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by Li Min 

(Acupuncture Department, The First Affiliated Hospital of 

Henan Medical University, Zhengzhou 450052, China )

Abstract 60 cases of postherpetic neuralgia were treated with arranged electro-acupuncture and 30 cases with medicine as control. All cases were HIV carriers. The 6-point behavioral rating scale (BRS-6) was used to observe the effect before and after treatment. The results indicate arranged electro-acupuncture can cure or reduce the severe pain of postherpetic neuralgia of HIV carriers an d the effect was better than medicine.

Key Words  Arranged electro-acupuncture  Postherpetic neuralgia  6-point  behavioral rating scales(BRS-6) 

Due to the damaged of the immune system of HIV carriers, their resistance to virus and bacteria is cut down. It is easy that opportunistic infections are achieved. Herpes Zoster is one of them. The blisters are big and dense, and there are also many ulcers on the local areas. After treatment, although the symptoms of skin lesion have disappeared, the sequelae of neuralgia often were left. The stubborn and severe postherpetic neuralgia is recurrent and difficult to be cured. During worked in Zambia, Africa from 1997 to 1999, I treated many patients of this kind with arranged electro-acupuncture. I gave them marks to the painful degree before and after treatment with 6-point behavioral rating scale (BRS-6). There was a medicine group as control. The results were reported as follows.

Clinical Data
  All patients came from the AIDS clinic of Ndola Central Hospital in Zambia and were diagnosed as HIV carriers. There were 90 cases in total. Males were 55 and females were 35. Their ages ranged from 28-42 years old. The youngest one was 21. The oldest was 58. The courses of disease were one week up to one year. All cases were divided into two groups at random. The arranged electro-acupuncture had 60 cases while the control group 30.

Method of  Treatment
  Arranged electro-acupuncture group(AG): The stainless steel needles of No.32 and 3 inches long and the needles were horizontally punctured along the lower margins of ribs in painful areas. Three needles were inserted in sequence. Punctured areas were above and below one rib of painful places except painful place. After getting sensation of needling, the handles of needles were connected with acupuncture machine of G6805-2 type and the continued wave was selected. The needles were kept for 30 minutes each time. Once a day, 10 days were one course. The interval was 7-10 days between two courses. Medicine group (MG): Pannodo(a kind of painful killer) was taken. One pill a time, three times per day. 10 days were one course. The interval was 7-10 days between two courses.  The patients of two groups were observed for two courses.


Judgement of  Effect

 6-point rating scale (BRS-6) was used to comment the effect of treatment. The method was divided into six grades. Grade I, no pain; Grade II, pain, but it is easily ignored; Grade III, pain, it cannot be ignored, but daily work and life were not disturbed; Grade IV, pain, it can not be ignored and the mind will b e disturbed; Grade V, pain, it cannot be ignored, all of the daily work and life will be influenced, but the essential physiological requirements can be done ( e.g eating, excreting, and so on); And grade VI severe pain, it cannot be ignore d, the patient has to rest or lie in bed. Above each grade is defined as from zero (no pain) to five points respectively. The patients read the content of the 6 point behavioral rating scale before and after treatment. The grades which were suitable for themselves' symptoms were told to the doctor. The doctor recorded the results.

Analysis of  Results
   The results indicated that painful grades and scores of patients were clearly fallen off after the treatment of arranged electro-acupuncture for two courses. The effect of patients were relatively poor with medicine. 10 patients in the A G were followed, only one was recurrent. In the MG, 5 patients were followed, 2 patients were recurrent after one month     

A Typical Case

LKONAKD AULU, male, 54 years old, businessman. The time of seeing doctor was on Nov. 6, 1997. The patient complained he had a herpeszoster two months ago. Three weeks later the skin rash disappeared, but severe pain was left in the area of skin lesion up to now. The man had HIV positive. PT, there were dark brown spots of pigmenlation on the right chest wall, axilla and back. The grade of the pain was V, the score was 4. Above method was used. After the first course of treatment, the painful grade became into III, the score was 3. When the second course was finished, the pain disappeared, the score was zero point. Following up for 3 months, the illness was not recurred.

Experience
  The postherpetic neuralgia belongs to “hypochondriac pain?or “pain in chest ?of TCM Blocking of local meridian qi and obstruction of collateral by blood stasis often cause it. It is often complained that there has a prickling like severe pain in the areas innervated by intercostal areas nerves, but general symptoms are not clear. After HIV carriers infected the virus of herpes Zoster, the severe skin rash could be showed. The most of patients have an intense and intractable postherpetic neuralgia, the pain lasts a long time and easy to be recurred. I have used the method to horizontaly puncture along the innervating areas of intercostal nerves with 3 inches long needles so that dispersing stasis of blood and removing obstruction of collateral can be achieved. The 6-point behavioral rating scale (BRS-6) established by BUDZYNSKI, et al. was used to research the painful diseases. Comparing two groups before and after treatment. The scores of the patients with arranged electro-acupuncture were from 2-4 down to 0-1 after two courses of treatment. But the scores of the patients with medic ine were only from 2-4 to 1-2. The effect of former group was better and was not easy to be recurred. It indicated that the arranged electro-acupuncture could get good results for the postherpetic neuralgia of HIV carriers.

 

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