pilot controlled clinical trial. J Spinal Cord Med 2017;40:432–8.

  6. Ahn C-B, Lee S-J, Lee J-C, et al. A clinical pilot study comparing traditional acupuncture to combined acupuncture for treating headache, trigeminal neuralgia and retro-auricular pain in facial palsy. J Acupunct Meridian Stud 2011;4:29–43.

  7. Tian H, Tian Y-J, Wang B, et al. Impacts of bleeding and cupping therapy on serum P substance in patients of postherpetic neuralgia. Zhongguo Zhen Jiu 2013;33:678–81.

  8. Huang S-X, Mao M, Pu I-J, et al. Clinical research on fire filiform needle combined with mild moxibustion for postherpetic neuralgia. Zhongguo Zhen Jiu 2014;34:225–9.

  9. Lei W, Ling Q, Xu Z, et al. Effectiveness of electroacupuncture at Jiaji acupoints (EX-B 2), plus moxibustion and intermediate on postherpetic neuralgia: a randomized controlled trial. J Tradit Chin Med 2020;40:121–7.

  10. Ruengwongroj P, Muengtaweepongsa S, Patumanond J, et al. Effectiveness of press needle treatment and electroacupuncture in patients with postherpetic neuralgia: A matched propensity score analysis. Complement Ther Clin Pract 2020;40:101202.

 

Acupuncture and TCM for postherpetic neuralgia (prolonged pain from shingles)

Post-herpetic neuralgia (PHN) is the most common complication and sequela of herpes zoster (HZ) that greatly affects the life and emotional experience of patients. There is no cure, but treatments can ease symptoms. For most people, postherpetic neuralgia improves over time. Acupuncture therapy has been confirmed as an effective and safe treatment for PHN.

What is post-herpetic neuralgia (PHN)- the prolonged pain from shingles?

Postherpetic neuralgia (PHN) is the most common complication of shingles. Once a person has chickenpox, the virus will always be in the body. Sometimes the virus becomes active again, causing shingles followed by PHN. PHN affects nerve fibers and skin, causing burning pain that lasts long after the rash and blisters of shingles disappear. The risk of postherpetic neuralgia increases with age, primarily affecting people older than 50. Around one in five people with shingles will get post-herpetic neuralgia. Many people with post-herpetic neuralgia make a full recovery within a year. But symptoms occasionally last for several years or may be permanent.

Symptoms of postherpetic neuralgia (PHN)

The signs and symptoms of postherpetic neuralgia are generally limited to the area of your skin where the shingles outbreak first occurred — most commonly in a band around your trunk, usually on one side of your body.

Signs and symptoms might include:

  • Pain that lasts three months or longer after the shingles rash has healed. The associated pain has been described as burning, sharp and jabbing, or deep and aching.

  • Sensitivity to light touch. People with the condition often can't bear even the touch of clothing on the affected skin (allodynia).

  • Itching and numbness. Less commonly, postherpetic neuralgia can produce an itchy feeling or numbness.

Risk factors

When you have shingles, you might be at greater risk of developing postherpetic neuralgia as a result of:

  • Age. You're older than 50.

  • Severity of shingles. You had a severe rash and severe pain.

  • Other illness. You have a chronic disease, such as diabetes.

  • Shingles location. You had shingles on your face or torso.

Complications

Depending on how long postherpetic neuralgia lasts and how painful it is, people with the condition can develop other symptoms that are common with chronic pain such as:

How long does postherpetic neuralgia (PHN) last?

Postherpetic neuralgia (PHN) can last for weeks, months, or in some people, years after the shingles rash goes away. In most people, shingles pain goes away in one to three months. However, in one in five people, pain lasts more than one year.

The pain from PHN can be so severe in some people that it disrupts their life. Researchers don’t know why some people have severe or long-lasting pain and others do not.

