Shingles, commonly known as "snake around the waist," often leads people to believe the rash disappearing means recovery. However, many are unaware that the lingering enemy is Postherpetic Neuralgia (PHN). Excruciating pain – burning, stabbing, or electric shock-like – can recur repeatedly, lasting for months or even years, severely impacting quality of life. How can Traditional Chinese Medicine (TCM) rapidly relieve this pain?
What is Postherpetic Neuralgia?
Dr. Que Poh Yuen Albert, a TCM Dermatology Specialist at Singapore's Gong Fang Tang TCM, explains that from a TCM perspective, Postherpetic Neuralgia is often closely related to blood stasis blocking the collaterals, lingering residual toxins, and deficiency of Qi and Blood.
Blood Stasis Blocking Collaterals (Primary cause of pain)
Virus lurks in nerve ganglia → Qi and Blood stasis and obstruction → "Obstruction causes pain"
Signals: Stabbing pain, knife-cutting pain, lightning-like pain triggered even by touching clothing.
Lingering Residual Toxins (Pain catalyst)
Damp-heat toxins deeply lodged → Continuous damage to nerve sheaths.
Signals: Dark purple skin in the painful area, pain worsens with heat, pain wakes patient at night.
Deficiency of Qi and Blood (Root cause of chronic pain)
Poor nerve repair ability in the elderly or weak → "Malnourishment causes pain"
Signals: Constant dull ache, fatigue, dizziness, sallow complexion.
How does TCM treat Postherpetic Neuralgia?
For this condition, Dr. Que Poh Yuen Albert commonly uses Xue Fu Zhu Yu Tang (Drive Out Blood Stasis in the Mansion of Blood Decoction). This formula, originating from the Qing Dynasty physician Wang Qingren's "Corrections of Errors in Medical Classics," is hailed as an "ace formula" for invigorating blood and moving Qi.
Composition: Taoren (Peach Kernel), Honghua (Safflower), Danggui (Chinese Angelica), Shengdihuang (Raw Rehmannia Root), Niuxi (Achyranthes Root), Chuanxiong (Szechuan Lovage Root), Jiegeng (Platycodon Root), Chishao (Red Peony Root), Zhiqiao (Bitter Orange), Gancao (Licorice Root), Chaihu (Bupleurum Root).
Formula Breakdown:
Monarch Herbs (Jun): Peach Kernel breaks blood stasis, moves stagnation, and moistens dryness; Safflower invigorates blood, dispels stasis, and alleviates pain.
Minister Herbs (Chen): Red Peony Root and Szechuan Lovage Root assist the Monarch herbs in invigorating blood and dispelling stasis; Achyranthes Root invigorates blood, unblocks channels, dispels stasis, relieves pain, and guides blood downward.
Assistant Herbs (Zuo): Raw Rehmannia Root and Chinese Angelica nourish blood, benefit Yin, clear heat, and invigorate blood; Platycodon Root and Bitter Orange – one ascending, one descending – soothe the chest and move Qi; Bupleurum Root soothes the liver, resolves depression, and lifts clear Yang. Used together with Platycodon and Bitter Orange, they are particularly effective in regulating Qi and moving stagnation, ensuring "Qi moves, then blood flows."
Guide Herbs (Shi): Platycodon Root also carries the other herbs upward, serving a guiding function; Licorice Root harmonizes the various herbs. Combined, the formula activates blood, transforms stasis, and moves Qi, resolving the symptoms. It is an excellent formula for treating blood stasis in the chest.
Modifications:
Electric shock-like pain: Add Quanxie (Scorpio) 5g (to search wind and unblock collaterals).
Burning pain: Add Shuiniujiao (Water Buffalo Horn) 20g (to cool blood and resolve toxins).
Severe night pain: Add Cishi (Magnetitum) 40g (to calm the spirit and relieve pain).
Key Treatment Phases:
Acute Phase (<3 months): 1 dose daily; use warm herbal dregs as a compress on the painful area.
Chronic Phase (>3 months): 1 dose every other day; combine with bloodletting cupping.
Case Study:
Patient: Ms. Wu, 57 years old, 10-year history of diabetes.
Chief Complaint: Persistent burning pain at the site of healed lumbar shingles for 5 months, preventing sleep.
Initial Consultation: Painful skin area showed tree-bark like changes; tongue body densely covered with purple spots; pulse wiry and choppy (like a knife scraping bamboo).
TCM Pattern Differentiation: Toxic stasis congealed, channels and collaterals withered and damaged.
Prescription: Modified Xue Fu Zhu Yu Tang.
Formula: Xue Fu Zhu Yu Tang + Quanxie (Scorpio) 6g + Shuiniujiao (Water Buffalo Horn) 30g (decocted first) + Huangqi (Astragalus Root) 50g.
External Therapy: Combined with acupuncture.
Outcome:
Day 7: Pain reduced by half; could lie flat for 2 hours.
Day 14: Burning pain turned into slight numbness.
Day 22: All symptoms resolved.
