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E-raamat: Evidence-based Clinical Chinese Medicine - Volume 6: Herpes Zoster And Post-herpetic Neuralgia

Editor-in-chief (Guangdong Provincial Hospital Of Chinese Medicine, China), (Rmit Univ, Australia), (Guangdong Provincial Hospital Of Chinese Medicine, China), Editor-in-chief (Rmit Univ, Australia)
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Evidence-based Clinical Chinese Medicine provides a "whole evidence" analysis of the Chinese medicine management of herpes zoster and post-herpetic neuralgia. Evidence from the classical Chinese medicine literature, contemporary clinical literature, the outcomes of clinical trials and experimental studies are reviewed, analysed and synthesised. The data from all these sources are condensed to provide evidence-based statements which will inform clinical practice and guide future research.This book has been designed to be an easy reference at the point of care. During a patient consultation, Chinese medicine practitioners can refer to this book for guidance on which Chinese herbal medicine formulas, specific herbs, or acupuncture points, can best treat their patient, and be confident there is evidence which supports its use.Currently, Chinese medicine practitioners who develop a special interest in a particular health condition such as herpes zoster and its common sequelae post-herpetic neuralgia have to consult a variety of sources to further their knowledge. Typically, they use the contemporary clinical literature to understand the theory, aetiology, pathogenesis and obtain expert opinions on the Chinese medicine management of herpes zoster and post-herpetic neuralgia. They search the electronic literature to identify systematic reviews of clinical trials, if any exist, to obtain assessments of the current state of the clinical evidence for particular interventions. If they have the skills and resources, they may search the classical Chinese medicine literature for an historical perspective on treatments that have stood the test of time.This book provides all of this information for practitioners in one handy, easy to use reference. This allows practitioners to focus on their job of providing high quality health care, with the knowledge it is based on the best available evidence.
Disclaimer v
Foreword vii
Purpose of the Monograph xi
Authors and Contributors xv
Members of Advisory Committee and Panel xvii
Professor Charlie Changli Xue, PhD xix
Professor Chuanjian Lu, MD xxi
Acknowledgments xxiii
List of Figures
xxxix
List of Tables
xli
1 Introduction to Herpes Zoster
1(16)
Definition of Herpes Zoster
1(2)
Epidemiology
3(1)
Burden
3(1)
Risk Factors
4(1)
Pathological Processes
5(1)
Diagnosis
6(1)
Management
7(5)
Vaccination
7(1)
Pharmacological Management
8(3)
Non-pharmacological Management
11(1)
Prognosis
12(1)
References
12(5)
2 Herpes Zoster in Chinese Medicine
17(12)
Introduction
17(1)
Aetiology and Pathogenesis
18(1)
Syndrome Differentiation and Treatments
19(1)
Oral Chinese Herbal Medicine Treatment Based on Syndrome Differentiation
19(3)
Stagnated Heat in the Liver Meridian or Dampness and Heat in the Liver and Gallbladder
19(1)
Spleen Deficiency Syndrome with Damp Retention
20(1)
Qi Stagnation and Blood Stasis
21(1)
Topical Chinese Herbal Medicine Treatment
22(1)
Acupuncture Therapies
23(3)
Acupuncture
25(1)
Electro-acupuncture
25(1)
Ear Acupuncture
25(1)
Scalp Acupuncture
25(1)
Moxibustion
26(1)
Acupuncture-point Magnetic Therapy
26(1)
Other Chinese Medicine Therapies
26(1)
Other Management Strategies
26(2)
References
28(1)
3 Classical Chinese Medicine Literature
29(24)
