Objective

2

To observe the clinical efficacy of wrist-ankle acupuncture for postherpetic neuralgia (PHN) and its effects on serum levels of voltage-gated sodium channel 1.7 (NaV1.7) and calcitonin gene-related peptide (CGRP).

Methods

2

A total of 90 PHN patients were randomized into a wrist-ankle acupuncture group (45 cases

2 cases dropped out) and a western medication group (45 cases

1 case dropped out

1 case was discontinued). In the western medication group

the topical 5% lidocaine gel plaster was used locally. In the wrist-ankle acupuncture group

wrist-ankle acupuncture was applied 30 min each time

once a day

5-day treatment was as one course

with 2-day interval between courses. The treatments lasted for 4 weeks in both groups. The scores of visual analogue scale (VAS)

Pittsburgh sleep quality index (PSQI)

self-rating anxiety scale (SAS)

and self-rating depression scale (SDS) were observed before treatment

after 2 and 4 weeks of treatment

and in the follow-up of 4 weeks after treatment completion. The serum levels of NaV1.7 and CGRP were measured before and after 4 weeks of treatment. The use of rescue analgesics and the occurrence of adverse reactions were recorded

and the clinical efficacy was evaluated after 4 weeks of treatment.

Results

2

Compared with those before treatment

the scores of VAS

PSQI

SAS and SDS were decreased after 2 and 4 weeks of treatment

and in follow-up (

P

<

0.05). After 4 weeks of treatment and in follow-up

the above scores in the wrist-ankle acupuncture group were lower than those in the western medi

cation group (

P

<

0.05). After 4 weeks of treatment

the serum levels of NaV1.7 and CGRP were decreased compared with those before treatment (

P

<

0.05)

and the serum levels of NaV1.7 and CGRP in the wrist-ankle acupuncture group were lower than those in the western medication group (

P

<

0.05). During the trial

5 cases in the wrist-ankle acupuncture group and 11 cases in the western medication group required rescue analgesics

with no statistical difference between the two groups (

P

>

0.05). The incidence of adverse reactions was 9.3% in the wrist-ankle acupuncture group

which was lower than 27.9% in the western medication group (

P

<

0.05). The total effective rate in the wrist-ankle acupuncture group was 90.7% (39/43)

that of the western medication group was 83.7% (36/43)

there was no statistical difference between the two groups (

P

>

0.05).

Conclusion

2

Wrist-ankle acupuncture can effectively treat PHN

reduce pain

improve sleep quality and relieve negative emotions. Its mechanism may relate to the down-regulation of serum NaV1.7 and CGRP levels.