Summarizing the great majority of the treatments that I've
been exposing to this group, inspired from various sources including
personal experiences, I have mentioned non-ritualistic
approaches all along.

Rituals pressume certain patterns that are culturally or other
particularity specific. In such a ritualistic approach, the
non-related patterns would be limited
to a large extent, due to treatments specificity and simplicity.

Most of the methods, though, are folk remedies, layman's herpes
treatments etc.

You don't need to be a buddhist monk, a catholic priest, a dim-mak
martial artist
to be able to apply all these methods on yourself.

Recently I have gained more interest in acupuncture.

Perl Molson

http://users.med.auth.gr/~karanik/english/articles/herpes.html#a19

Acupuncture in the treatment of herpes and postherpetic neuralgia: A
Bibliography

Phil Rogers MVB MRCVS
1, Esker Lawns, Lucan, Dublin, Ireland
e-mail : philrogers@tinet.ie  

Acupuncture Progress
[http://users.med.auth.gr/~karanik/english/acuprog.html] output 50
abstracts on May 29 1999 that dealt with herpes. The abstracts, edited
slightly to standardise the terminology and point names, are listed
alphabetically below. Those with practical details of therapy were
summarised.

This bibliography has five elements:

1. Summary of all treatments used in Herpes

2. Summary of the AP- and related- methods in Herpes

3. Summary of the acupoints used in Herpes

4. Other keywords, hyperlinked to the relevant abstracts

5. Edited abstracts, sorted alphabetically

Within the following text, references asterisked (*) have the relevant
keyword, or its concept, in the title of the paper.

Conclusions

1. A large body of evidence suggests AP-type therapy to be of great
benefit in treating acute or early cases of herpes, especially in the
first dew days when the lesions are present.

2. AP-type therapy, as the sole treatment of chronic cases, has not
been adequately shown to be of benefit. It may have a role if combined
with amitriptyline, topical capsaicin and TENS.

1. Summary of all treatments used in Herpes

[Top of File]

The varicella-zoster virus (2) can infect the skin, mucosa and nerves,
initially causing pain, vesicles, scabs and scars (early herpes), and
later, postherpetic problems (pain, or rarely paralysis).

In contrast to early cases of herpes, with vesicles or lesions
present, postherpetic neuralgia is a very difficult problem to
resolve. Chronic cases (>6 months), especially in aged or
immuno-compromised people (HIV / AIDS) are especially difficult (2, 8,
16, 17, 29, 30, 31*, 34). The earlier one begins effective therapy,
the better is the outcome, and the less likely the case will progress
to postherpetic neuralgia or paralysis (2, 5, 8, 35).

Volmink et al (1996) did a systematic review of existing randomized
controlled trials. Based on published evidence from those trials, they
concluded that tricyclic anti-depressants are the only agents of
proven benefit for established postherpetic neuralgia, although
topical capsaicin also seemed to help (39). In an earlier study,
Carmichael (1991) concluded that the best therapy currently available
for postherpetic neuralgia is amitriptyline, topical capsaicin and
TENS (2). Section 2 will discuss TENS with acupuncture (AP) and
related methods.

Other useful therapies were epidural spinal cord stimulation (1*), or
anaesthetic blocks of affected nerves (13*, 16), ophthalmic,
supraorbital (45), sympathetic nerves (15), Gasserian ganglion (45*)
or Stellate ganglion (15*). Tranquilizers (22), carbamazepine (22, 45)
and imipramine (45) were said to he useful also.

Acyclovir (2, 39), lorazepam (39), and topical benzydamine (39) had no
significant analgesic effect in postherpetic neuralgia. Though
acyclovir may speed up the resolution of early cases, it does not
prevent recurrence (19). Steroids have questionable efficacy in
prevention of recurrence (2) but hydrocortisone (22) and prednisolone
(22, 45*) have been tried. Other treatments tried were antihistamine,
Bonaphthon, calcium drugs, diuretics, essential oils and vitamin B1
(22) and vitamin E (41). Vincristine iontophoresis had no effect (39).



2. Summary of the AP- and related- methods in Herpes

[Top of File]

TCM makes no differential diagnosis of various skin diseases. They are
usually grouped into two large categories: Xuen (dermatitides) and
Chuan (ulcerations). They are said to be caused by Wind-qi and Damp-qi
pathogens or excessive Heat in the Blood. Wind and Damp pathogens
cause itchiness while excessive Blood Heat cause red skin rash. The
general principle of AP treatment involves a dispersion of Wind and
Damp pathogens and a reduction of the Blood Heat (20).

Most of the abstracts below claim great, or some benefit from AP, or
AP-related methods in early herpes, when the lesions are still
present, or before the infection becomes chronic.

As mentioned in Section 1, Carmichael (1991) concluded that the best
therapy currently available for postherpetic neuralgia is
amitriptyline, topical capsaicin and TENS (2). Others also found TENS
to be useful (15*, 16, 45*), but Broggi et al (1) found it to be of no
value.

Three studies (1, 17, 39) found AP to be of no significant value in
chronic postherpetic neuralgia, and Hyodo (1988, 13*) found nerve
block to be better than AP in that condition.

Very few papers claim good results for AP-type therapy in chronic
herpes, or postherpetic neuralgia (25, 26, 28, 35, 38, 42), and the
number of cases treated in those papers are few.

AP techniques used in early herpes, and in postherpetic neuralgia,
neuritis, pain or paralysis (1, 2*, 5, 8*, 13, 16*, 17*, 25, 26, 28,
29*, 35, 38, 39*, 41, 42*, 45*) were very varied. They included simple
acupuncture (AP) needling, but also:

Cupping (6)

Earpoint LU + Chinese ink + Realgar powder painted around lesion (50*)

Electro-AP (5, 30, 31, 37, 42)

Electromagnetic channel activation (46*)

Fire needling (48*)

Gentian violet painted on lesions after treatment of broken herpes
(18)

Lamp irradiation (24)

Laser-AP and irradiation of the lesions (3*, 6, 11*, 12*, 14*, 22,
26*, 33*)

Moxibustion (6, 23, 24*, 31, 32*, 35)

Nerve root irradiation (33)

Paediatric massage / tuina (49*)

Plum-blossom needling (4*, 7, 24, 31)

