The Treatment of Herpes Zoster in TCM

Professor Yi Zhu was graduated from Beijing University of Chinese Medicine and Pharmacy in 1976. She has been study the master’s degree course in ‘The Clinical and Experimental Studies on Psoriasis with The Integrating Treatment of Chinese Medicine and Western Medicine ‘in The China Academy of Traditional Chinese Medicine in China.Professor Yi Zhu has been working in Guang An Men Hospital in Bei Jing for 21 years. She came to work in the UK since 1997. She is the specialist of dermatopathya. She is the senior member of The Association of Traditional Chinese Medicine (ATCM).

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It is well known that Herpes zoster is a common skin disease. The classic books of traditional Chinese medicine record and describe Herpes zoster (Shingles) by its clinical manifestations, as ‘ Zheng Dai Chuang’ , ‘Chan Yao Huo Dan’, which means ‘red and hot linear eruptions around the waist’, and ‘She Chuan Chuang’, etc.

In modern medicine, the cause of Herpes zoster is the reactivation of the varicella-zoster virus (VZV), that cause the Chickenpox, usually in childhood, the virus then remains latent in the body and become reactivated again at a later stage, when the body condition has changed.

As for the theory of Chinese medicine, the main cause of this disease has a close correlation with the internal accumulation of damp-heat, from excessive fire in liver-gallbladder, longstanding dampness in spleen-stomach, and the invasion of toxic evil as well.

One of the best classics of Chinese medicine,《Yi Zong Jin Jian》（1742）, has recorded some prescriptions, clearly pointed out the principles of treating Herpes zoster with Chinese medicine, such as the "Longdan Xiegan Decoction" for clearing the liver-gallbladder fire and purging damp-heat, the "Chushi Weiling Decoction" for invigorating the spleen to remove damp-heat, and the "Chaihu Qinggan Decoction" for soothing liver Qi and clearing liver fire and so on.

Although current medical textbooks divide Herpes zoster into several different types based on TCM Syndrome differentiation, but it is important to realize the treatment of Herpes zoster requires further consideration and analysis of the individual patient's characteristic and clinic symptoms. The principle of "same treatment for different diseases" and "different treatments for the same disease" is critical to getting good results.

The differentiation of dermpathic symptoms and signs have a special significance in clinic medical practice. For instance, the skin redness, or irregular erythema, as the result of the pathogenic fire accumulating in the blood system, should be treated by the principle of clearing heat and cooling the blood to purge fire in most cases.

When clusters of vesicles appear, from the size of a millet to mung bean or even bigger, it is a sign that damp-heat is accumulating inside the body, the treatment should focus on invigorating the spleen to resolve dampness, or draining damp and clearing heat in certain circumstance.

In order to deal with the secondary infection and erosion in the affected skin area, it is necessary to pay more attention to the principle of clearing heat and removing toxins. If the skin's superficial ulcer is not healed, the method of nourishing blood and replenishing Qi, which promote tissue regeneration, should be used after clearing internal heat and removing toxins.

The hot sensation and neuralgia are caused by the accumulation of pathogenic fire mixed with damp-heat, and Qi stagnation with blood stasis, where the channels are blocked. Therefore, the correct solution is to clear the damp-heat first, then unblock channels to improve blood circulation.

Herpes zoster, in certain parts of the body, needs to be properly treated as early as possible, considering how serious some of the complications could be, such as zosterophthalmia, blindness, deafness, facial palsy, zostermeningocephalitis etc.

Herpes Zoster itself may be the complication of another disease, or caused by long term use of immunosuppressant, which means the patient's medical history must be carefully analysed. It might be helpful to strengthen the patient's immune system using tonic herbs.

Postherpetic neuralgia is the most difficult problem. The symptons include a burning, continuous pain in areas of previous lesions. The pain usually lasts for a long time, particularly in elderly patients. In Chinese medical theory, this kind of pain is caused by QI stagnation with blood stasis and blockage of channels. First step is to clear heat and remove toxins, then remove obstruction in the channels to resolve stasis, finally, to replenish Qi and nourish blood in order to harmonize Qi and blood to relieve the pain.

For external treatment, crushed fresh herbs or herb powder can be applied to affected skin areas for dispersing redness and swelling, removing toxins and alleviating pain. Other traditional therapies include acupuncture, moxibustion, fire needling, plum-blossom needling, cupping, ear-acupuncture therapy etc, can also have significant therapeutic effect.