Introduction
29(1)
Search Terms
30(2)
Search Procedure and Data Coding
32(1)
Data Analysis Procedure
32(2)
Search Results
34(4)
Citations Related to Herpes Zoster
36(1)
Definitions of Herpes Zoster and Aetiology
36(2)
Chinese Herbal Medicine
38(10)
Frequency of Treatment Citations by Dynasty
38(1)
Symptoms Described in Treatment Citations
39(1)
Treatment with Chinese Herbal Medicine
39(1)
Most Frequent Formulas in `Possible' Herpes Zoster Citations
40(1)
Most Frequent Herbs in `Possible' Herpes Zoster Citations
41(3)
Most Frequent Formulas in `Most Likely' Herpes Zoster Citations
44(2)
Most Frequent Herbs in `Most Likely' Herpes Zoster Citations
46(2)
Discussion
48(1)
Acupuncture and Other Therapies
48(2)
Treatment with Acupuncture and Other Therapies
49(1)
Interventions in Possible Herpes Zoster Citations
49(1)
Interventions in `Most Likely' Herpes Zoster Citations
49(1)
Discussion
49(1)
Classical Literature in Perspective
50(1)
References
51(2)
4 Methods for Evaluating Clinical Evidence --- Herpes Zoster
53(14)
Introduction
53(1)
Search Strategy
54(1)
Inclusion Criteria
55(1)
Exclusion Criteria
56(1)
Outcomes
56(4)
Risk of Bias Assessment
60(1)
Statistical Analyses
61(1)
Assessment Using Grading of Recommendations Assessment, Development, and Evaluation
62(2)
References
64(3)
5 Clinical Evidence for Chinese Herbal Medicine --- Herpes Zoster
67(60)
Introduction
67(1)
Previous Systematic Reviews
67(1)
Characteristics of Chinese Herbal Medicine Clinical Studies
68(5)
Randomised Controlled Trials of Chinese Herbal Medicine
73(3)
Risk of Bias
75(1)
Oral Chinese Herbal Medicine
76(20)
Pain Score
77(1)
Oral Chinese Herbal Medicine Alone
77(1)
Oral Chinese Herbal Medicine as Integrative Medicine
78(1)
Time Taken for Resolution of Pain
79(1)
Oral Chinese Herbal Medicine Alone
79(1)
Oral Chinese Herbal Medicine as Integrative Medicine
80(1)
Time Taken for Crust Formation
81(1)
Oral Chinese Herbal Medicine Alone
81(1)
Oral Chinese Herbal Medicine as Integrative Medicine
82(1)
Time Taken for Cessation of New Lesions
82(1)
Oral Chinese Herbal Medicine Alone
82(2)
Oral Chinese Herbal Medicine as Integrative Medicine
84(2)
Time Taken for Resolution of Rash
86(1)
Oral Chinese Herbal Medicine Alone
86(1)
Oral Chinese Herbal Medicine as Integrative Medicine
86(1)
Incidence of Post-herpetic Neuralgia
87(1)
Oral Chinese Herbal Medicine Alone
87(1)
Oral Chinese Herbal Medicine as Integrative Medicine
88(2)
Effective Rate
90(1)
Oral Chinese Herbal Medicine Alone
90(1)
Oral Chinese Herbal Medicine as Integrative Medicine
90(2)
Frequently Reported Orally Used Herbs in Meta-analyses Showing Favourable Effects
92(3)
Safety of Oral Chinese Herbal Medicine for Herpes Zoster
95(1)
Oral Chinese Herbal Medicine Alone
95(1)
Oral Chinese Herbal Medicine as Integrative Medicine
96(1)
Topical Chinese Herbal Medicine
96(6)
Pain Score
97(1)
Topical Chinese Herbal Medicine Alone
97(1)
Topical Chinese Herbal Medicine as Integrative Medicine
97(1)
Time Taken for Resolution of Pain
97(1)
Topical Chinese Herbal Medicine Alone
97(1)
Topical Chinese Herbal Medicine as Integrative Medicine
97(1)
Time Taken for Crust Formation
98(1)
Topical Chinese Herbal Medicine Alone
98(1)
Topical Chinese Herbal Medicine as Integrative Medicine
98(1)
Time Taken for Cessation of New Lesions
98(1)
Topical Chinese Herbal Medicine Alone
98(1)
Topical Chinese Herbal Medicine as Integrative Medicine
99(1)
Time Taken for Resolution of Rash
99(1)
Topical Chinese Herbal Medicine Alone
99(1)
Topical Chinese Herbal Medicine as Integrative Medicine
99(1)
Incidence of Post-herpetic Neuralgia
100(1)
Topical Chinese Herbal Medicine Alone
100(1)
