4 Traditional Chinese Medicine Resources on the Diagnosis and Treatment of Herpes Zoster

(1) Liver and Gallbladder Fire Syndrome: Patients often experience burning and intense pain in the affected skin, with redness and inflammation, prominent papules and vesicles, dry throat, bitter taste in the mouth, irritability, constipation, short yellow urine, a red tongue with a yellow coating, and a tense, rapid pulse. Treatment focuses on clearing heat, reducing fire, detoxifying, and relieving pain; the formula uses Longdan Xie Liver Decoction combined with Banlan Gen, Xiu, Honeysuckle Flower, and Portulaca Oleracea. 2. Spleen and Stomach Damp Heat Syndrome: Patients often present with pale skin, clustered rashes, cloudy vesicle fluid, ulceration and exudation, or moist, inflamed rashes with abdominal distension, poor appetite, dry mouth, and reluctance to drink. The tongue is pale red, with a white or yellowish greasy coating, and the pulse is slow, tense, or string-like. Treatment focuses on strengthening the spleen, eliminating dampness, and detoxifying to relieve pain. The formula uses Zhushi Wei Ling Tang combined with Coix Seed, Plantago Major, Kieria, Portulaca Oleracea, and other herbs. 3. Qi Stagnation and Blood Stasis: Patients often experience severe pain in the affected area, or the rash subsides but the pain persists, restless sleep, a dark purple tongue, a thin white coating, and a fine, tense pulse. Treatment focuses on regulating qi, improving blood circulation, resolving stasis, and calming the mind; the formula uses Taohong Siwu Tang combined with Chuan Lianzi, Yuan Hu, Angelica Sinensis, Frankincense, and Myrrh. In the later stages of the disease, especially in elderly patients with qi and blood deficiency, it is advisable to tonify qi and blood, resolve stasis, and calm the mind; the Eight Treasure Decoction combined with Pearl Mother, Frankincense, and Myrrh can be used. (4) Traditional Chinese Medicine Resources on the Diagnosis and Treatment of Herpes Zoster Based on the severity of the condition, the disease can be classified as mild, moderate, or severe. If the rash appears within 1–2 days, the skin is red, the vesicles are small and grain-like, with burning and pain, and the tongue is red with a tense pulse, it is considered a mild case; a two-component Baidu Du San can be applied externally. If the disease has progressed to 3–4 days, the affected area is intensely painful, the vesicles are bright red and swollen in clusters, the skin is red, and the tongue is red with a tense pulse, it is considered a moderate case; the Longdan Xie Liver Decoction can be taken internally, while a two-component Baidu Du San can be applied externally. If the rash has persisted for 5–7 days or longer, the skin is burning, red, or purplish, or there are pus-filled scabs, with severe pain that is difficult to bear, accompanied by high fever, headache, and even confusion or delirium, it is considered a severe case; the Longdan Xie Liver Decoction combined with Wu Wei Xiao Du Yin can be taken internally, while a two-component Baidu Du San can be applied externally. In recent years, many physicians have developed their own proprietary formulas for treating this disease, such as Jin Shao Yiguan Jian (10–30g each of Bai Shao, Rehmannia Root, Yujin, Sha Shen, Ophiopogon, and Goji Berry, along with 6–15g each of Angelica Sinensis and Chuan Lianzi), Dai Xie Xiao R疹 Tang (using indigo powder (prepared by decoction), fresh Sophora Flavescens, Cortex Phellodendri, and whole Scorpion (ground into powder and taken orally), along with 20g each of Ban Lan Gen and Coix Seed, 20g each of Mulberry Leaf and Ground Ficus, 20g each of Mulberry Leaf and Ground Ficus, 20g each of Mulberry Leaf and Ground Ficus, 20g each of Mulberry Leaf and Ground Ficus, 20g each of Mulberry Leaf and Ground Ficus, 20g each of Mulberry Leaf and Ground Ficus, 20g each of Mulberry Leaf and Ground Ficus, 20g each of Mulberry Leaf and Ground Ficus, 20g each of Mulberry Leaf and Ground Ficus, 20g each of Mulberry Leaf and Ground Ficus, 20g each of Mulberry Leaf and Ground Ficus, 20g each of Mulberry Leaf and Ground Ficus, 20g each of Mulberry Leaf and Ground Ficus, 20g each of Mulberry Leaf and Ground Ficus, 20g each of Mulberry Leaf and Ground Ficus, 20g each of Mulberry Leaf and Ground Ficus, 20g each of Mulberry Leaf and Ground Ficus, 20g each of Mulberry Leaf and Ground Ficus, ......Task output rules: Translate this markdown block from Chinese to English. Preserve markdown markers, links, and formatting. Keep headings and list structure unchanged. Return only the translated block.

