Effect of Fire-acupuncture therapy in the treatment of acute herpes zoster with heat stagnation in liver meridian pattern based on the theory of removing the stagnation of fire

Objective To investigate the effect of Fire-acupuncture therapy based on the theory of removing the stagnation of fire in the treatment of acute herpes zoster with heat stagnation in liver meridian pattern. Methods A total of 60 patients with acute herpes zoster with heat stagnation in liver meridian pattern were randomly divided into the control group and treatment group, with 30 cases in each group. All patients received integrative medicine treatment including oral administration of Longdanxiegan decoction, valaciclovir hydrochloride, pregabalin and mecobalamin, and those in the treatment group were given Fire-needle therapy. The time of skin lesion repair including blister-associated symptom controlled, scab formed and scab falling off were recorded. The visual analogue scale on zoster-related pain, comprehensive therapeutic effect, incidence of postherpetic neuralgia at 30 days and 60 days after treatment, safety of treatment and patient tolerance were compared between two groups. Results The during of skin lesion repair including blister-associated symptom controlled, scab formed and scab falling off in the treatment group were shorter than those in the control group (P＜0. 01). The VAS score was decreased in both group at 1 hour after intervention(P＜0. 01), and a better analgesic effect was observation in the treatment group (P＜0. 01). The vas score was markedly decreased and the decrease was more obvious in the treatment group than that in the control group (P＜0. 05). The comprehensive therapeutic efficacy score was markedly decreased in both groups after intervention (P＜0. 05), and the decrease was more obvious in the treatment group than that in the control group(P＜0. 01). The incidence of postherpetic neuralgia at 30 days after intervention in the treatment group was lower than that in the control group (P＜0. 05). There was no significant difference in incidence of postherpetic neuralgia at 60 days after intervention between two groups (P＞0. 05). Patients had good tolerance to integrative treatment, and there was no significant difference in tolerance assessment score between two groups (P＞0. 05). There was no seriously adverse reaction reported during treatment period. Conclusion The Fire-acupuncture therapy is effective to accelerate process of skin lesion repair, alleviate pain, and offers good treatment safety and tolerability, thereby improving patients' quality of life and treatment confidence. It is an effective treatment for acute herpes zoster with heat stagnation in liver meridian pattern. (目的 探讨火针“火郁发之”疗法治疗急性期带状疱疹肝经郁热证的临床效果。方法 选取2023年10月—2024年10月江苏省中医院皮肤科收治的60例急性期带状疱疹肝经郁热证患者, 按随机数字表法分为两组。对照组(n=30)采用中西医结合治疗(口服龙胆泻肝汤加减+盐酸伐昔洛韦+普瑞巴林+甲钴胺); 治疗组(n=30)在对照组的基础上加用火针“火郁发之”疗法, 隔日治疗1次, 每周不超过3次。观察两组皮损修复时间包括止疱、结痂、脱痂时间; 比较两组治疗周期内疼痛缓解程度、治疗结束后带状疱疹综合疗效评分及结束后30 d和60 d后遗神经痛发生率, 并对治疗的安全性和耐受性进行评价。结果 治疗组的止疱、结痂、脱痂时间均较对照组缩短(P＜0. 01)。两组患者治疗后的即刻疼痛视觉模拟评分(VAS)(治疗后1 h)均有改善(P＜0. 01), 且治疗组即刻镇痛效果优于对照组(P＜0. 01); 两组治疗后的疼痛程度均有下降(P＜0. 01), 治疗组疼痛下降趋势优于对照组(P＜0. 01)。治疗后两组综合疗效评分较治疗前改善(P＜0. 05), 且治疗组低于对照组(P＜0. 01)。两组第30 天后遗神经痛发生率比较, 治疗组低于对照组(P＜0. 05); 两组第60天后遗神经痛发生率比较, 差异无统计学意义(P＞0. 05)。两组治疗耐受性均较好, 差异无统计学意义(P＞0. 05)。两组治疗过程中均无不良事件发生, 安全性良好。结论 在中西医药物治疗基础上, 火针“火郁发之”疗法能加速皮损修复, 减轻疼痛, 治疗安全性和耐受性良好, 能够提升患者生活质量和治疗信心, 是行之有效的治疗急性期带状疱疹肝经郁热证的优势技术。)