Topical Chinese Herbal Medicine as Integrative Medicine
100(1)
Effective Rate
100(1)
Topical Chinese Herbal Medicine Alone
100(1)
Topical Chinese Herbal Medicine as Integrative Medicine
100(1)
Frequently Reported Topically Used Herbs in Meta-analyses Showing Favourable Effects
101(1)
Safety of Topical Chinese Herbal Medicine for Herpes Zoster
101(1)
Topical Chinese Herbal Medicine Alone
101(1)
Topical Chinese Herbal Medicine as Integrative Medicine
102(1)
Oral plus Topical Chinese Herbal Medicine
102(5)
Pain Score
102(1)
Oral plus Topical Chinese Herbal Medicine Alone
102(1)
Oral plus Topical Chinese Herbal Medicine as Integrative Medicine
102(1)
Time Taken for Resolution of Pain
103(1)
Oral plus Topical Chinese Herbal Medicine Alone
103(1)
Oral plus Topical Chinese Herbal Medicine as Integrative Medicine
103(1)
Time Taken for Crust Formation
103(1)
Oral plus Topical Chinese Herbal Medicine Alone
103(1)
Oral plus Topical Chinese Herbal Medicine as Integrative Medicine
103(1)
Time Taken for Cessation of New Lesions
104(1)
Oral plus Topical Chinese Herbal Medicine Alone
104(1)
Oral plus Topical Chinese Herbal Medicine as Integrative Medicine
104(1)
Time Taken for Resolution of Rash
105(1)
Oral plus Topical Chinese Herbal Medicine Alone
105(1)
Oral plus Topical Chinese Herbal Medicine as Integrative Medicine
105(1)
Incidence of Post-herpetic Neuralgia
105(1)
Oral plus Topical Chinese Herbal Medicine Alone
105(1)
Oral plus Topical Chinese Herbal Medicine as Integrative Medicine
105(1)
Effective Rate
106(1)
Oral plus Topical Chinese Herbal Medicine Alone
106(1)
Oral plus Topical Chinese Herbal Medicine as Integrative Medicine
106(1)
Safety of Oral plus Topical Chinese Herbal Medicine for Herpes Zoster
106(1)
Oral plus Topical Chinese Herbal Medicine Alone
106(1)
Oral plus Topical Chinese Herbal Medicine as Integrative Medicine
106(1)
Chinese Herbal Medicine Compared with Guideline-recommended Doses of Antiviral Therapy
107(6)
Assessment Using Grading of Recommendations
109(1)
Oral Chinese Herbal Medicine as Integrative Medicine vs. Antivirals plus Pain Management Therapies
110(1)
Topical Chinese Herbal Medicine as Integrative Medicine vs. Antivirals plus Pain Management Therapies
110(3)
Randomised Controlled Trial Evidence from Individual Formulas
113(2)
Randomised Controlled Trial Evidence for Formulas Commonly Used in Clinical Practice
115(1)
Controlled Clinical Trials of Chinese Herbal Medicine
116(3)
Non-controlled Studies of Chinese Herbal Medicine
119(2)
Summary of Clinical Evidence for Chinese Herbal Medicine
121(3)
References
124(3)
6 Pharmacological Actions of Frequently Used Herbs --- Herpes Zoster
127(14)
Introduction
127(1)
Methods
127(1)
Experimental Studies on Can Cao
128(1)
Experimental Studies on Huang Qin
129(1)
Experimental Studies on Chai Hu
130(1)
Experimental Studies on Long Dan Cao
130(1)
Experimental Studies on Shu Di Huang
131(1)
Experimental Studies on Zhi Zi
131(1)
Experimental Studies on Dang Gui
132(2)
Experimental Studies on Ze Xie
134(1)
Experimental Studies on Ban Lan Gen
134(1)
Experimental Studies on Che Qian Zi
135(1)
Experimental Studies on Van Hu Suo
135(1)
Experimental Studies on Herbal Formulas
136(1)
Summary of Pharmacological Actions of the Frequently Used Herbs
137(1)
References
137(4)
7 Clinical Evidence for Acupuncture and Related Therapies --- Herpes Zoster
141(22)
Introduction
141(1)
Previous Systematic Reviews
142(1)
Characteristics of Clinical Studies of Acupuncture and Related Therapies
142(2)
Randomised Controlled Trials of Acupuncture and Related Therapies
144(13)
Risk of Bias
145(2)
Acupuncture
147(1)
Acupuncture Alone
147(1)
Acupuncture as Integrative Medicine
