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The treatment of herpes zoster has a deep foundation and rich clinical experience in traditional Chinese medicine. Herpes zoster, also known as "snake sores" in traditional Chinese medicine, is an acute viral infection caused by the reactivation of the varicella-zoster virus. It is mainly characterized by the appearance of herpeti-like blisters on the skin, arranged in bands along the distribution area of the ganglia, often accompanied by severe neuralgia. Based on the classic of Chinese medicine "Treatise on Typhoid Fever" and combined with clinical experience, this article discusses in detail the etiology, pathogenesis, clinical manifestations and differential diagnosis of herpes zoster, as well as the effective methods and clinical case analysis of traditional Chinese medicine in the treatment of herpes zoster.
1. Etiology and pathogenesis of herpes zoster
The pathogenesis of herpes zoster is mainly due to reactivation of varicella-zoster virus (VZV). Traditional Chinese medicine believes that after the external evil qi invades the body, after a period of incubation, the virus becomes active again, causing the meridians to be blocked by the evil spirit, and the qi and blood are stagnant, and finally appear as band blisters on the skin. Especially in cases of weakness or weakened immunity, the virus is more likely to reactivate and cause disease.
According to the relevant provisions of the Treatise on Typhoid Fever, such as the physical pain symptoms of sun disease mentioned in Article 3, and the pain in various parts of the body caused by cold evil as described in Articles 31 and 35, it can be inferred that the formation of herpes zoster also involves pathological processes such as cold evil coagulation and poor qi and blood. These theories provide an important theoretical basis for the TCM treatment of herpes zoster.
2. Clinical manifestations and differential diagnosis of herpes zoster
The clinical manifestations of herpes zoster include localized pain, burning, stinging, followed by erythema, blisters on the skin, arranged in bands along the distribution of nerves. It is distinguished from other skin diseases mainly by its unique band-like distribution and concomitant neuralgia symptoms.
In the differential diagnosis of traditional Chinese medicine, it is necessary to observe in detail the characteristics of skin lesions, accompanying symptoms such as the nature of pain, tongue image, pulse pattern, etc. Depending on the location and nature of the lesion, it can help determine the nature and location of the lesion, so as to develop a personalized treatment plan.
3. Traditional Chinese medicine treatment methods for herpes zoster
According to the theory of traditional Chinese medicine, the key to the treatment of herpes zoster is to distinguish the syndrome and choose the appropriate prescription for treatment. The following are some commonly used Chinese herbal formulas and their main effects:
Cinnamon and kudzu soup
Composition: cinnamon sticks, kudzu, white peony, licorice, etc.
Function: Cinnamon branch warms yang and relieves the surface, Pueraria lobata dissolves muscle and reduces fever, white peony nourishes blood and relieves pain, and licorice reconciles various medicines.
Indications: It is suitable for early herpes zoster, with cold and heat exchanges, body pain and other manifestations.
Ephedra with coix and licorice jujube soup
Composition: Ephedra, coix seeds, licorice, jujube, etc.
Function: Ephedra sweats and dissolves the surface, coix clears heat and dampness, licorice and jujube reconcile medicinal properties.
Indications: It is suitable for mild disease in the early stage, with symptoms such as cold and heat discomfort and slight blisters.
逍遥散
Composition: peony, tangerine peel, bupleurum, ginger, etc.
Function: Activates blood circulation and dispels blood stasis, relaxes tendons and activates the meridians, and reconciles qi.
Indications: It is suitable for those who have obvious pain in the initial stage of herpes or the residual period of ecchymosis after healing.
4. Clinical case analysis
1. Case 1: Cinnamon and Ge root decoction for the treatment of shingles
The patient, Wang, a 65-year-old female, presented with herpes zoster on the left side of the chest and abdomen accompanied by severe burning pain. The patient complained of no special trigger in the near future, but the onset of the herpes was sudden, the herpes was arranged in a band, distributed along the nerves, the local redness and swelling were obvious, and the pain was intense, which affected sleep and daily life. The tongue is red and less mossy, and the pulses are fine.
Syndrome differentiation analysis: the patient's tongue was red and lackluster, and the pulse strings were fine, indicating qi stagnation and blood stasis, and the cold evil was unresolved. Combined with the patient's medical history and clinical manifestations, the diagnosis was herpes zoster (called "snake disc sore" in traditional Chinese medicine), and the syndrome differentiation was qi stagnation and blood stasis type.
Treatment plan: Cinnamon and kudzu root decoction are used for treatment. Cinnamon branch warms the yang and relieves the surface, Pueraria lobata dissolves muscle and reduces fever, white peony nourishes blood and relieves pain, and licorice reconciles various medicines. At the same time, ginger is added to enhance the power of dissipating cold, and jujube is added to reconcile medicinal properties.
Prescription: 10g of cinnamon stick, 15g of kudzu, 15g of white peony, 6g of licorice, 10g of ginger, 5 jujubes. Decoction with water, twice daily.
Treatment effect: After one week of treatment, the patient's symptoms were significantly reduced, the herpes gradually subsided, the pain was reduced, and the sleep quality improved. After a week of continued treatment, the herpes healed completely, the pain disappeared, and the patient returned to normal life.
2. Case 2: Ephedra and coix licorice jujube decoction for the treatment of herpes zoster
The patient, Li, a 50-year-old male, presented with shingles on the right side of his neck and chest accompanied by a severe stinging sensation. The patient complained of obvious redness and swelling at the herpes site, unbearable pain, and impaired eating and activities. The tongue coating is yellow and greasy, and the pulses are slippery.
Syndrome differentiation analysis: the patient's tongue coating was yellow and greasy, and the pulse was slippery, indicating that the dampness and heat were contained and the heat evil was flourishing. Combined with the patient's medical history and clinical manifestations, the diagnosis was herpes zoster (known as "snake disc sore" in traditional Chinese medicine), and the syndrome differentiation was damp heat intrinsic type.
Treatment plan: Ephedra plus coix licorice jujube decoction is used. Ephedra sweats and dissolves the surface, coix clears heat and dampness, and licorice and jujube reconcile medicinal properties. At the same time, according to the specific situation of the patient, add heat-clearing and detoxification products to enhance the curative effect.
Prescription: Ephedra 8g, Coix Seed 12g, Licorice Root 6g, Jujube 5pcs, Skullcap 10g, Coptis chinensis 6g. Decoction with water, three times a day.
Treatment effect: After a week of treatment, the patient's condition improved significantly, the herpes gradually subsided, the pain decreased, and the appetite increased. After a week of continued treatment, the herpes healed completely, the pain disappeared, and the patient returned to normal life and work.
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I Note: The purpose of this article is to spread the idea of diagnosis and treatment of traditional Chinese medicine, please follow the doctor's instructions for specific treatment and medication! Don't try it blindly! (Thank you for your attention, spread the culture of Chinese medicine, feel the power of Chinese medicine, and let more people benefit~)