A randomized controlled trial of acupoint application for postherpetic neuralgia

To assess the clinical efficacy of acupressure application in treating postherpetic neuralgia (PHN) of the qi (vital energy) stagnation and blood stasis type, as well as its impact on blood inflammatory factors, T-cell subpopulations, and neurotransmitter levels.

A total of 134 patients diagnosed with PHN characterized by qi stagnation and blood stasis were randomly assigned to either the treatment group (67 patients, including 10 dropouts) or the control group (67 patients, including 7 dropouts). In addition to standard health education, the treatment group received treatment with anti-swelling and analgesic patches in combination with Chinese medicine fine powder acupoint patches. The control group, on the other hand, received placebo anti-swelling and analgesic patches along with placebo Chinese medicine fine powder acupoint patches. Both groups underwent treatment at specific acupoints including bilateral Sanyinjiao, Shenque, and Ashi points. The Sanyinjiao acupoint was stimulated for 30 min per session, once every 7 days. The Shenque and Ashi acupoints were stimulated for 6-8 h daily for a single session. Patients in both groups were assessed before and after treatment using the Visual Analog Scale (VAS) score, Traditional Chinese Medicine (TCM) syndrome score, Pittsburgh Sleep Quality Index (PSQI) score, 36-item Short Form Health Survey (SF-36) score, inflammatory factors including monocyte chemotactic protein-1 (MCP-1), interleukin 6 (IL-6), tumor necrosis factor alpha (TNF-α), T-cell subpopulations cluster of differentiation 3 (CD3+), cluster of differentiation 4 (CD4+), cluster of Differentiation d (CD8+), as well as neurotransmitters 5-hydroxytryptamine (5-HT), substance P (SP), and β-endorphin (β-EP). Changes in content were observed, and any adverse reactions were monitored. Clinical efficacy was evaluated after a 4-week treatment period.

After 4 weeks of treatment, the VAS score, TCM syndrome score, PSQI score, levels of MCP-1, IL-6, TNF-α, CD8+, 5-HT, and SP in both groups significantly decreased compared to pre-treatment levels (P < 0.05). Moreover, these parameters were lower in the treatment group than that in the control group (P < 0.05). Conversely, the SF-36 scores, CD3+, CD4+, and β-EP levels were significantly higher in post-treatment analyses compared to that at the baseline (P < 0.05). In addition, these values were higher in the treatment group than that in the control group (P < 0.05). The total effective rate in the treatment group was 84.21%, significantly surpassing the control group's rate of 61.67% (P < 0.05).

Acupuncture point paste therapy for PHN of the qi stagnation and blood stasis type has been shown to decrease levels of MCP-1, IL-6, TNF-α, CD8+, 5-HT, and SP in the blood. Simultaneously, it increases levels of CD3+, CD4+, and β-EP. This treatment leads to amelioration of pain symptoms and TCM symptoms and enhancement of sleep quality and overall quality of life. The therapeutic outcomes are both safe and dependable.

CONSORT ChiCTR2200056614.