Efficacy and Safety of Integrated Traditional Chinese and Western Medicine in the Treatment of Postherpetic Neuralgia: A Meta Analysis

Zhengjin Zhu; Jun Yan; Zhijin Zhao; Na Liang; Suoyu Liu

Authors

Zhengjin Zhu Shaanxi University of Chinese Medicine, Xianyang 712046, Shaanxi, China
Jun Yan Shaanxi Provincial Hospital of Chinese Medicine, Xi'an 710003, Shaanxi, China
Zhijin Zhao Shaanxi Provincial Hospital of Chinese Medicine, Xi'an 710003, Shaanxi, China
Na Liang Shaanxi University of Chinese Medicine, Xianyang 712046, Shaanxi, China
Suoyu Liu Shaanxi University of Chinese Medicine, Xianyang 712046, Shaanxi, China

Keywords:

Postherpetic neuralgia, Integrated Traditional Chinese and Western Medicine, Meta-analysis, Randomized controlled trial

Abstract

Objective: To evaluate the efficacy and safety of integrated traditional Chinese and Western medicine in the treatment of postherpetic neuralgia (PHN) by meta-analysis. Methods: the randomized controlled trial (RCT) of integrated traditional Chinese and Western medicine in the treatment of postherpetic neuralgia published in CNKI, VIP, CBM, Wanfang and PubMed databases were searched by computer from the establishment of the database to January 2024. The retrieved literatures were independently screened by two researchers, and the quality methodology was evaluated. The original data were extracted. The Revman manager 5.4 software was used for meta-analysis. Results: a total of 577 articles were retrieved, and 32 studies were selected according to the nanodischarge criteria. The total sample size was 2957 cases, including 1508 cases in the experimental group and 1449 cases in the control group. The results of meta-analysis showed that integrated traditional Chinese and Western medicine treatment significantly improved the total effective rate [RR=1.22, 95% CI (1.18, 1.26)] and cure rate [RR=1.58, 95% CI (1.42, 1.75)]; The visual analogue scale (VAS) score [MD=-1.62, 95% CI (-1.90, -1.34)] and Pittsburgh sleep quality index (PSQI) score [MD=-2.90, 95% CI (-4.39, -1.41)] were reduced; 52, 95% CI (-4. 46, -2. 38)]; The incidence of adverse reactions was reduced [RR=0.77, 95% CI (0.60, 0.99)], and the differences were statistically significant. Conclusion: the clinical efficacy of integrated traditional Chinese and Western medicine in the treatment of postherpetic neuralgia is significantly better than that of Western medicine alone, and the safety is high. Due to the low quality of the included literature and publication bias, high-quality, multicenter randomized controlled trials are still needed to further verify the above results.

References

ISAGULYAN E, TKACHENKO V, SEMENOV D, et al. The Effectiveness of Various Types of Electrical Stimulation of the Spinal Cord for Chronic Pain in Patients with Postherpetic Neuralgia: A Literature Review [J]. Pain Res Manag, 2023, 2023: 6015680.

JOHNSON R W, RICE A S. Clinical practice. Postherpetic neuralgia [J]. N Engl J Med, 2014, 371(16): 1526-33.

FELLER L, KHAMMISSA R A G, FOURIE J, et al. Postherpetic Neuralgia and Trigeminal Neuralgia [J]. Pain Res Treat, 2017, 2017: 1681765.

LIN C S, LIN Y C, LAO H C, et al. Interventional Treatments for Postherpetic Neuralgia: A Systematic Review [J]. Pain Physician, 2019, 22(3): 209-28.

DUBINSKY R M, KABBANI H, EL-CHAMI Z, et al. Practice parameter: treatment of postherpetic neuralgia: an evidence-based report of the Quality Standards Subcommittee of the American Academy of Neurology [J]. Neurology, 2004, 63(6): 959-65.

KAWAI K, GEBREMESKEL B G, ACOSTA C J. Systematic review of incidence and complications of herpes zoster: towards a global perspective [J]. BMJ Open, 2014, 4(6): e004833.

Wang jiashuang, Bao Jiajin, Wei Xing, et al Clinical investigation and analysis of postherpetic neuralgia [j] Chinese Journal of pain medicine, 2011, 17 (04): 198-200

SALAH S, THOMAS L, RAM S, et al. Systematic Review and Meta-analysis of the Efficacy of Oral Medications Compared with Placebo Treatment in the Management of Postherpetic Neuralgia [J]. J Oral Facial Pain Headache, 2016, 30(3): 255-66.

LI D, SUN G, SUN H, et al. Combined therapy of pulsed radiofrequency and nerve block in postherpetic neuralgia patients: a randomized clinical trial [J]. PeerJ, 2018, 6: e4852.

