(206) Shingles (Herpes Zoster)

[HB KIM]

SHINGLES: HERBAL & ACUPUNCTURE TREATMENT

DEFINITION AND SYMPTOMS
Shingles is a skin rash caused by the same virus that causes chickenpox. The virus responsible for these conditions is called Varicella zoster. After an individual has chickenpox, this virus lives in the nerves and is never fully cleared from the body. Under certain circumstances, such as emotional stress, immune deficiency (from AIDS or chemotherapy) or with cancer, the virus re-activates causing shingles. In most cases, however, a cause for the reactivation of the virus is never found. The herpes virus that causes shingles and chicken pox is not the same as the herpes virus that causes genital herpes (which can be sexually transmitted) and herpes mouth sores. Shingles is medically termed Herpes zoster.

AGE: Most common between the ages of 50 and 70
GENDER, GENETICS, LIFESTYLE: Not significant factors

Symptoms
1. Initially the patient may experience tingling, itching, and a sharp pain in an area of skin.
2. After a few days, the following symptoms may also develop: painful rash of fluid-filled blisters, fever, headache and fatigue
3. The blisters follow the path of individual nerves that comes out of the spinal cord (called dermatomal pattern).  The entire path of the nerve may be involved or there may be areas with blisters and areas without blisters.
4. Within 3-4 days, the blisters form scabs.  The scabs heal in 10 days but may leave scars in some people.
5. If a nerve that supplies the eye is affected, it may cause inflammation of he cornea.  Rarely, infection of a facial nerve causes paralysis of the face.
6. On occasion, the pain will be present but the blisters may never appear.  This can be a very confusing cause of local pain!

DIFFERENTIAL DIAGNOSIS
In Oriental Medicine, Shingles (Herpes Zoster) is categorized under "Huo Dan".  There are three main differential diagnoses.
1. Excess Heat: bright red color on the local, sharp pain, bitter taste, dry throat, propensity to anger, yellow urine, dry stool, red tongue, yellow coating, wiry-slippery-rapid pulse.
2. Excess Damp: thick-wall blisters, color of blister is not too red, no appetite, loose stool, obesity, thick-white coating, deep-soft-slippery pulse
3. Qi and Blood stagnation: After blister disappear, pain is still there, purple tongue, white coating, wiry-thready pulse.

HERBAL FORMULAS
Formulas by Differential Diagnosis
(1) Excess Heat:
Long Dan Xie Gan Tang (Chai Hu 3g, Ze Xie 3g, Che Qian Zi 1.5g, Mu Tong 1.5g, Sheng Di 9g, Dang Gui 9g, Long Dan Cao 9g) + Yan Hu Suo 6g, Da Qing Ye 6g
(2) Excess Damp:
Wei Ling Tang (Gan Cao 4g, Fu Ling 10g, Cang Zhu 15g, Chen Pi 10g, Bai Zhu 10g, Rou Gui 7g, Ze Xie 15g, Zhu Ling 10g, Hou Po 10g) + Ban Lan Gen 9g, Yan Hu Suo 9g
(3) Qi and Blood stagnation:
Chai Hu Shu Gan San (Chen Pi 6g, Chai Hu 6g, Chuan Xiong 4.5g, Zhi Ke 4.5g, Zhi Gan Cao 1.5g, Xiang Fu 4.5g) + Dan Shen 6g, Ru Xiang 6g, Mo Yao 6g

Empirical Formulas
Jia Jian Xiao Chai Hu Tang:
Chai Hu 10g, Huang Qin 12g, Zhi Zi 12g, Dang Gui 12g, Ze Xie 12g, Jin Yin Hua 15g, Pu Gong Ying 15g, Sheng Di 15g, Mu Dan Pi 15g, Zhu Ling 15g, Chen Pi 10g, Gan Cao 6g
External Use (powder form+sesame oil):
Hua Shi 90g + Gan Cao 15g + Huang Lian 30g + Di Yu 30g + Bing Pian (Borneol) 3g + Sesame oil

ACUPUNCTURE
CHINESE TEXT
(1) Prick the skin around herpes zoster with a three-edged needle to cause a little bleeding
(2) Five pricks at 0.5cun from the head of the herpes zoster area
(3) And then five pricks at 0.5cun from the tail, and also several pricks along both sides
(4) Then select LI11, SP10, UB40, GB34, LV3

HB's CLINIC (according to Korean Yin-Yang Balancing Treatment)
Opposite side: Sedate GB38 (fire point)
Same side: Sedate LV2 (fire point)