Input: Purulent or turbid fluid in the vesicles; or accompanied by sores on the mouth and tongue, swollen and painful gums, constipation, short yellow urine, a pulse that is rapid and numbing or deep and solid, a red or purplish tongue, and a yellow, dry tongue with little saliva. Treatment should focus on clearing heat and detoxifying, cooling the blood and nourishing yin. The formula should be a modified Qingying Decoction combined with Qingwei Powder; use 10g of Water Buffalo Horn, 15g of Rehmannia Root, 10g of Salvia Miltiorrhiza, 10g of Scrophularia Ningpoensis, 12g of Ophiopogon japonicus, 6g of Coptis chinensis, 15g of Honeysuckle Flower, 12g of Forsythia Suspensa, 12g of Angelica sinensis, 15g of Paeonia lactiflora. Brew the herbs in water and take one dose per day. For those with dark red rashes, add Purple Flowered Groundsel, Purple Herb, or Gardenia to clear heat and cool the blood; for severe yin and liquid depletion with dry mouth, add Pollen, Ophiopogon japonicus, and Reed Grass to nourish yin and generate fluids; for swollen and painful gums, sores on the mouth and tongue, and constipation, add Shuixiang Powder or Rhubarb, Citrus Aurantium Fruit, and other herbs to clear fire and promote bowel movements.

(4) Traditional Chinese Medicine Resources on the Diagnosis and Treatment of This Disease

Wang Junhua conducted a literature review on traditional Chinese medicine formulations, patent medicines, and integrated Chinese-Western medicine treatments for varicella between 2003 and 2006 as follows:

1. Formulas for Treatment Traditional Chinese Medicine views varicella as an external infection caused by harmful external factors affecting the lungs and spleen, leading to dampness and heat, which then manifest on the skin. Treatment should focus on clearing heat, cooling the blood, and detoxifying. Since patients are often children—whose bodies are still developing and whose constitutions are still weak—there is a high risk of yin and liquid depletion during the course of the disease; therefore, it is crucial to strengthen the body’s vital energy and consolidate its foundation. Traditional Chinese medicine formulas emphasize syndrome differentiation and individualized medication adjustments based on each patient’s specific condition, ensuring that medications are tailored to address the unique needs of each case. Yang Longsheng treated 20 cases of varicella based on Yin Qiao San, all of whom experienced fever resolution, rash regression, skin lesion recovery, and elimination of complications such as infections, with overall health improving significantly. Zhang Hua and others used a self-prepared disinfectant decoction for internal administration and a topical decoction for external washing, treating 57 adult cases of varicella, achieving a cure rate of 1% within 10 days. Zhao Ping et al. compared a traditional Chinese medicine formula called “Disinfection Drink” for internal use with “Virus Zol” administered via intramuscular or intravenous injections, finding that the treatment group showed significantly better efficacy than the control group. Yang Jingbo et al. used a combination of Yin Huang Detoxification and Clearing Evil Decoction for internal administration, while Ma Yinglong applied Longzhu Soft Paste to apply directly to the skin lesions, treating 21 cases of varicella, with 18 cases cured, resulting in an effective rate of 95.24%. Yang Xia et al. developed a silver-stone mixture for treating varicella in children, averaging a treatment duration of 4 days, with no significant adverse reactions observed. Zheng Dunfa compared a Qingre Decoction with a reduced formulation to a control group receiving intravenous acyclovir infusion; the treatment group achieved a cure rate of 35 cases, with a total effective rate of 100%, outperforming the control group (94.67%).