Polyinosinic acid i/m good, but as good as AP (3*)

Pricking to bleed using a three-edged or other needle (18*, 24, 44*,
36*, 44*)

Transcutaneous electroanalgesia (28*)

Warming needle (41)

3. Summary of the acupoints used in Herpes

[Top of File]

Acupoints used to treat herpes infections (early cases) and
postherpetic neuralgia were:

AP at parallel lines 2 cm from corresponding vertebrae (4)

Ashi, tender points (14, 23, 35, 40)

Bagua (49)

BL01 (14), BL13 (48), BL18 (48), BL19 (48), BL20 (48), BL23 (35), BL25
(35), BL26 (35), BL43 (23)

Earpoints (17, 50*, Earpoint trigeminus (27))

GB08 (42), GB20 (14, 40, 42), GB22 (40), GB34 (7, 40, 42, 48)

LI04 (3, 14, 40), LI11 (18, 40), LI15 (23), LI20 (41)

Liufu (49)

Circling the Dragon (local needling or moxa; local points around
lesions) ( 4, 6, 24, 23, 31, 36, 37, 48)

LV01 (18), LV13 (40), LV14 (40)

Neijianjing outside-GB21 (23)

NZ11-Waiming (Outer Brightness) (14)

Point lateral and right of vertebra C4 (23)

Puncturing the Channels (24)

Qinwei (49)

Scalp AP (47*)

Segmental points (30)

Shangtun (35)

SI11 (23), SI18 (41)

Sihengwen (49)

SP01 (18), SP09 (40), SP10 (40)

ST04 (41), ST06 (41), ST07 (41), ST36 (3, 40), ST40 (40)

TH05 (40), TH06 (7, 40, 48), TH17 (40)

Tianying (lasering the lesion, or needling at or near, but not
directly into, the lesion) (3, 4, 6, 7, 11, 14, 37*)

X_35-Huatojiaji (30, 37*, 38, 40)

Xiaochang (49)

Z_08-Qiuhou (Pupils Behind) (14)

Z_09-Taiyang, (14, 41)



4. Other keywords, hyperlinked to the relevant abstracts

[Top of File]

Below lumbar area (48) | Blood stasis (24) | Body weakness (24) |
Chest (15, 50) | Chest pain (32*) | Conjunctiva (14*) | Controlled
randomized trials (39*) | Controlled trial (3, 17, 46) | Damp-Heat
type (24) | Damp-qi (20) | Depression (35*) | Earpoint diagnosis (27*)

37, 42) | Herpes (20*) | Herpes genitalis (19) | Herpes simplex (19*,
27*, 44) | Herpes zoster, herpetic infection, pain (2*, 3*, 4*, 5*,
6*, 7*, 9*, 10, 11, 12, 15*, 16, 18*, 21, 22, 23*, 24*, 27*, 30*, 31*,
32, 33, 35, 36*, 37*, 38*, 40*, 41*, 42*, 43, 44, 46*, 47, 48*, 50*) |
Herpetic conjunctivitis (14) | Herpetic stomatitis (49*) | Iliac spine
(35) | Inguinal region (35) | Limbs (50) | Lumbar lesions (37, 50) |
Meta-analysis (39) | Mock-TENS (17) | Naloxone (28*) | Neck lesions
(15, 41) | Neuralgia (32) | Ophthalmic area (45) | Oral-labialis (19)

Qi-Xue Stasis (40) | Review (39*) | Simple AP (38) | Skin diseases
(20*) | SP Xu excessive Damp Type (40) | Toxic Heat type (40) |
Trigeminal neuralgia (22*, 42*, 45) | Wind-Damp type (40) | Wind-qi
(20) | Xue-Heat (20)|





5. The edited abstracts, sorted alphabetically

[Top of File]

1#Broggi G, Servello D, Dones I, Carbone G (1994) Italian multicentric
study on pain treatment with epidural spinal cord stimulation.
Stereotact Funct Neurosurg 62(1-4):273-278. Istituto Nazionale
Neurologico C. Besta, Milano, Italia. A multicentric study on the
treatment of nonmalignant chronic pain with epidural spinal cord
stimulation (SCS) has been carried out in 32 Italian centres devoted
to pain therapy. Neurosurgical and anaesthesiology units participated
in this retrospective study. 410 of the eligible patients were
enrolled in the protocol: 48% were male, 52% female. All patients
underwent a screening test period (average 21 d) and 74% underwent the
definitive implant. The diagnosis was failed back surgery syndrome in
45%, reflex sympathetic dystrophy in 15%, phantom limb pain in 14%,
postherpetic neuralgia in 8%, peripheral nerve injury in 5%, others
13%. 84% had received noninvasive unsuccessful treatment (TENS or AP).
All had previous pharmacological therapy which was not always
discontinued when SCS took place. Pain assessment had been done with
the visual analog scale and verbal scale both subjectively and by the
physician and nurses. Neuropsychological profile with minimal mental
test or MMPI was obtained in 68% of the patients. These results were
favourable (i.e. excellent or good; >50% reduction of pain) in 87% of
the patients at the 3-mo follow-up, 75% at the 6-mo follow-up, 69% at
the 1-yr follow-up, and 58% at the 2-yr follow-up. Complication rate
was: dislocation of the electrocatheter 4%, technical problems 3%,
infections of the system 2%. The results will be discussed in
correlation with the different etiologies of the nonmalignant chronic
pain syndrome.

2#Carmichael JK (1991) Treatment of herpes zoster and postherpetic
neuralgia. Am Fam Physician Jul;44(1):203-210. Univ of Arizona College
of Medicine, Tucson. Herpes zoster results from reactivation of latent
varicella-zoster virus. It is most common in elderly patients and
immunosuppressed patients, especially those with human
immunodeficiency virus (HIV) infection. Zoster is often the earliest
indicator of HIV infection. The acute course of herpes zoster is
generally benign, but systemic complications may be fatal.
Postherpetic neuralgia is the major chronic complication and is a
difficult management problem. High-dose acyclovir (800 mg orally 5
times/d) has recently been approved for treatment of herpes zoster
and, if started early, decreases the duration and severity of
symptoms. In the prevention of postherpetic neuralgia, acyclovir does
not appear to be effective, and the efficacy of steroids is
questionable. The best therapy currently available for postherpetic
neuralgia is amitriptyline, topical capsaicin and TENS.

