ObjectiveTo compare the analgesic effect of different treatment for herpes zoster neuralgia, and optimize herpetic neuralgia treatment. MethodsWe collected hospital inpatient data with herpes zoster by the First Military Medical Case Management System between January 1st, 2009 and December 20th, 2013. All the patients were divided into five groups according to different treatments. Patients in group A accepted valaciclovir capsules and doxepin hydrochloride tablets; patients in group B accepted valaciclovir capsules; patients in group C accepted valaciclovir capsule, nefopam hydrochloride tablets and doxepin hydrochloride tablets; patients in group D accepted valaciclovir capsules and nefopam hydrochloride tablets; patients in group E accepted valaciclovir capsules and non-steroidal anti-inflammatory drugs (including nimesulide capsules and ibuprofen sustained-release capsules). We collected such statistic data as sex, age, time of onset, time of pain disappearing after treatment. Then, we analyzed the difference among the groups on the time of pain disappearing. ResultsThere were 336 cases compliant with the standard in all the 898 cases of medical record data. The number of the patients was 72, 86, 66, 60 and 52; while the pain disappearing time after treatment was (5.94±2.54), (8.60±3.09), (5.77±1.85), (5.80±1.96) and (6.86±2.18) days, respectively in group A, B, C, D and E. Pain disappearing time after treatment of group B was significantly different from groups A, C, D, and E (P<0.05); group E was significantly different from groups A, C, and D (P<0.05); there was no significant difference between group A and groups C and D, and between group C and D (P>0.05). ConclusionThe combination of nefopam hydrochloride tablets, doxepin hydrochloride tablets, nimesulide capsules, and ibuprofen sustained-release capsules is effective in the treatment of herpes zoster neuralgia. The use of nefopam hydrochloride tablets with doxepin hydrochloride tablets is more effective than the combination of nimesulide capsules and ibuprofen sustained-release capsules. Doxepin hydrochloride tablets are not significantly different from nefopam hydrochloride tablets. Nefopam hydrochloride tablets and doxepin hydrochloride tablets are not associated with increased efficacy.
Objective To assess the quality reports on acupuncture in the treatment of postherpetic neuralgia. Methods MEDLINE, CBM, CMCC and CNKI from 1994 to 2006 were searched electronically. Handsearching was also done. The retrieved articles were assessed in terms of several factors, including the type of clinical research, methodology, diagnostic criteria, inclusion/exclusion criteria, effectiveness measurements, calculation of sample size, follow-up, etc. Results Among the 109 included articles, only 6 were true randomized controlled trials. There were 17 quasi-randomized controlled trials, 13 non-randomized concurrent controlled trials, 1 case-control study and 63 narrative studies. 29 of the reports clearly described the diagnostic criteria, 14 mentioned the inclusion/exclusion criteria, 79 reported the effectiveness measurements, none mentioned the calculation of sample size, 24 reported the follow-up outcomes, and only 1 mentioned adverse reactions. Conclusion More prospective, multicenter, large-scale, high-quality randomised trials are needed, and recommendations should also be made for future evaluations of methodological quality.
Objective To investigate the general state, psychologic status and health related quality of life (HRQOL) in patients with post-herpetic neuralgia (PHN), and explore the influencing factors on HRQOL and their major and minor relationship. Methods From August 2014 to August 2015, a questionnaire survey was conducted to patients with PHN. The data of the patients’ general situation was colleted, the psychologic status was assessed by Self-rating Depression Scale (SDS), and the HRQOL of the patients was assessed by 36-item Short Form Survey. One-way ANOVA and stepwise regression analysis were used to analyze the influencing factors of HRQOL. Results A total of 177 questionnaires were issued, and 158 were recovered with a response rate of 89.3%. The average score of HRQOL of the 158 patients was 513.67±119.79, and the average score of SDS was 43.65±11.34. SDS scores showed no depression in 41 patients (25.9%), mild depression in 47 (29.7%), moderate depression in 39 (24.8%), and severe depression in 31 (19.6%). Whether receiving regular treatment, course of PHN, SDS score, physical exercise, sleep time and age were the main influencing factors of HRQOL. Conclusions Most patients with PHN suffer from depressive symptoms with poor HRQOL scores. Receiving early treatment with integrated traditional Chinese and western medicine, strengthening exercise, ensuring adequate sleep and receiving psychological counseling can significantly improve the HRQOL of PHN patients.
ObjectiveTo systematically review the efficacy and safety of fire needle in the treatment of post-herpetic neuralgia. MethodsPubMed, EMbase, The Cochrane Library, CNKI, WanFang Data, VIP, and CBM databases were electronically searched to collect randomized controlled trials (RCTs) of fire needle for post-herpetic neuralgia from inception to June 5th, 2021. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies; then, meta-analysis was performed using RevMan 5.3 software. ResultsA total of 31 RCTs involving 2 755 patients were included. The results of meta-analysis showed that compared with western medicine, fire needle could reduce VAS score (SMD=−1.00, 95%CI −1.36 to −0.63, P<0.000 01). Fire needle combined with western medicine could improve the total efficiency (RR=1.15, 95%CI 1.06 to 1.23, P=0.000 3), reduce VAS score (SMD=−1.92, 95%CI −2.87 to −0.97, P<0.000 1), and SAS rating (SMD=−0.89, 95%CI −1.20 to −0.59, P<0.000 01). Compared with conventional acupuncture, fire needle could reduce VAS score (SMD=−1.37, 95%CI −2.35 to −0.39, P=0.006), and immediate analgesic time (SMD=−0.64, 95%CI −0.88 to −0.39, P<0.000 01). Compared with the traditional Chinese medicine, fire needle could reduce VAS score (SMD=−1.00, 95%CI −1.53 to −0.47, P=0.000 2), SDS rating (SMD=−1.59, 95%CI −1.18 to −1.31, P<0.000 01), SAS rating (SMD=−1.79, 95%CI −2.08 to −1.49, P<0.000 01). In addition, the incidence of adverse reactions in experimental group was significantly lower than that in the control group. ConclusionCurrent evidence shows that fire needle can significantly reduce pain intensity, relieve anxiety, and improve the quality of life of post-herpetic neuralgia patients. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify the above conclusion.