Traditional Chinese medicine’s understanding about Shingles

Acupuncture and herbs have been used to help the condition we recognize as shingles for over a thousand years. TCM philosophy views shingles as being related mainly to heat and dampness. As acupuncturists, we see shingles generally presenting in one of three ways:

Acupuncture and Herbs Stop Shingles Pain, Outperforms Drugs

Acupuncture and herbs prove effective for the treatment of shingles. Researchers from three independent studies [1-3] conclude that acupuncture and herbal medicine significantly relieve rashes and pain associated with the herpes zoster virus (shingles). Importantly, acupuncture and herbal medicine outperformed antiviral and anti-inflammatory medications, indicating that usual care protocols are suboptimal without inclusion of acupuncture and herbal medicine. -quoted from healthcmi.com

How Can Acupuncture Help postherpetic neuralgia (PHN)

Acupuncture therapy, including acupuncture, electroacupuncture, moxibustion, cupping, bloodletting etc., has been widely used in different pain conditions. Studies have shown acupuncture has a favorable effect on neuropathic pain.[4–6] Acupuncture therapy has already been confirmed to be effective in treating PHN, not only in relieving pain sensation, but also in improving the quality of life, anxiety, and depression.[7-10] Acupuncture and herbs can be used safely, alone or as an adjunct therapy, to relieve the herpes zoster rash and to prevent long-term nerve damage and pain due to neuralgia. TCM treatment also work holistically taking other symptoms of shingles, like headache and stomach upset into the regular course without the need for additional medications. In the long run, TCM can strengthen the immune system and prevent chronic illness.


Reference

  1. Cao Bo (2018) “Clinical Study of Longdan Xiegan decoction Combined with Acupuncture and Moxibustion for Herpes Zoster” Guide of China Medicine Vol.16(25) pp. 174-175.

  2. Zhang Qin, Ding Yujie (2018) “Study on the Effect of Dialectical Treatment with Chinese Medicine and Acupuncture on Clinical Symptoms of Herpes Zoster Neuralgia” Cardiovascular Disease Journal of Integrated Traditional Chinese and Western Medicine Vol.6(25) pp. 134.

  3. Zhao Yun (2018) “Observation on the Effect of Combined Chinese Medicine and Cupping Method on 36 Patients with Herpes Zoster” Traditional Chinese Medicine Vol.16(16) pp.172-174.

  4. Ursini T, Tontodonati M, Manzoli L, et al. Acupuncture for the treatment of severe acute pain in herpes zoster: results of a nested, open-label, randomized trial in the VZV Pain Study. BMC Complement Altern Med 2011;11:46.

  5. Estores I, Chen K, Jackson B, et al. Auricular acupuncture for spinal cord injury related neuropathic pain: a pilot controlled clinical trial. J Spinal Cord Med 2017;40:432–8.

  6. Ahn C-B, Lee S-J, Lee J-C, et al. A clinical pilot study comparing traditional acupuncture to combined acupuncture for treating headache, trigeminal neuralgia and retro-auricular pain in facial palsy. J Acupunct Meridian Stud 2011;4:29–43.

  7. Tian H, Tian Y-J, Wang B, et al. Impacts of bleeding and cupping therapy on serum P substance in patients of postherpetic neuralgia. Zhongguo Zhen Jiu 2013;33:678–81.

  8. Huang S-X, Mao M, Pu I-J, et al. Clinical research on fire filiform needle combined with mild moxibustion for postherpetic neuralgia. Zhongguo Zhen Jiu 2014;34:225–9.

  9. Lei W, Ling Q, Xu Z, et al. Effectiveness of electroacupuncture at Jiaji acupoints (EX-B 2), plus moxibustion and intermediate on postherpetic neuralgia: a randomized controlled trial. J Tradit Chin Med 2020;40:121–7.

  10. Ruengwongroj P, Muengtaweepongsa S, Patumanond J, et al. Effectiveness of press needle treatment and electroacupuncture in patients with postherpetic neuralgia: A matched propensity score analysis. Complement Ther Clin Pract 2020;40:101202.

Comentários


bottom of page