3#Chen Baozhu; Zhao Jianhua (1993) [A comparative observation on
therapeutic effects of He-Ne laser and polyinosinic acid on herpes
zoster]. Chin Acupunct Moxibust 13(2):59-60. 65 cases of herpes zoster
were randomly divided onto the He-Ne laser group (33 cases) and
polyinosinic acid group (32 cases). Type JI He-Ne laser apparatus was
used to irradiate the lesions and to radiate LI04 and ST36 with
photoconductive fibres once everyday in the He-Ne laser group; 2 ml of
polyinosinic acid was intramuscularly injected once every other day in
the other group. 63/65 cases were cured, and sequela of neuralgia
remained in the other two cases of the latter group. Pain was
disappeared and scars were formed respectively after 1.48 and 7.56 d
of treatment with He-Ne laser therapy, and after 10.5 and 10.4 d with
polyinosinic acid treatment. The differences in therapeutic effects
between the two groups were noticeably significant (p<.05).

4#Chen JX; Feng SH (1984) [Treatment of herpes zoster by plum-blossom
needling: A clinical observation of 110 cases]. J New Chin Med
(7):29,20. 110 cases of herpes zoster were treated by plum-blossom
needling, with an effective rate of 98%. The analgesic effect is more
evident than other therapies. The location for needling may vary with
different damaged parts. The needling manipulation included (1)
general stimulation, i.e. needling along the parallel lines 2 cm
lateral to the corresponding vertebrae, and (2) topical stimulation,
i.e., needling around the skin lesion 1 cm distant to the margin of
lesion. However, needling at the lesion is absolutely prohibited. In
general, a strong stimulation is advisable, but a moderate stimulation
may be applied for some cases.

5#Coghlan CJ (1992) Herpes zoster treated by AP. Cent Afr J Med
Dec;38(12):466-467. 7th Avenue, Surgical Unit, Mutare. The treatment
of Herpes zoster by AP is described. These were 4 patients with acute
zoster and 4 with postherpetic neuralgia. In most cases EAP was
effective, and this treatment should be instigated as early as
possible. Since the treatment of Herpes zoster by drugs is not
routinely successful and can prove expensive, AP, whose side effects
are minimal, merits a trial.

6#Ding JB (1987) [Current status on AP therapy of herpes zoster].
Shaanxi JTCM (5):44-46. This article reviewed the general aspect of
various reports in treating herpes zoster with AP since 1976,
including AP, moxibustion, cupping, He-Ne laser local radiation, laser
local radiation in acupoints, etc. The author expresses his own
understandings on clinical application.

7#Du XS (1985) [AP therapy: Report of 3 cases]. Jiangsu JTCM
6(7):34-35. 1) Migraine: GB20, GB43, GB34 (the open acupoint in
midnight-noon ebb-flow, with contralateral puncture) were used. The
needles were retained for 90 min. Pain disappeared after 3 treatments.
2) Herpes zoster: TH06, GB34 (reducing method) were punctured on the
diseased. Plum-blossom needle was also used to peck local area.
Patient recovered after one-week treatments. 3) Facial spasm: First,
ST02 and GB01 were punctured, and then magnetic therapy was applied.
And LI04 were added bilaterally. Patient recovered after ten
treatments.

8#Dung HC (1987) AP for the treatment of postherpetic neuralgia. Am J
Acupunct 15(1):5-14. We had 29 cases of postherpetic neuralgia within
the past 3 yr. This report reviews the results of using AP as a
therapeutic method to control herpetic pain. Incidences of
postherpetic neuralgia are most often encountered among elderly
people. The pain is a difficult problem to manage. Patients >65
yr-old, with a duration of pain suffering >6mo, and a high degree of
pain quantification, are practically hopeless in terms of obtaining
relief from pain by AP therapy. Manageability of postherpetic
neuralgia is only possible among younger patients with a duration of
pain shorter than 6 mo, and a low degree of pain. It is concluded that
AP is effective for patient with postherpetic neuralgia, but only if
they are treated early in the course of the disease.

9#Erez S (1984) Research the use of AP in the treatment of herpes
zoster. Br J Acupunct 7(1):6-20. We have studied the use of AP in the
treatment of Herpes Zoster. The investigation is based on a group of
18 subjects of age range 55-80. The research strategy is mainly based
on the so called multiple case studies. The patients received 5-20
treatments. The number of needles employed and their location varied
according to the location of the symptoms and the patients general
condition. The results observed 6 mo after the treatment indicate that
61 of the patients were feeling well, 11 had not responded to the
treatment, 11 were showing partial improvement, and 13 were eliminated
from the statistics. The influence of other factors, such as sex,
medication and the presence of other diseases was also studied.

10#Fischer MV, Behr A, von Reumont J (1984) AP: a therapeutic concept
in the treatment of painful conditions and functional disorders:
Report on 971 cases. Acupunct Electrother Res 9(1):11-29. The results
in 971 outpatients who have been treated with AP for different
diseases are reported. The outcome of treatments and number of
sessions are discussed in relation to the different diseases. AP
treatment was regarded as successful when 1. the patients had no pain
at all without medication and 2. there was a significant improvement
(no long-term medication, only mild pain under unusual strain, minimal
medication under such circumstances). We obtained positive results in
cephalalgias, sinusitis, cervical spine syndrome, shoulder-arm
syndrome, ischialgias, back pain, constipation, herpes zoster,
allergic rhinitis and disturbances of peripheral blood flow. For the
following ailments, in order to reduce the medication, we recommend AP
despite a high rate of recurrence: Trigeminal neuralgia, colitis
ulcerosa, bronchial asthma and cancer pain. Results in the treatment
of mental disturbances were unsatisfactory, and in cases of tinnitus
results were negative.

11#Hu GZ (1989) [Observation on curative effect of laser needle
treatment in 76 cases of pain]. Acupunct Res 14((1-2)):259-260. "Laser
Needle", low output laser irradiation analgesia is effective in the
therapy of pain. The author used 3mW He-Ne laser irradiation directly
on the AP point or on the painful area in a study of herpes zoster,
trigeminal neuralgia, aphthous ulcer, and others with 93% effective
and 62% cured. Laser needle has the advantage of no pain, no
possibility of infection, and especially adequate to aged and
children.

