Acupuncture and moxibustion combined with cupping for the treatment of post-herpetic neuralgia

Abstract

Background: There are still controversies between the curative effect of acupuncture combined with cupping therapy and western medicine for post-herpetic neuralgia (PHN). Our meta-analysis fully incorporates the research of acupuncture combined with cupping therapy versus Western medicine for PHN, aiming to explore the difference in the efficacy of the 2 therapies, so as to provide guidance for clinical treatment.Methods: We searched PubMed, Embase, Cochrane Library, CNKI, Wanfang, CQVIP, CBM, from establishment of the database to September, 2020. Include studies that are clearly defined as PHN or herpes zoster, and exclude duplicate publications; studies with no full text, incomplete information, or inability to extract data; the definition of exposure is quite different from most literature; animal experiments.Results: The total effective rate (relative ratio [RR] = 1.21, 95% confidence interval [CI]: 1.12-1.31) and the rate of remarkable effect (RR = 1.46, 95% CI: 1.30-1.63) of acupuncture and moxibustion combined with cupping in the treatment of PHN were significantly higher than that of conventional western medicine. The visual analogue scale score of acupuncture and moxibustion combined with cupping for PHN was significantly lower than that of conventional western medicine treatment (WMD = -1.77, 95% CI [-2.79, -0.75]). In addition, acupuncture and moxibustion combined with cupping therapy significantly reduced the occurrence of PHN compared with conventional western medicine treatment after treatment of acute herpes zoster (RR = 0.30, 95% CI: 0.20-0.45). In order to explore the differences in the efficacy and preventive effects of different types of acupuncture and cupping therapy, we have further conducted a subgroup analysis. Conclusion:The effect of acupuncture and moxibustion combined with cupping in the treatment of PHN is significantly higher than that of conventional western medicine, and it can significantly prevent the occurrence of PHN. Chinese medicine should be used more widely in the treatment of PHN.Abbreviations: PHN = post-herpetic neuralgia, RR = relative ratio, VAS = visual analogue scale/score.

Efficacy of Electroacupuncture for the Treatment of Postherpetic Neuralgia: Study Protocol for a Multicenter Randomized Controlled Trial

“…As is reported, researches 34–37 reveal that EA exerts inhibitory effect on pain via the interaction and integration between acupuncture signals and pain signals at different levels of the nervous system, with plenty of bioactive substances participating in, such as serotonin, 38 , 39 γ-aminobutyric acid (GABA), 40 opioid peptide, 41 TRPV1 and P2X3, 42 , 43 and so on. 44 Although various clinical experience and previous studies demonstrate that 14 , 45–47 acupuncture will alleviate the intensity of pain in PHN patients and concomitant clinical symptoms of PHN, like insomnia, depression, anxiety, and low quality of life, most exiting trials exhibited poor methodological quality and evidence. 12 , 48 , 49 …”

Comparison of Efficacy of Acupuncture-Related Therapy in the Treatment of Postherpetic Neuralgia: A Network Meta-Analysis of Randomized Controlled Trials

“…A large number of clinical studies on acupuncture-related therapies for the treatment of PHN have been conducted in China and abroad, and there are various forms of acupuncture, including acupuncture, moxibustion, electroacupuncture, fire acupuncture, and blood-letting [8]. Recent systematic evaluations have confirmed that acupuncture-related therapies (including fire acupuncture, acupuncture, electroacupuncture, and moxibustion) are effective for PHN and that they can reduce pain intensity, relieve anxiety, and improve quality of life in patients with PHN [15][16][17]. As these studies have mainly focused on the comparison of acupuncture therapies with traditional drug therapies, there is a lack of comparison of efficacy between different acupuncture therapies, and therefore, there is still controversy in clinical practice as to which acupuncture therapy is the best choice.…”

Propensity score matching comparing short-term nerve electrical stimulation to pulsed radiofrequency for herpes zoster-associated pain: A retrospective study

“…However, complete pain relief cannot be achieved by taking medications, and 20–40% of patients do not respond to the drugs ( Binder and Baron, 2016 ). Conservative treatments such as acupuncture and physical therapy combined with pharmacy have been reported to provide greater pain relief for ZAP ( Fleckenstein et al, 2009 ; Zhou Q. et al, 2021 ). However, these therapeutic effects are still limited and lack quality supporting evidence.…”