[Tongyuan acupuncture for postherpetic neuralgia: a randomized controlled trial]

To observe the clinical efficacy of Tongyuan acupuncture in treatment of postherpetic neuralgia (PHN).

A total of 106 patients with PHN were randomly divided into a Tongyuan electroacupuncture group (53 cases, 3 cases dropped out) and a conventional electroacupuncture group (53 cases, 4 cases dropped out, 2 cases were eliminated). In the Tongyuan electroacupuncture group, Baihui (GV20), Yintang (GV24⁺), Shuigou (GV26), Qihai (CV6), Guanyuan (CV4), ashi points and bilateral Xinshu (BL15), Geshu (BL17), Ganshu (BL18), Pishu (BL20), Tianshu (ST25) were selected, and 5 to 6 pairs of acupoints were selected to connect the electroacupuncture therapeutic apparatus; in the conventional electroacupuncture group, ashi points and Jiaji points (EX-B2) of the relevant ganglion segments in the affected area were selected, and Jiaji points (EX-B2) and ashi points were connected to the electroacupuncture therapeutic apparatus. In both groups, dense-disperse waves were selected at a frequency of 2 Hz/100 Hz and a current of 2 mA. The needles were retained for 30 min per session, once daily. Five sessions constituted one treatment course, with a 2-day interval between courses. A total of four treatment courses were administered. The simplified McGill pain questionnaire (SF-MPQ) score (including the pain rating index [PRI] score, visual analogue scale [VAS] score, and present pain intensity [PPI] score) of both groups were observed before treatment, after 2 weeks of treatment, and after 4 weeks of treatment. The Pittsburgh sleep quality index (PSQI) score, Hamilton anxiety scale (HAMA) score, and Hamilton depression scale (HAMD) score of both groups were observed before treatment and after 4 weeks of treatment. Clinical efficacy was evaluated after treatment, and pain recurrence was followed up at 3 months after treatment completion.

Compared with before treatment, the sub-scores and total scores of the SF-MPQ in both groups decreased after 2 and 4 weeks of treatment (P<0.05), and the scores after 4 weeks of treatment were lower than those after 2 weeks of treatment (P<0.05). After 2 weeks of treatment, the scores of VAS and PPI, and the total score of SF-MPQ in the Tongyuan electroacupuncture group were lower than those in the conventional electroacupuncture group (P<0.05). After 4 weeks of treatment, all sub-scores and total score of the SF-MPQ in the Tongyuan electroacupuncture group were lower than those in the conventional electroacupuncture group (P<0.05). After treatment, the PSQI, HAMA, and HAMD scores in both groups were lower than those before treatment (P<0.05); the PSQI, HAMA, and HAMD scores in the Tongyuan electroacupuncture group were lower than those in the conventional electroacupuncture group (P<0.05). The total effective rate and marked effective rate in the Tongyuan electroacupuncture group were 90.0% (45/50) and 72.0% (36/50), respectively, both higher than those in the conventional electroacupuncture group (74.5% [35/47] and 44.7% [21/47], P<0.05). During follow-up, the pain recurrence rate in the Tongyuan electroacupuncture group was 2.2% (1/45), which was lower than that in the conventional electroacupuncture group (17.1% [6/35], P<0.05).

Tongyuan acupuncture can alleviate pain, improve sleep disturbances, and ameliorate emotional comorbidities in patients with PHN, and its short-term and long-term efficacy is superior to that of conventional electroacupuncture.