12#Hu GZ (1989) Treatment of pain by laser irradiation: A report of 76
cases. JTCM (ENG) 9(4):256-258. 76 cases of pain syndrome due to
various etiological factors (herpes zoster, inflammation of nervi
occipitalis major, trigeminal neuralgia, parotitis, osteochondritis of
ribs, frozen shoulder, oral cavity ulcer, cholecystitis and
cholelithiasis, ureteral calculus, sciatica) were treated by laser
irradiation. All cases in this series were treated with BXS-1 model
He-Ne laser therapeutic machine with a wave length of 6328 angstrom, a
light spot of 2 mm in diameter, an output potential of 3 mW, a working
current of 1-10 mA, an irradiation distance of about 30-50 cm from
exit of laser light to the skin. Focal irradiation was combined with
acupoint irradiation. For acupoint irradiation, acupoints were
selected according to TCM differentiation. 1-3 acupoints were selected
for each session of treatment once daily, with 10 sessions
constituting a therapeutic course. It was shown that the analgesic
effect was better in oral cavity ulcer and herpes zoster, but less
effective in abdominal pain due to cholecystitis and cholelithiasis,
the chief reason being that it was difficult for the calculi to be
expelled.

13#Hyodo M (1988) [Comparison of the effect between nerve block and AP
for various painful diseases]. Orient Med Pain Clin 18(2):58-63. A
comparison was made between the effect of nerve block and AP to treat
a variety of painful diseases. Nerve block was better in the treatment
of headache (especially in its acute stage, neck pain, periarthritis
of shoulder joint, low back pain, knee-joint pain, postherpetic
neuralgia etc. For such diseases as whiplash injury, pain of frozen
neck or shoulder and pain originated form disorder of vegetative nerve
or climacteric symptom, AP therapy was more preferable.

14#Jiang ZR (1985) [He-Ne laser radiation on AP points in treatment of
51 cases of conjunctival allergic reaction]. Shanghai J Acupunct
Moxibust (3):9-10. 36 cases of spring catarrh conjunctivitis were
treated with He-Ne Laser AP at following acupoints: above
BL01-Jingming, below BL01-Jingming, Waiming, Qiuhou (Ex24), Ashi
(affected conjunctival area) and bilateral GB20. Each point was
radiated for 3 min (total radiation time 20-25 min), q.d., 10-15
times/course. The effective rate was 97%. 15 patients with herpetic
conjunctivitis were radiated at the following acupoints of affected
eye: BL01, Z_09-Taiyang, Ashi, GB20 and bilateral LI04. The effective
rate reached 100%.

15#Jungck D (1986) Stellate ganglion block with ramp-impulse-TENS in
the treatment of acute herpes zoster. Acupunct Electrother Res
11(3-4):299. Postherpetic neuralgia can safely be prevented by
administration of sympathetic nerve blocks during the first days of
the disease. In patients under anticoagulant therapy or
poor-risk-patients these anaesthesiological methods cannot be used. In
these patients we prefer "electric blockades" following the techniques
published by JENKNER. Electric stellate ganglion blocks are indicated,
when we find cranial, cervical or upper thoracic localisation of
herpes zoster. To improve the efficiency, we use the
Ramp-Inpulse-TENS, published 1985 (Jungck). R-Tens is characterized by
- no painful stimulation at high output (up to 112 V and 400 mA), -
rise time less than 0, 5 usec, low output impedance (109,5 Ohm), no
direct current. The electric blockades were followed by increase of
skin temperature (0, -2, 3 C degree), often by HORNER's syndrome. Pain
reduction was sufficient. Postherpetic neuralgia was not been observed
in 18 patients. Electric stellate ganglion blocks can be recommended,
when anaesthesiologic blocks cannot be used. The efficiency can be
improved by the use of the Ramp-Impulse-TENS.

16#Lefkowitz M, Marini RA (1994) Management of postherpetic neuralgia.
Ann Acad Med Singapore Nov;23(6 Suppl):139-144. Pain Management
Service, Long Island College Hospital, Brooklyn 11201, USA.
Postherpetic neuralgia is a perplexing disorder in which pain develops
as a result of herpes zoster. It is a common cause of neuropathic pain
and may render its effects especially on the elderly and
immunocompromised. Once established, postherpetic neuralgia is
resistant to most treatment modalities and can lead to much despair.
Many therapeutic approaches have been attempted through the years,
most with varying results. This review describes clinical
manifestations including allodynia, hyperaesthesia and anaesthesia. It
also reviews pharmacologic and non-pharmacologic treatment modalities
including a review of anaesthetic nerve blocks, neurostimulation, AP
and surgical techniques.

17#Lewith GT, Field J, Machin D (1983) AP compared with placebo in
postherpetic pain. Pain Dec;17(4):361-368. A single blind randomised
controlled study of auricular and body AP compared with placebo (mock
transcutaneous nerve stimulation) was performed in 62 patients with
postherpetic neuralgia. There was no difference in the amount of pain
relief recorded in the two groups during or after treatment; 7
patients in the placebo group and 7 patients in the AP group
experienced significant improvement in their pain at the end of
treatment. This suggests that AP is of little value as an analgesic
therapy for postherpetic neuralgia. However the study method and the
use of a mock TENS as a placebo may be of value when assessing the
effects of AP in other conditions. Publication Types:. * Clinical
trial. * Randomized controlled trial

18#Li LG (1992) [Herpes zoster treated by pricking blood with 3-edged
needle: Report of 23 cases]. New JTCM 24(6):33. Three-edged needle was
applied to prick 0.1" on spots 0.1" distal to medial and lateral
corners of nails of thumbs and big toes (corresponding to LI11, SP01,
LV01 and opposite area) on bilateral sides, to cause bleeding. Blood
was wiped away after 5-10 min. Treatment was given once every 1-2 d.
On broken herpes, 1-2 gentian violet was applied to prevent infection.
After 1-9 treatments, all cases were cured.

