Efficacy and Safety of Electroacupuncture for Pain Control in Herpes Zoster: A Systematic Review and Meta-Analysis

Abstract

Introduction. Herpes zoster is caused by the reactivation of the latent varicella-zoster virus, which leads to acute pain that may disturb routine activities and affect patients’ quality of life. Electroacupuncture (EA) has been commonly used for treating herpetic pain in clinical treatment. However, no relevant studies have been performed to evaluate the efficacy and safety of EA for acute control in herpetic neuralgia patients. The purpose of the current study was to conduct a systematic review and meta-analysis to address the deficiencies of the current research. Methods. Three English (PubMed, Cochrane Library, and Web of Science) and four Chinese (China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature database (CBM), Wan-fang database, and the Chinese Scientific Journals Full-text Database (VIP)) were comprehensively searched from inception to 31 December 2021. Two independent reviewers evaluated the retrieved data based on the eligibility criteria in advance. In addition, the Cochrane Risk of Bias Tool was used to assess the methodological quality of the included studies. Outcome indexes in this study included the visual analog scale, the time to cessation of pustules, the time to scabs, the time to rash healing, adverse reactions, and the incidence of postherpetic neuralgia. Sensitivity and subgroup analyses were also performed to evaluate the intervention effect specifically. In addition, publication bias was analyzed. Results. Six randomized controlled trials (167 participants in the experimental groups and 174 participants in the control groups) were identified as reporting the application of EA for acute herpes zoster pain and were included in this study. The results from our meta-analysis revealed that EA was superior to control treatment according to visual analog scale, the time of rash healing, and the incidence of postherpetic neuralgia. However, in terms of the time to cessation of pustules, scabs, and adverse reactions, the results showed that EA compared with the control group showed no significant difference. In addition, subgroup analyses indicated that 2/100 Hz-EA has more significant effects on herpetic pain. Sensitivity analyses revealed that the results of EA for acute pain control and the rash healing time in herpetic neuralgia patients were stable. However, a publication bias was observed. Conclusion. Our meta-analysis results showed that EA could offer certain advantages in treating acute pain in herpetic neuralgia patients. However, small sample sizes, heterogeneity in study design, and variable methodological quality weaken these inferences. In addition, weak evidence was found for the safety of EA.

Efficacy and safety of therapies related to acupuncture for acute herpes zoster: A PRISMA systematic review and network meta-analysis

“…Electroacupuncture could activate a variety of bioactive chemicals and desensitized peripheral nociceptors, [ 96 ] thereby blocking pain caused by acute HZ. [ 97 ] PC has been found to be effective in reducing serum substance P (SP) levels and relieving symptoms in patients with HZ at the acute stage. [ 98 ] FN is capable of alleviating the pain of acute HZ probably by inhibiting the release of inflammatory cytokines and reducing the level of pain mediators such as SP.…”

Effects of Intradermal Botulinum Toxin Injections on Herpes Zoster Related Neuralgia

“…18 , 19 Results from some recent studies have demonstrated that electroacupuncture can be effective in treating the acute pain of Herpes Zoster and low-level laser therapy can reduce the incidence of PHN. 2 , 20 Moreover, there are some case reports documenting the efficacy of toxins in patients with PHN refractory to conventional treatments in terms of VAS score reduction, with an analgesic duration ranging from 52 to 64 days and a good degree of tolerability. 14 , 21…”

Hotspots and Trends in Research on Treating Pain with Electroacupuncture: A Bibliometric and Visualization Analysis from 1994 to 2022

“… 12 Furthermore, EA therapy for acute herpes zoster-associated pain also surpasses conventional approaches such as oral antiviral medications. 68 …”