Clinical effect of acupuncture along fascia, meridians, and nerves combined with ultrasound-guided paravertebral nerve block in the treatment of postherpetic neuralgia: a randomized parallel-controlled study

doi:10.19852/j.cnki.jtcm.2023.02.007

Abstract

Abstract:

OBJECTIVE: To observe the clinical efficacy of acupuncture along fascia, meridians, and nerves combined with ultrasound-guided nerve blockage in the treatment of postherpetic neuralgia.

METHODS: A total of 61 outpatients with post-chest and back herpes zoster neuralgia were recruited in the Department of Pain at the Xiyuan Hospital, China Academy of Chinese Medical Sciences from May 2019 to June 2021. They were randomly divided into two groups. Thirty-one patients in the control group were treated with ultrasound-guided thoracic paravertebral nerve block (PVB) alone, one patient declined to continue during treatment (n = 30), and thirty patients in the observation group received the acupuncture along the fascia, meridians, and nerves combined with ultrasound-guided PVB treatment (n = 30). Both control and observation group received treatment weekly for 4 weeks. The medical history data such as age, sex, presence or absence of comorbidities and disease course were analyzed. The visual analog scale (VAS) score was used to assess the pain degree of two groups at T0 (before treatment), T1 (1-time treatment ended), T2 (2 times treatment ended), T3 (3 times treatment ended), and T4 (4 times treatment ended). The sleep state was examined by Pittsburgh Sleep Quality Index (PSQI) before and after the study.

RESULTS: There was no significant difference in general conditions between the control group and the observation group (P > 0.05). The VAS score in both control and observation group was decreased in a time-dependent manner after 1-4 weeks of treatment. There were no significant differences in VAS scores between the two groups after 1 or 2 weeks of treatment (P > 0.05). After 3 and 4 weeks of treatment, the VAS score was significantly decreased in the observation group compared with that in the control group (P < 0.001). In addition, the reduction in VAS score (after treatment-before treatment) between the two groups was statistically significant [D value: -1.53, 95% CI (-2.32, 0.74), P < 0.001]. Furthermore, the sleep state of patients in both groups markedly improved and much obvious in the observation group than that in the control group (P < 0.05).

CONCLUSION: These results suggest that a combination of acupuncture along fascia, meridians, and nerves with ultrasound-guided PVB treatment is more effective than ultrasound-guided PVB treatment alone.

Trial registration: Chinese Clinical Trial Registry ChiCTR2200057955.

Key words: neuralgia, postherpetic, visual analog scale, acupuncture along fascia, meridians and nerves, ultrasound-guided paravertebral nerve block

GAO Xiumei, WANG Chenyan, NI Yong, ZHANG Huiling. Clinical effect of acupuncture along fascia, meridians, and nerves combined with ultrasound-guided paravertebral nerve block in the treatment of postherpetic neuralgia: a randomized parallel-controlled study[J]. Journal of Traditional Chinese Medicine, 2023, 43(2): 359-364.

Figures/Tables 4

Figure 1 Flow chart of participants throughout the study

Table 1 Baseline characteristics in observation and control group ($\bar{x}\pm s$)

Item	Observation group (n = 30)	Control group (n = 30)	P value
Age (years)	60.4±9.4	63.0±9.0	0.284
Gender (male) (n)	15/30	16/30	1.000
Course (months)	10.5±10.6	10.2±10.1	0.910
Comorbidities (n)	16/30	15/30	1.000
VAS scores (scores)	6.9±1.3	6.6±1.4	0.363

Figure 2 Comparison of the VAS score of two groups after 1, 2, 3, and 4 weeks of treatment Observation group: ultrasound-guided paravertebral nerve block combined with acupuncture along the fascia, meridians and nerves; control group: ultrasound-guided paravertebral nerve block. The nerve block technique in both groups using 2% lidocaine 3-5 mL, vitamin B12 0.5 mg, and debaosone 0.2 mL and was diluted to 10 mL with normal saline, 3-5 mL per target segment. Once a week for a month. VAS: visual analog scale. Compared with T0, aP < 0.001; compared with T1, bP < 0.001; compared with T2, cP < 0.01; compared with T3, dP < 0.01; eP < 0.001 versus control group.

Table 2 Comparison of PSQI between the control group and observation group

Time	Observation group (n = 30)	Control group (n = 30)	t value	P value
Before treatment	15.2±1.8	15.6±2.1	-0.722	0.473
After treatment	5.5±2.4	6.8±2.7	-2.013	0.049
t value	15.791	25.777
P value	< 0.001	< 0.001

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