19#Liao SJ, Liao TA (1991) AP treatment for herpes simplex infections:
A clinical case report. Acupunct Electrother Res 16(3-4):135-142.
Boston Univ Medical School, Massachusetts. Herpes simplex is a common
skin disorder. There is no effective cure. The recent introduction of
drugs, such as acyclovir, is indeed a great advance in its
therapeutics. However, these drugs may only modestly reduce the length
of an attack, but do not lengthen the remission nor prevent
recurrences. Our very limited experience in two cases of herpes
oral-labialis and 3 cases of herpes genitalis with AP treatment seemed
to indicate the possibility of a marked reduction of an episode, a
lengthening of the remission, and a prevention of recurrences. We hope
our report would encourage our colleagues to try AP in
he clinical
management of herpes cases and to study its immunologic effects.
Publication Types:. * Clinical trial

20#Liao SJ; Lia TA (1985) AP for skin diseases including psoriasis,
acne, keloid, herpes, etc. Acupunct Electrother Res 10(4):371-373. The
skin is one of the largest vital organs of our body. Its importance to
our health and survival is usually not fully appreciated.
Pathologically, some skin diseases may cause systemic disorders, such
arthritis in psoriasis while systemic diseases may have skin
manifestations, such as dermatitis in pellagra. Nevertheless the skin
has many disorders of its own. Their pathogeneses are often not well
understood. The therapeutic regime in western medicine are usually
quite experimental and sometimes even toxic. Thus, patients with skin
disorders often search for alternative cures, such as AP. TCM makes no
differential diagnosis of various skin diseases. They are usually
grouped into two large categories: Xuen (dermatitides) and Chuan
(ulcerations). They are said to be caused by Wind-qi and Damp-qi
pathogens or excessive Heat in the Blood. Wind and Damp pathogens
cause itchiness while excessive Blood Heat cause red skin rash. The
general principle of AP treatment involves a dispersion of Wind and
Damp pathogens and a reduction of the Blood Heat. We would like to
describe our personal experience in the treatment of psoriasis, cystic
acne, painful keloids or surgical scars, eczema, urticaria, allergic
dermatitis, and herpes. All these patients had received western
medical treatments with great disappointment.

21#Liu Jiaying; Yang Deli (1992) [Application of AP in neurological
clinic in recent years]. Chin Acupunct Moxibust 12(5):271-274. The
article introduced the application of AP in neurological Depts in
recent years for treating the common disorders such as cerebrovascular
accident, facial paralysis, herpes zoster, sciatica, trigeminal
neuralgia, migraine and nervous lesions.

22#Lobzin VS, Elagin VV (1991) [Pathogenetic therapy of trigeminal
neuralgia - Article in Russian]. Zh Nevropatol Psikhiatr Im SS
Korsakova 91(4):25-27. The authors describe a clinical case of severe
neuralgia of the third branch of the trigeminal nerve, in whose
etiology and pathogenesis a role was played by allergic vasomotor
rhinosinusopathy, general allergization of the body, and recurrent
herpetic infection. The patient was treated by carbamazepine,
tranquilizers, prednisolone, antihistamine and diuretic agents,
calcium drugs, bonaphthon, vitamin B1, essential oils, AP, local
hydrocortisone phonophoresis and laser therapy. Such treatment made it
possible to effectively remove the neuralgic painful syndrome. The
case shows that the syndrome is due to several pathological systems
having different pathophysiological and neurochemical organization,
demanding a differentiated individual approach and providing evidence
for the necessity of carrying out the etiological and pathogenetic
therapy.

23#Matsumoto T (1987) [Case study (23): Zoster]. J Jpn Acupunct
Moxibust 46(11):11-14. Effective AP treatment of a case of zoster is
reported. The patient, male, aged 20 yr came to the clinic because of
zoster of right arm. Treatment: AP was first applied on surrounding
site of the most painful herpes, and then on the tender spot (lateral
and right to the 4th cervical vertebra), right Nei Jianjing
Outside-GB21 and l cm posterior to right LI15 (with retaining of
needles for 10 min and warm heat therapy added). During his 2nd visit,
he complained of more severe pain and increase of herpes, which might
result from the development of the disease itself. In addition to
above points, right SI11 and right BL43. During his third visit, pain
was obviously reduced. It was cured after 6 times of treatment.

24#Ni SN (1990) Comparative studies on various AP-Moxibustion methods
in the treatment of herpes zoster. Xinjiang TCM (4):44-45. The paper
introduces briefly the following methods of treating herpes zoster:
surrounding AP and surrounding moxibustion, cotton moxibustion,
plum-blossom needling, puncturing the Channels and blood-letting, lamp
radiation, etc. In general, the patients of Damp-Heat type were
treated with surrounding AP and surrounding moxibustion, cotton
moxibustion; those with body weakness and Blood Stasis were treated
with plum-blossom therapy or pricking blood therapy. During treatment,
Renshenbaidu San (ginseng detoxic powder) or longdanxiegan wan might
be added, and others who were treated with hormones showed
unsatisfactory results.

25#Rapson LM (1986) [AP and facial pain; a rational approach to
treatment]. Akupunkt Theorie Praxis 14(4):266. The usefulness of AP in
the treatment of facial pain was evaluated in all patients treated in
a private chronic pain practice over a 10-yr period. Conditions
treated included Tic. Douloureux, atypical facial neuralgia,
Postherpetic neuralgia, temporomandibular joint (TMJ) dysfunction,
facial migraine and mixed cases. A rational approach to these
conditions was developed based on empirically and anatomically chosen
acupoints. Thorough histories and physical examinations were done to
determine the etiology of pain. Appropriate investigations were
evaluated of ordered. If TMJ dysfunction was considered to be an
important perpetuating factor a short trial of treatment (3) was
undertaken prior to referral to an orthodontist or physiotherapist.
Others received a trial of 5 treatments; those responding positively
to AP treatment were treated thereafter on an individual basis.
Outcomes were measured by patients' assessment of relief, duration of
relief, change in drug intake and response to medication. The majority
of patients showed a good response to treatment. Side effects and
complications were virtually non-existent. AP is a safe, effective,
conservative modality with which to treat facial neuralgias.

26#Richand P, Boulnois JL (1983) [Laser radiations in medical therapy
- Article in Italian]. Minerva Med Jun 30;74(27):1675-1682. The
therapeutic effects of various types of laser beams and the various
techniques employed are studied. Clinical and experimental research
has shown that He-Ne laser beams are most effective as biological
stimulants and in reducing inflammation. For this reasons they are
best used in dermatological surgery cases (varicose ulcers, decubital
and surgical wounds, keloid scars, etc.). Infrared diode laser beams
have been shown to be highly effective painkillers especially in
painful pathologies like postherpetic neuritis. The various
applications of laser therapy in AP, the treatment of reflex
dermatologia and optic fibre endocavital therapy are presented. The
neurophysiological bases of this therapy are also briefly described.