148(1)
Acupuncture Plus Moxibustion Alone
149(1)
Acupuncture Plus Plum-blossom Needle Therapy as Integrative Medicine
150(1)
Acupuncture Plus Plum-blossom Needle Therapy Plus Moxibustion Alone
151(1)
Frequently Reported Points in Meta-analyses Showing Favourable Effects: Acupuncture
151(2)
Assessment Using Grading of Recommendations
153(1)
Moxibustion
153(1)
Moxibustion Alone
154(1)
Moxibustion as Integrative Medicine
154(1)
Moxibustion Plus Plum-blossom Needle Therapy Alone
155(1)
Frequently Reported Points in Meta-analyses Showing Favourable Effects: Moxibustion
155(1)
Plum-blossom Needle Therapy
155(1)
Plum-blossom Needle Therapy Alone
156(1)
Plum-blossom Needle Therapy as Integrative Medicine
156(1)
Acupuncture Therapies Compared with Guideline-recommended Doses of Antiviral Therapy
156(1)
Controlled Clinical Trials of Acupuncture and Related Therapies
157(1)
Non-controlled Studies of Acupuncture and Related Therapies
158(1)
Summary of Clinical Evidence for Acupuncture and Related Therapies
159(2)
References
161(2)
8 Clinical Evidence for Combination Therapies --- Herpes Zoster
163(18)
Introduction
163(1)
Randomised Controlled Trials of Combination Therapies
163(15)
Risk of Bias
168(1)
Pain Score
169(2)
Time Taken for Resolution of Pain
171(1)
Time Taken for Crust Formation
171(1)
Time Taken for Cessation of New Lesions
172(1)
Time Taken for Resolution of Rash
173(1)
Incidence of Post-herpetic Neuralgia
173(1)
Effective Rate
174(3)
Combination Therapies Compared with Guideline-recommended Doses of Antiviral Therapy
177(1)
Safety of Combination Therapies
178(1)
Summary of Combination Therapies Evidence
178(2)
References
180(1)
9 Summary and Conclusions --- Herpes Zoster
181(14)
Introduction
181(1)
Chinese Herbal Medicine
182(4)
Chinese Herbal Medicine Formulas in Contemporary Literature, Classical Literature, and Clinical Studies
183(3)
Acupuncture and Related Therapies
186(3)
Acupuncture Therapies in Contemporary Literature Classical Literature, and Clinical Studies
188(1)
Implications for Practice
189(1)
Implications for Research
190(2)
References
192(3)
10 Introduction to Post-herpetic Neuralgia
195(14)
Definition of Post-herpetic Neuralgia
195(1)
Epidemiology
196(1)
Burden
196(1)
Risk Factors
197(1)
Pathological Processes
197(1)
Diagnosis
198(1)
Management
199(4)
Prevention
200(1)
Pharmacological Management
200(2)
Non-pharmacological Management
202(1)
Prognosis
203(1)
References
203(6)
11 Post-herpetic Neuralgia in Chinese Medicine
209(8)
Introduction
209(1)
Aetiology and Pathogenesis
210(1)
Syndrome Differentiation and Treatments
210(1)
Chinese Herbal Medicine Treatment Based on Syndrome Differentiation
211(2)
Qi Stagnation and Blood Stasis
211(1)
Liver Yin Deficiency
212(1)
Acupuncture Therapies and Other Chinese Medicine Therapies
213(1)
Other Management Strategies
214(1)
Post-herpetic Neuralgia in Classical Chinese Medicine Literature
215(1)
References
215(2)
12 Methods for Evaluating Clinical Evidence --- Post-herpetic Neuralgia
217(8)
Introduction
217(1)
Inclusion Criteria
218(2)
Exclusion Criteria
220(1)
Outcomes
220(1)
Risk of Bias Assessment
221(1)
Statistical Analyses
221(1)
Assessment Using Grading of Recommendations Assessment, Development and Evaluation
222(1)
References
222(3)
13 Clinical Evidence for Chinese Herbal Medicine --- Post-herpetic Neuralgia
225(18)
Previous Systematic Reviews
225(1)
Characteristics of Chinese Herbal Medicine Clinical Studies
225(3)
Randomised Controlled Trials of Chinese Herbal Medicine
228(7)
Risk of Bias
229(2)
Oral Chinese Herbal Medicine
231(1)
Pain Score
231(1)
Oral Chinese Herbal Medicine Alone
231(1)