DONG D S, YU X, WAN C F, et al. Efficacy of Short-Term Spinal Cord Stimulation in Acute/Subacute Zoster-Related Pain: A Retrospective Study [J]. Pain Physician, 2017, 20(5): E633-e45.

SACKS G M. Unmet need in the treatment of postherpetic neuralgia [J]. Am J Manag Care, 2013, 19(1 Suppl): S207-13.

XIUMEI G, CHENYAN W, YONG N I, et al. Clinical effect of acupuncture along fascia, meridians, and nerves combined with ultrasound-guided paravertebral nerve block in the treatment of postherpetic neuralgia: a randomized parallel-controlled study [J]. J Tradit Chin Med, 2023, 43(2): 359-64.

Yan Huan, Hu libing Observation on the efficacy of integrated traditional Chinese and Western medicine in the treatment of postherpetic neuralgia [j] Shizhen Guoyi Guoyao, 2022, 33 (07): 1684-5

LAN Weiming, leizhenhai, Ma Lele, et al Clinical observation on 63 cases of postherpetic neuralgia treated with integrated traditional Chinese and Western medicine [j] New traditional Chinese medicine, 2015, 47 (05): 228-9

Liuzhuli, zhangyu'e, lvxiaoliang Scheme research and pharmaceutical evaluation of integrated traditional Chinese and Western medicine in the treatment of postherpetic neuralgia [j] Clinical research of traditional Chinese medicine, 2019, 11 (05): 85-6

Lu Haisong, Wang Xiangqi, liuxuewei Chaihu Shugan powder combined with bergamot gold patch in the treatment of postherpetic neuralgia [j] Journal of traditional Chinese medicine, 2019, 34 (1): 209-13

Lu Junwu Clinical study on the treatment of herpes zoster neuralgia in middle-aged and elderly patients with integrated traditional Chinese and Western medicine [j] Chinese medical guidelines, 2007, (S1): 27-8

Wu Xiao Clinical observation of Qutong Tongluo decoction combined with famciclovir tablets in the treatment of postherpetic neuralgia [j] Journal of Practical Traditional Chinese medicine, 2020, 36 (04): 471-2

Zhangxiaodan Qutong Tongluo decoction combined with western medicine in the treatment of 60 cases of postherpetic neuralgia [j] Chinese medicine research, 2018, 31 (12): 30-2

Zhang Jie, PI Xianming Clinical observation on 50 cases of postherpetic neuralgia treated by fire needle combined with traditional Chinese medicine [j] Hunan Journal of traditional Chinese medicine, 2016, 32 (07): 103-4+26

zhangyusong, Wen Qinsheng, lijiere Clinical observation on treating postherpetic neuralgia with traditional Chinese medicine combined with gabapentin [j] New traditional Chinese medicine, 2018, 50 (5): 147-50

zhangxiuguo, Wang Rui, di Chunjian, et al Efficacy of integrated traditional Chinese and Western medicine in the treatment of elderly herpes zoster neuralgia and its impact on immune function [j] Hebei Traditional Chinese medicine, 2007, (11): 1006-7

Xu Li Effects of pricking and cupping combined with warm acupuncture and moxibustion on TCM syndrome and inflammatory response in patients with postherpetic neuralgia [j] Reflection therapy and rehabilitation medicine, 2022, 3 (14): 46-9

caoguixi, Huang Shu, chenchuntao, etc Clinical observation on 40 cases of postherpetic neuralgia treated with integrated traditional Chinese and Western medicine [j] Sichuan Traditional Chinese medicine, 2013, 31 (08): 86-8

Cha Jindong Shentong Zhuyu Decoction Combined with doxepin in the treatment of postherpetic neuralgia [d]; Hubei University of traditional Chinese medicine, 2013

Qiao Shuhong, koupentao, guojuanli, et al Efficacy and mechanism of Taohong Siwu Decoction Combined with pregabalin in the treatment of postherpetic neuralgia [j] Shaanxi traditional Chinese medicine, 2019, 40 (09): 1251-4

Duan Baoxue, Liang Hong Xuefu Zhuyu Capsule Combined with LED red light irradiation in the treatment of postherpetic neuralgia [j] Chinese Journal of practical neurological diseases, 2016, 19 (16): 5-8

jiangliying, chenhuijuan, Hong Wen Clinical observation of 60 cases of postherpetic neuralgia treated with integrated traditional Chinese and Western medicine [j] New traditional Chinese medicine, 2014, 46 (05): 118-9

wangaijun Effects of combined Chinese and Western Medicine on pain and inflammatory factors in the treatment of postherpetic neuralgia [j] Journal of Practical Traditional Chinese medicine, 2020, 36 (12): 1574-5

wanghongjuan, wenzefa, lirunsheng Observation on the efficacy of electroacupuncture at Jiaji point combined with pricking and cupping in the treatment of acute postherpetic neuralgia [j] Chinese medical emergency, 2023, 32 (1): 133-5

