Prevention and Integrated Chinese-Western Treatment of Herpes Zoster

Herpes zoster (shingles) is a viral infectious disease caused by reactivation of the varicella-zoster virus (the same virus that caused chickenpox in our childhood), characterized by severe neuralgia and unilateral rash. It commonly affects middle-aged and elderly people over 50; by age 85, about half of adults may develop shingles. People with chronic diseases such as diabetes and cancer, or those with immunosuppression due to treatment, have a significantly increased risk of shingles.

Shingles is a typical virus that exploits weakness; aging, low immunity, and overexertion are all high-risk factors that trigger shingles.

In typical shingles, 2–3 days before the rash appears, one side of the body may first experience pain, burning, or tingling. Then, in the painful area, clusters of blisters appear, distributed in a band along the nerve, usually not crossing the midline of the body. The patient feels severe pain, which may be needle-like, knifelike, burning, or electric-shock-like. In about 10% of patients, especially the elderly, pain may persist for months or even years after the rash heals; this is called "postherpetic neuralgia."

Shingles is a preventable disease; we can prevent it by vaccination with the shingles vaccine (Shingrix). The vaccine is highly effective in preventing shingles. China encourages and supports middle-aged and elderly people over 50 to receive the shingles vaccine, and some regions even provide a certain subsidy for the vaccination cost.

If shingles can be detected in its early stage, the difficulty of treatment will be greatly reduced. Beginning antiviral treatment within 72 hours of the rash's appearance can most effectively relieve symptoms, shorten the course, and reduce the risk of postherpetic neuralgia. Commonly used Western antiviral drugs include valacyclovir and famciclovir.

I also have an experienced TCM formula for treating shingles.

Internal decoction: Machixian (Portulacae Herba) 50 g, Daqingye (Isatidis Folium) 30 g, Banlangen (Isatidis Radix) 30 g, Jinyinhua (Lonicerae Flos) 30 g, Lianqiao (Forsythiae Fructus) 30 g, Yejuhua (Chrysanthemi Indici Flos) 30 g, Chishao (Paeoniae Rubra Radix) 15 g, Shengdi (Rehmanniae Radix) 15 g. External use: Chonglou Jiedu Ding (Paris Root Toxin-Resolving Tincture).

This regimen was optimized by me on the basis of the experienced shingles formula of veteran TCM physician Zhu Yongxian. This formula is suitable for shingles patients at all stages, and also has good efficacy in shingles patients who respond poorly to Western treatment. In fast cases, effect may be seen in one day; in slow cases, within a week. If there is still no effect after a week, the medicine should be stopped and the prescription changed. If the above formula shows effect, it may be continued until the disease is cured.