27#Sachsse H (1985) [Auricularmedical diagnosis and therapy of herpes
simplex I and II abortive herpes zoster]. Akupunkturarzt /
Aurikulotherapeut 12(6):160-164. It is reported about auricularmedical
observations on Herpes simplex I and II and Herpes zoster. A certain
combination of points lead to a very good success. According to the
principal of genetic line + 1 the treatment consists in a combination
of genetic line of laterality and Trigeminus point.

28#Salar G, Iob I (1978) [Transcutaneous electroanalgesia and
naloxone: Clinical aspects - Article in French]. Neurochirurgie
24(6):415-417. Mayer (1977) and Adams (1976) proved that both AP and
direct ES of deep encephalic structures produce an analgesic effect
releasing a neurotransmitter similar to morphine (endorphin). We have
verified this hypothesis, using the transcutaneous electrotherapy in 5
patients with chronic pain at the back (postherpetic neuralgia in 3,
pain cancer in 2). All patients related a certain analgesic effect
during electrotherapy, with a reduction in pain of more than 50 per
cent. During electroanalgesia we administered Naloxone (an antagonist
of morphine). In 3 cases we observed a clear, although short, return
of pain symptomatology. At the contrary, in other two patients
Naloxone caused briefly a further and clear reduction in the pain.

29#Schott GD (1980) Neurogenic facial pain. Trans Ophthalmol Soc U K
Jul;100( Pt 2):253-256. Neurogenic facial pain can be classified as
either paroxysmal or persistent. Trigeminal neuralgia is the commonest
example of the former, and postherpetic neuralgia, atypical facial
pain, and tension head and facial pains are examples of the latter.
The cause of many of these pains is poorly understood, the complex
neuroanatomy of the head and neck being a contributory factor. Even
when the aetiology is known, the mechanism whereby pain is produced is
usually obscure. While treatment with drugs and surgical measures for
trigeminal neuralgia are often satisfactory, and AP for pain due to
"muscle tension" may be beneficial, there is often little effective
treatment for a considerable proportion of patients with neurogenic
facial pain.

30#Serres G (1988) Comments on the technique of the treatment of
herpes zoster. Acupunct Res 13(1):7-9,5. The author has used AP for
treatment of herpes zoster and considers that EAP at X_35-Huatuojiaji
points at the vertebral level corresponding to the location of the
herpes zoster produce an obvious analgesic effect. But the remaining
pains of >1 yr-old herpes zoster are more difficult to treat and
relieve very slowly. The older the disease, the longer the treatment.

31#Shi Youqi (1993) [AP treatment for 5 cases of herpes zoster
accompanying AIDS]. Shanghai J Acupunct Moxibust 12(3):119. The
patient was instructed to lie on bed and expose the herpes region.
Surrounding needling was performed around the region with 6-12
filiform needles(0.35 mm * 40 mm). In the meantime, placed a self-made
moxibustion box on the affected area and cauterized this area for 60
min. For patients with more severe pain, additional EAP was applied
for 15 min; For patients with purulent herpes, tapped the herpes part
with a plum-blossom needle, cleaned away the pus and blood and then
apply moxibustion over it. The treatment was given once daily to
patients in mild type and twice daily for those in severe type.
Results showed that all the 5 patients were cured after treatment for
10 or 14 d.

32#Shirota F (1985) [Treatment of chest pain by AP and moxibustion]. J
Tradit Sin Jpn 6(2):39-43. A review is made on different kinds of
chest pain treated by AP, including: 1. The pain produced at the body
surface: (1) Pain of skin scar, (2) Breast pain. 2. Muscle and bone
pain: (1) Muscular overstrain, (2) Connective tissue pain, (3) Bone
fracture, (4) Acute and chronic infection of bone. 3. Nerve pain: (1)
Herpes zoster, (2) Neuritis, (3) Intercostal pain, (4) Cervicobrachial
neuralgia. 4. Pain produced from the thoracal viscera: (1) Affected
lung, trachea, pleura caused pain, (2) Oesophageal disease, (3)
Cardiovascular disease. 5. Cardiovascular neurosis. According to
various conditions of these chest pain the AP was applied, some got
good efficacy.

33#Song TC; Li QY; Wu XZ (1984) [Clinical uses of He-Ne laser AP].
Shanxi Med J 13(4):207-208. 106 cases of various diseases were treated
by 4 kinds of irradiation with laser. 1. Focal irradiation: hordeolum,
wound infection, chronic ulcer, chronic chilitis, etc.; 2. Painful
point irradiation: temporal jaw arthritis (mandible or maxilla) on the
tenderness point; 3. AP point irradiation: acute and subacute
pharyngitis, irradiation on points of bilateral Zengyin(EX-HN); 4.
Nerve root irradiation: herpes zoster, etc. local irradiation might be
used in combination. Results: The total effective rate was 98% and the
cure rate 72% (pharyngitis 90%, hordeolum or stye 83%). There was no
statistic significant difference as compared with other therapeutic
methods.

34#Spoerel WE, Varkey M, Leung CY (1976) AP in chronic pain. Am J Chin
Med 4(3):267-279. A course of 10 daily AP treatments was given to 200
patients who suffered from chronic pain syndromes of =/>1 yr duration
and the result assessed at the end of the course of treatment and
after an interval of at least 2 mo. Treatments were individualized
using needling of body loci distally and near the site of pain, and
ear AP. In 38 patients suffering from chronic headaches, including 13
cases of migraine-type headache, 81% reported an improvement in their
condition, but only one patient was pain free for the 2-mo observation
period. In 162 patients with other chronic pain problems, 99 or 61%
were improved or pain free at the end of treatment; in 69 of these a
worthwhile degree of improvement persisted over the observation period
of 2 mo. Thirteen percent of all patients did not respond to AP and in
26% the response was considered as transient only. Daily treatments
are not more effective than weekly or biweekly treatments. Pain in the
neck and shoulder region, in the knee and low back pain responded to
AP with prolonged improvement in over 50% of the patients treated.
Facial pain syndromes and pain in the region of the trunk were least
responsive and only 3/11 cases with postherpetic neuralgia reported
still having less pain after 2 mo. Needling of effective loci and
particularly ear needling often causes an instantaneous reduction or
disappearance of pain; the speed of this response can only be
explained by a mechanism within the nervous system. Based on our
experience AP represents a useful therapeutic modality in the
management of pain.

