Postherpetic neuralgia (PHN) is the most common clinical complication of herpes zoster. PHN can persist for months to years, and in some cases, the pain may last for more than five years. Patients suffering from severe, prolonged pain endure significant distress, which seriously affects their quality of life and daily activities. Moreover, PHN can lead to insomnia, anxiety, depression, or even suicide. Currently, the treatment of PHN primarily focuses on pain management. First-line treatment options include gabapentin, pregabalin, tricyclic antidepressants, and 5% lidocaine patches.
Acupuncture is a widely used non-pharmacological therapy. A large number of clinical trials have demonstrated its effectiveness in treating various neuropathic pain conditions, including PHN. Acupuncture not only reduces pain perception but also alleviates anxiety and improves the quality of life for PHN patients. Among different acupuncture techniques, Warm Acupuncture (WA) is considered the most effective for treating peripheral neuropathic pain. Clinical case reports have also shown its pain-relieving effects in PHN patients.
However, there has been no study in Vietnam on the effectiveness of WA in pain reduction for patients with PHN. Therefore, this study is conducted to evaluate whether WA is effective in reducing pain and ensuring safety for treating PHN patients with Qi Stagnation and Blood Stasis syndrome. The findings will serve as a basis for the broader application of WA in the treatment of PHN.
Individuals with a history of herpes zoster in the trunk area.
Individuals diagnosed with Postherpetic neuralgia (PHN) by a dermatologist, based on PHN diagnostic criteria, with pain persisting for 3 months or more after the skin lesions have healed.
Individuals with a pain intensity score of ≥ 3, assessed using the Visual Analog Scale (VAS).
Individuals diagnosed with Qi Stagnation and Blood Stasis syndrome by a Traditional Medicine doctor.
Active herpes zoster lesions, confirmed by the dermatologist treating the patient.
Pregnant or breastfeeding women.
Patients with severe cognitive impairment who cannot understand the study protocol.
Patients with a history of allergy to Gabapentin.
Parallel
Warm acupuncture and Gabapentin
Other interventionThis group used gabapentin 300mg per tablet, twice a day, for a treatment period of 4 weeks, combined with warm acupuncture at the Ashi point, EX-B2, LI4, TE6, PC5 and SP6, five times a week for 4 weeks.
Gabapentin
DrugThis group used gabapentin 300mg per tablet, twice a day, for a treatment period of 4 weeks
The change of the Visual Analog Scale (VAS)
Pain will be measured using the Visual Analog Scale (VAS). Patients will be asked to circle a number from 0 to 10, where 0 represents "no pain" and 10 represents "the worst possible pain.
Proportion of intervention-related adverse events
While Warm acupuncture is generally considered safe, some patients may experience minor side effects at the application site. Studies on Warm Acupuncture have reported negligible adverse effects. The recorded adverse effects include burns, pain at the acupuncture site, and bleeding at the acupuncture site. The study will closely monitor and document any unexpected adverse events associated with the procedure.
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