Oral Chinese Herbal Medicine as Integrative Medicine
231(1)
Hamilton Rating Scale for Depression
232(1)
Oral Chinese Herbal Medicine Alone
232(1)
Oral Chinese Herbal Medicine as Integrative Medicine
233(1)
Frequently Reported Orally Administered Herbs in Meta-analyses Showing Favourable Effects
233(1)
Safety of Oral Chinese Herbal Medicine for Post-herpetic Zoster
234(1)
Oral Chinese Herbal Medicine Alone
234(1)
Oral Chinese Herbal Medicine as Integrative Medicine
235(1)
Assessment Using Grading of Recommendations Assessment, Development and Evaluation
235(1)
Oral Chinese Herbal Medicine plus Gabapentin vs. Gabapentin
236(1)
Oral Chinese Herbal Medicine plus Tricyclic Anti-depressants vs. Tricyclic Anti depressants
236(1)
Evidence-based Clinical Chinese Medicine --- Vol 6 Randomised Controlled Trial Evidence for Formulas Commonly Used in Clinical Practice
236(1)
Controlled Clinical Trials of Chinese Herbal Medicine
236(3)
Non-controlled Studies of Chinese Herbal Medicine
239(2)
Summary of Clinical Evidence for Chinese Herbal Medicine
241(1)
References
242(1)
14 Pharmacological Actions of Common Herbs --- Post-herpetic Neuralgia
243(12)
Introduction
243(1)
Methods
244(1)
Experimental Studies on Dang Gui
244(1)
Experimental Studies on Yan Hu Suo
245(1)
Experimental Studies on Hong Hua
246(1)
Experimental Studies on Gan Cao
246(1)
Experimental Studies on Chuan Xiong
247(1)
Experimental Studies on Bai Shao and Chi Shao
247(1)
Experimental Studies on Huang Qi
248(1)
Experimental Studies on Chai Hu
249(1)
Experimental Studies on Dan Shen
249(1)
Experimental Studies on Tao Ren
250(1)
Summary of Pharmacological Actions of the Frequently Reported Herbs Used to Treat Post-herpetic Neuralgia
250(1)
References
251(4)
15 Clinical Evidence for Acupuncture and Related Therapies --- Post-herpetic Neuralgia
255(14)
Introduction
255(1)
Previous Systematic Reviews
256(1)
Characteristics of Clinical Studies of Acupuncture and Related Therapies
256(2)
Randomised Controlled Trials of Acupuncture and Related Therapies
258(7)
Risk of Bias
259(1)
Acupuncture
260(1)
Acupuncture Alone
261(1)
Acupuncture as Integrative Medicine
261(1)
Assessment Using Grading of Recommendations Assessment, Development and Evaluation
262(1)
Acupuncture plus Gabapentin vs. Gabapentin
262(1)
Acupuncture plus Pregabalin vs. Pregabalin
262(1)
Frequently Reported Points in Meta-analyses Showing Favourable Effects: Acupuncture
262(3)
Moxibustion
265(1)
Controlled Clinical Trials of Acupuncture and Related Therapies
265(1)
Non-controlled Studies of Acupuncture and Related Therapies
265(1)
Summary of Clinical Evidence for Acupuncture and Related Therapies
266(1)
References
267(2)
16 Clinical Evidence for Combination Therapies --- Post-herpetic Neuralgia
269(10)
Introduction
269(1)
Randomised Controlled Trials of Combination Therapies
269(9)
Risk of Bias
273(1)
Pain Score
274(1)
Time Taken for Resolution of Pain
275(1)
Pittsburgh Sleep Quality Index
276(1)
Frequently Reported Herbs and Points in Meta-analyses Showing Favourable Effects
276(1)
Safety of Combination Therapies for Post-herpetic Neuralgia
277(1)
Summary of Clinical Evidence for Combination Therapies
278(1)
17 Summary and Conclusions --- Post-herpetic Neuralgia
279(8)
Introduction
279(1)
Chinese Herbal Medicine
280(2)
Chinese Herbal Medicine Formulas in Contemporary Literature and Clinical Studies
282(1)
Acupuncture and Related Therapies
282(2)
Acupuncture Therapies in Contemporary Literature and Clinical Studies
283(1)
Implications for Practice
284(1)
Implications for Research
285(1)
References
286(1)
Glossary 287(10)
Appendix 1 References for Included Clinical Studies 297(18)
Index 315