35#Sumita K; Kogure K; Sasaki T (1988) [AP therapy of depression (2):
Theory and therapy of depression in traditional Oriental medicine]. J
Jpn Acupunct Moxibust 47(6):6-13. After healing of herpes zoster,
severe neuralgia usually remains, hardly to be cured. A patient with
herpes zoster was treated with AP by the author with satisfactory
result. The patient was male, 52 yr-old, had suffered from crops of
vesicles around the right anterior superior iliac spine since 2 weeks
ago, later extended to the right inguinal region. 5-6 d later he
experienced severe pain from the right flank to the inguinal region
and did not respond well to analgesics. He sought medical care on
December 21, 1984, asking for AP treatment. He was then diagnosed as
postherpetic neuralgia and treatment was aiming mainly at analgesia.
The patient was in the left lateral position, tender points such as
BL25, BL26 and Shangtun were used for puncture, the depth of the
needle was 3 cm. Moxibustion was applied at BL23 and BL25. After 4
trials of treatment, pain was markedly relieved, only mild
uncomfortableness at the affected site. The patient could resume his
work. It was suggested that early treatment was essential.

36#Sun Qi Liang (1990) Pricking needling in the treatment of herpes
zoster: Report of 57 cases. Xinjiang TCM (1):37. Needling was carried
out at the peripheral healthy skin near the lesions. After routine
sterilization, a 28-gauge 0.5" needle was used to prick directly
(0.4"), by rapid insertion and withdrawal, no needle retaining, once/d
for 5 d/course. 42/57 cases were cured within one course, 15 were
cured within 2 courses.

37#Sun YZ; Yang JL; Guo WH (1990) Herpes zoster treated by AP at
Huatojiaji and needling along lesions: Report of 35 cases.
Heilongjiang TCM Mater Med (6):38. Local needling (Circling the
Dragon) was used in case the lesions were in head region. It was
accompanied by needling the X_35-Huatojiaji points in lumbar lesions.
method: Gauge 28 filiform needle (2") was used in puncturing around
each herpes zoster lesion through its centre to opposite side and
twisting by reducing method. Then the needle was connected with EAP
apparatus for 20 min. 7 d of treatments accounted for one course. The
course interval was 3 d. Result: Of 35 cases 26 were cured, 8 markedly
effective and 1 improved.

38#Tanabe S; Shiba K (1984) [The effect of AP for herpetic pain]. J
Jpn Soc Acupunct 33(4):383-387. 41 cases of herpetic pain were treated
with AP mainly at X_35-Huatuojiaji points. The treatment was found
significantly effective in 69 of fresh cases and 13 of cases of
postherpetic neuralgia.

39#Volmink J, Lancaster T, Gray S, Silagy C (1996) Treatments for
postherpetic neuralgia: A systematic review of randomized controlled
trials. Fam Pract Feb;13(1):84-91. Dept of Public Health and Primary
Care, Univ of Oxford, Radcliffe Infirmary, UK. Different therapies
have been used for postherpetic neuralgia. We decided to conduct a
systematic review of existing randomized controlled trials. OBJECTIVE.
To determine the efficacy of available therapies for relieving the
pain of established postherpetic neuralgia. We performed a systematic
review, including meta-analysis, of existing randomized controlled
trials. Eleven published trials and one unpublished trial were
identified which met the inclusion criteria and were included in the
current review. Pooled analysis of the effect of tricyclic
antidepressants show statistically significant pain relief (OR 0.15,
CI 0.08-0.27). Pooling of the results of the 3 trials comparing the
effects of capsaicin and placebo could not be done due to
heterogeneity. This heterogeneity was mainly attributable to an
unpublished trial which differed in terms of the dose and duration of
treatment. When this study was omitted, no heterogeneity was found and
the pooled analysis revealed a statistically significant benefit (OR
0.29, 95% CI 0.16-0.54). However, problems with blinding in patients
using capsaicin may have accounted for the positive effect. One small
study of vincristine iontophoresis compared to placebo also yielded a
favourable result (OR 0.05, 95% CI 0.01-0.26). Other treatment
evaluated include lorazepam, acyclovir, topical benzydamine, and AP.
We found no evidence that these are effective in relieving pain
associated with postherpetic neuralgia. Based on evidence from
randomized trials, tricyclic anti-depressants appear to be the only
agents of proven benefit for established postherpetic neuralgia.

40#Wang MQ; Yu SF (1987) [Herpes zoster treated by AP: Report of 50
cases]. Beijing JTCM (2):37-38. Treatment varied with the types of
herpes zoster. 1. Exopathogenic Wind-Damp Type, GB20, LI11, LI04,
TH05, SP10 by reducing method. 2. Toxic heat endopathogenic type, Ashi
points, X_35-Huatojiaji, by reducing method. 3. SP Xu excessive Damp
type, ST36, LV14, GB22, ST40 by plain reinforcing and reducing method.
4. Qi and Blood Stasis type, LV13, TH17, TH06, GB34, SP09 by plain
reinforcing and reducing. Of 50 cases, 76% were cured, 24% improved.

41#Wei L; Yuan GB (1988) [AP in the treatment of herpes zoster].
Shanghai J Acupunct Moxibust 7(4):46. A male patient, aged 45 had
herpes zoster on the right neck and postauricular regions improved
following Chinese and Western medicinal treatments. In spite of the
improvement, he had his mouth angle aslant. Peripheral facial
paralysis following herpes zoster was diagnosed. Then, it was treated
with vitamins, hormones, physical therapy, etc. without improvement
for 25 d. Corresponding Channel points were selected. They were: ST07,
SI18, ST06 (warming needle), ST04, Z_09-Taiyang and LI20. The needle
was manipulated with normal reinforcement and normal reduction, and
retained for 20 min after getting the Qi. Treatment was given once
daily; vit E 100 mg was taken t.i.d at the same time. It was cured
after 25 times of treatments.

