Abstract
Background. Herpes zoster (HZ) is a disease that mainly causes severe segmental neuralgia and vesicles after infection with herpes zoster virus (VZV). At the same time, more than 9 to 34 percent of patients have postherpetic neuralgia (PHN) present with chronic pain for months or even years. Moxibustion has been used to treat herpes zoster and postherpetic neuralgia for many years; however, there has been no comprehensive study to evaluate the efficacy and safety of moxibustion in the treatment of herpes zoster and postherpetic neuralgia. More studies evaluated the combined effects of acupuncture and moxibustion. Therefore, the purpose of this systematic review is to evaluate their efficacy and safety, so as to provide an evidence-based basis for the clinical application of moxibustion in the treatment of HZ and PHN. Method. The literature search was conducted in nine Chinese and English databases, and randomized controlled trials were pooled from their inceptions to June 2020. The included literature was screened, and data were extracted. RevMan 5.3 software and Stata software were used for statistical analysis. The primary outcome was the total effect. The secondary outcomes include VAS, NRS, and time of analgesia. Outcomes. From a total of 1957 identified studies, 31 were included in analysis (N = 2334 cases). 31 RCTs contained the experimental sample of 1185 cases and the control sample of 1149 cases reported efficiency of different moxibustions in the treatment of herpes zoster, statistical heterogeneity inspection without heterogeneity. So, we used the fixed-effects model, merge effect quantity OR = 3.89 (95% CI: 2.88∼5.25), Z = 8.86, and it suggested sample merger analysis was statistically significant. Also, the moxibustion, compared to other methods in the treatment of herpes zoster and herpes zoster neuralgia efficiency, increased significantly. The VAS scales, WMD = 1.69 (95% CI: 1.17∼2.22), and the time of analgesia, WMD = 2.41 (95% CI: 3.26∼1.73), indicated that moxibustion surpassed others in the relief of pain. NRS was just reported in one study. It was not statistically significant. There was no significant difference in adverse effects OR = 0.61 (95% CI: 0.33∼1.13), Z = 1.56 ( P = 0.12). Conclusion. Moxibustion has obvious advantages over other therapies in the treatment of HZ and PHN. However, due to the obvious publication bias, the interpretation of the results should be cautious, and more rigorous randomized controlled clinical studies should be included to further confirm the results in the future.
Highlights
The moxibustion, compared to other methods in the treatment of herpes zoster and herpes zoster neuralgia efficiency, increased significantly. e VAS scales, weighted mean difference (WMD) 1.69, and the time of analgesia, WMD 2.41, indicated that moxibustion surpassed others in the relief of pain
Herpes zoster (HZ) is known as snake-like sore, fire girdle sore, or spider sore in traditional Chinese medicine. e cause of disease has not been determined; at present, it is believed that the pathogenesis is that, after the initial infection of varicella zoster virus in people with low immunity, the virus is latent in the ganglion of the posterior root of the spinal cord
Studies have shown that postherpetic neuralgia (PHN) occurs in more than 9 to 34 percent of patients, with chronic pain lasting months or years having detrimental effects on sleep, daily activities, and quality of life [2]
Summary
Herpes zoster (HZ) is known as snake-like sore, fire girdle sore, or spider sore in traditional Chinese medicine. e cause of disease has not been determined; at present, it is believed that the pathogenesis is that, after the initial infection of varicella zoster virus in people with low immunity (mostly children), the virus is latent in the ganglion of the posterior root of the spinal cord. Studies have shown that postherpetic neuralgia (PHN) occurs in more than 9 to 34 percent of patients, with chronic pain lasting months or years having detrimental effects on sleep, daily activities, and quality of life [2]. Western medicine treats herpes zoster with antiviral, nourishing nerve, anti-inflammatory and analgesic methods, and tricyclic antidepressants, opioids, gabapentin, lidocaine patch, capsaicin, and other therapies in pain relief, but the efficacy is limited [3], and the drug’s side effects on patients limit its use [4], while acupuncture and moxibustion combined therapy has a better performance in relieving pain and relieving symptoms [5,6,7]. Herpes zoster (HZ) is a disease that mainly causes severe segmental neuralgia and vesicles after infection with herpes zoster virus (VZV). More studies evaluated the combined effects of acupuncture and moxibustion
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