Wang Ziqiang, Yin Jun, chenxinde Clinical study on fire needle acupuncture trigger point combined with epidural nerve block in the treatment of intractable postherpetic neuralgia [j] New traditional Chinese medicine, 2020, 52 (6): 129-31

luohengchao, Huang Yanyan, Wu Di, et al Effect of Huoxue Jiedu Zhitong decoction on postherpetic neuralgia and inflammatory factors in patients [j] Shaanxi traditional Chinese medicine, 2018, 39 (11): 1596-8

Luo Feng, Gao Xiaoping, liwenbin Clinical observation on the treatment of postherpetic neuralgia with integrated traditional Chinese and Western medicine [j] China health nutrition, 2018, 28 (1): 86

xiaoweimin, lizhenmin, fanshufeng 80 cases of postherpetic neuralgia treated with integrated traditional Chinese and Western medicine [j] Sichuan Traditional Chinese medicine, 2014, 32 (03): 102-4

Hu Liufeng, Yang Xiangxiang, Chen Ying, et al 50 cases of postherpetic neuralgia treated with integrated traditional Chinese and Western medicine [j] Hunan Journal of traditional Chinese medicine, 2012, 28 (06): 9-10

gesuhua, wangxiugang Integrated traditional Chinese and Western medicine in the treatment of elderly herpes zoster neuralgia [j] International Journal of traditional Chinese medicine, 2008, 30 (5): 360,2

xuetianping, Shi Lei, maoliyan 58 cases of postherpetic neuralgia treated with modified Taohong Siwu Decoction [j] Hunan Journal of traditional Chinese medicine, 2017, 33 (02): 58-60

dengaihua Clinical observation on the treatment of postherpetic neuralgia with integrated traditional Chinese and Western medicine [j] Modern distance education of traditional Chinese medicine in China, 2021, 19 (21): 139-41

chenyumei Observation on the efficacy of integrated traditional Chinese and Western medicine in the treatment of postherpetic neuralgia [j] Journal of modern integrated traditional Chinese and Western medicine, 2016, 25 (09): 961-3

hanbingyu, Wang Lin Clinical observation on 43 cases of postherpetic neuralgia treated by fire needle combined with traditional Chinese medicine [j] Chinese national folk medicine, 2018, 27 (21): 90-2

gujinghui Clinical efficacy evaluation of self-made Yiqi Tongluo Decoction in the treatment of postherpetic neuralgia in middle-aged and elderly patients [j] Self care, 2023, 27 (6): 108-10

Gao Wenyou Efficacy analysis of traditional Chinese and Western medicine in the treatment of postherpetic neuralgia [j] Clinical research of traditional Chinese medicine, 2014, (32): 103-4

lizongwu, Ao Qiuyan, huangxiaolian, et al Effect of multimodal analgesia of traditional Chinese medicine on postherpetic neuralgia and its impact on prognosis [j] World Journal of integrated traditional Chinese and Western medicine, 2021, 16 (10): 1778-82

BARON R, WASNER G. Prevention and treatment of postherpetic neuralgia [J]. Lancet, 2006, 367(9506): 186-8.

jiangqunqun, caichunxia, Liu Weibing Research progress of traditional Chinese and Western Medicine on postherpetic neuralgia [j] Clinical research of traditional Chinese medicine, 2018, 10 (02): 135-40

Yu Shengyuan, Wanyou, Wan Qi, etc Chinese expert consensus on the diagnosis and treatment of postherpetic neuralgia [j] Chinese Journal of pain medicine, 2016, 22 (03): 161-7

Liu Bing, zhaojiaomei, Ren Changhe, et al Clinical value of infrared thermography in early prediction of postherpetic neuralgia [j] Chinese Journal of pain medicine, 2020, 26 (04): 276-81

anyuanyuan Research Progress on combined treatment of postherpetic neuralgia [j] Chinese medical science, 2022, 12 (23): 63-6

weeks Miao, Li Xiang, yangxudong Research progress in drug treatment and prevention of postherpetic neuralgia [j] Chinese Journal of integrated traditional and Western medicine dermatology and Venereology, 2020, 19 (05): 489-93

CHEN T, ZHANG W W, CHU Y X, et al. Acupuncture for Pain Management: Molecular Mechanisms of Action [J]. Am J Chin Med, 2020, 48(4): 793-811.

Wu Xiqing, Gao Jie, Cui Miaomiao Clinical study on the treatment of postherpetic neuralgia by Jiu Liu. acupuncture combined with pricking and cupping [j] Journal of modern integrated traditional Chinese and Western medicine, 2020, 29 (10): 1071-3+88

Xin Ling, Mei Wenhui, zhuxiaofeng Research progress of traditional Chinese medicine treatment of. postherpetic neuralgia [j] Abstract of the world's latest medical information, 2018, 18 (99): 32-3+56