42#Wen XQ (1988) [AP therapy of postherpes zoster trigeminal
neuralgia: A case report]. Guangxi JTCM Mater Med 11(6):247. A male,
55 yr-old, come to clinic for herpes zoster on head. He had tried
other medications which did not work. Acupoints: GB20 (left side),
GB34 (left side). EAP was applied on the two acupoints. GB08 (left
side) was punctured with reducing method. After 20 min, headache
decreased a lot. The needles were taken off after 45 min. 10
treatments cured the case.

43#Xie QM; Huang JM; Zhang SH (1987) [AP therapy: Report of 5 cases].
Jiangxi JTCM Pharmacol 18(4):36-37. This paper introduced 5 successful
cases with AP. They were cases of lacquer ulcer, acute tonsillitis,
urticaria, hairline ulcer and herpes zoster (one each).

44#Xiong GT (1988) [Current status of pricking blood therapy of
infectious diseases]. Chin Acupunct Moxibust 8(6):41-43. The article
has summarized the clinical application of venous bleeding therapy for
treating infectious diseases in the past 30 yr in our country,
including: epidemic influenza, herpes simplex, herpes zoster,
poliomyelitis, encephalitis, epidemic parotitis, pertussis, acute
halophil food poisoning, acute bacillary dysentery, malaria, etc. The
author held that this method has a bright prospect and merits further
study.

45#Yamashiro H, Hara K, Gotoh Y (1990) [Relief of intractable
postherpetic neuralgia with gasserian ganglion block using methyl
prednisolone acetate and with TENS - Article in Japanese]. Masui
Sep;39(9):1239-1244. Dept of Anaesthesia, Hamamatsu Medical Centre. A
58 yr-old man had been suffering from intractable left ophthalmic post
herpetic neuralgia (PHN) for 7 yr. He has also been treated for
polyarteritis nodosa for 10 yr. For pain relief, he was treated
initially with frequent (4 times a day) stellate ganglion block (SGB)
and peripheral ophthalmic nerve block for 1 mo without relief. Then
supraorbital nerve block with neurolytics, TENS and AP were done with
a slight relief of his pain. Recently his pain became worse even with
imipramine 75 mg and carbamazepine 100 mg a day which relieved
effectively the patient from the pain for the last 3 yr. The pain was
so severe to disturb his usual daily activity. Gasserian ganglion
block with methyl prednisolone acetate 10 mg was done. After the
block, his ADL improved markedly. 3 mo after the block, he had no
spontaneous pain and slight pain with light touch on the injured skin
did not annoy him. Several days before the block, electric stimulation
to control his pain was tested. Stimulation with the electricity (4.5
mA, 10 cycle and 400 microseconds) brought him complete relief from
the pain during the stimulation. Trigeminal SEP showed no response to
the stimulation of injured skin.

46#Yu ZF; Zhang JQ; Fan XY (1988) [Clinical observation on the effect
of herpes zoster treated with electromagnetic Channel-activating
apparatus]. Chin Acupunct Moxibust 8(3):15-16. This article presents
the treatment of herpes zoster with Electro-Magnetic
Channel-Activating Apparatus. Comparison was also done with control
group (treated with conventional medicine such as vitamin, hormone,
etc). Altogether 105 cases were treated and divided into 2 groups at
random. As for the result, there were 66% cured and the total effect
reached 97% in the group with the treatment of the Apparatus, while in
the control group the cured rate was only 27% and the total
effectiveness 90% (p<.01). This result apparently indicates the marked
therapeutic effect of Electro-Magnetic Channel-Activating Apparatus.

47#Zhang Z (1992) [General clinical condition of scalp AP in recent
ten years]. Hubei JTCM 14(2):45-46. Presented is a review on scalp AP
used in treating pathological changes in brain and spinal cord,
cardiovascular diseases, pain and arthralgia-syndrome, diseases of the
urinary system, hallucination in various types, retrobular neuritis,
ophthalmoplegia, nerve deafness and herpes zoster, etc. in recent
years.

48#Zheng XL; Huang H; Liu KL (1988) [Fire needle therapy of herpes
zoster: Report of 105 cases]. Chin J Integ Tradit West Med
8(7):441-442. In this series, there were 105 cases of herpes zoster.
Corresponding Channel point selection: points of the BL foot Taiyang
Channel were selected in the main, i.e. BL13, BL18, BL19, BL20. For
lesion above lumbar area, TH06 was added; for lesion below lumbar
area, GB34 was added. Local points: punctures were made surrounding
the region of herpes zoster. After the tip of the needle was burned
with an alcohol lamp to bright redness, the needle was perpendicularly
inserted into the point to a depth of 3 mm and promptly pulled out.
Treatment was every 3 d; generally 1-3 times was enough. All cases
were cured after 1-3 sessions.

49#Zheng YZ (1985) [Infantile herpetic stomatitis treated by
paediatric massage: Report of 17 cases]. Fujian JTCM 16( 4):53. 17
infants with herpetic stomatitis were treated by infantile tuina
therapy. Of them, 16 were cured and 1 failed to have any effect.
Manipulations included circulating method performed clockwise on point
Bagua and reducing method used by pushing downwards on points Liufu,
Qinwei and Xiaochang; by pushing back and forth on point Sihengwen.

50#Zou ZF (1988) [Herpes zoster treated by auricular AP combined with
local application of prepared Chinese ink mixed with realgar]. Jiangxi
JTCM Pharmacol 19(5):60. Of 45 cases treated, 13 had herpes zoster of
the face and upper lip, 8 in the back and the lumbar region, 9 in the
chest and abdomen and 5 in the 4 limbs. The handle of a filiform
needle was used to near Earpoint LU, and pressed with an even force
for several times to locate the sensitive LU Point. After routine
sterilization, the needle was inserted into LU perpendicularly (first
on the left ear), avoiding damage to the cartilage. The needle was
retained for 3-5 min. Then 100 g clean prepared Chinese ink was mixed
with 5 g Realgar Powder and the margins of the lesion were painted
with the mixture. Treatment was once/d. After 1-2 sessions, 24/45
cases were cured; 16 had marked effects after 3-4 sessions; 5 had some
benefit after 5-6 sessions. The total effective rate was 100%.