Patent medicines offer stable quality and convenient use, and the emergence of new dosage forms has expanded the range of delivery methods. Zhao Heying used Shuanghuanglian powder injections diluted to 0.8% for intravenous infusions; she also applied a 3% concentration solution topically to treat varicella, with 18 cases showing obvious improvement and 4 cases responding effectively. He Guodong treated 46 cases of varicella using Banlan Gen granules, all of whom were cured, with an average treatment duration of 2–5 days, sometimes up to 8 days. Cao Ning et al. used fishy herb injection for treating children with varicella, comparing intramuscular or intravenous injections of fishy herb injection with intramuscular injections of Vitamin B₂ and intramuscular or intravenous injections of Viral Zol, finding that both groups showed highly significant differences in average fever reduction time, time to stop new rashes, and time for complete rash crusting (p < 0.01). None of the treatment group experienced secondary rash development, and no adverse reactions occurred. Xiao Zhaowei soaked the compound Gua Zi Jin Granules (Jin Hong Sheng) in warm water for oral administration, treating 43 cases of varicella, with 22 cases cured, 17 cases showing marked improvement, and a total effective rate of 97.7%, surpassing the oral administration of Líba.

Part Two: Infectious Diseases

Wei Lin’s group reported a cure rate of 89.3%.

3. Integrated Chinese and Western Medicine Treatments Deng Hua used Qingkai Ling injection, fishy herb injection, and Astragalus injection, combined with Western medicine like Ribavirin for intravenous infusions, while simultaneously administering the traditional Chinese medicine formula Wu Wei Du Xian for oral consumption. A total of 46 patients underwent treatment with these combinations of Chinese and Western medicines, along with Ribavirin infusions and Western medicine therapies.

8 hours¹ 2 cases; rash regression took 2–3 days¹ 2 cases, 4–5 days 25 cases, 6–7 days 9 cases; the entire treatment process lasted a minimum of 3 hours¹ 2 cases, 6 hours² 4 cases,

the children’s mental state was relatively good, with no particular discomfort. Tang Yu used intravenous acyclovir infusion combined with fishy herb injection for intramuscular injections, and the treatment period was shorter for the children compared to the control group, with a faster fever reduction, earlier onset of new rashes, and quicker relief of itching, as well as more rapid skin crust formation—all of which were statistically significant compared to the control group (p < 0.01). No cases of secondary rash development were observed in the treatment group, and no adverse reactions occurred. Xiao Zhaowei soaked the compound Gua Zi Jin Granules (Jin Hong Sheng) in warm water for oral administration, treating 43 cases of varicella, with 22 cases cured, 17 cases showing marked improvement, and a total effective rate of 97.7%, surpassing the oral administration of Líba.

Second Article: Practical Internal Medicine

Zhao Rong randomly divided 76 confirmed cases of varicella into a treatment group of 42 cases and a control group of 24 cases. Based on standard treatment protocols, the treatment group received treatment with the traditional Chinese medicine formula Qingwen Baidu Decoction (composition: Mulberry Leaves, Forsythia, Honeysuckle Flower, Coptis Chinensis, Banlan Gen, Purple Flowered Groundsel, Cicada Wings, Red Peony, Tussilago, Wild Chrysanthemum, Coptis Chinensis, Job's Tears, and Licorice), while the control group received intramuscular injections of recombinant human interferon alpha-2b, oral acyclovir tablets, and external application of calamine lotion. Compared to the control group, there were no statistically significant differences in the effectiveness rate, total effective rate, time to relieve itching, or time for complete rash crusting (p > 0.05). However, the treatment group’s fever duration was significantly shorter than that of the control group (p < 0.01), indicating that the Qingwen Baidu Decoction could help restore normal body temperature more quickly, thereby alleviating the discomfort experienced by children. (Pediatric Pharmacy Journal, 2007.6)

Tian Lixiong et al. treated 50 pediatric cases of varicella with a decoction for internal and external use, randomly assigning 50 cases to the treatment group. The observation group received the decoction (composition: Honeysuckle Flower, Forsythia, Banlan Gen, Polygonum cuspidatum, Fangfeng, Jingjie, Dafu Ling, Huangqin, Shengma, Yiyiren, Mu Tong, Gancao, and others) for treatment. The treatment regimen involved two doses daily, with one dose prepared by boiling the herbs in water and taken in two portions; another dose was used for external applications through steam inhalation and topical application. The control group received intravenous acyclovir infusions. The treatment group had a cure rate of 76.0%, with 16.0% showing improvement, and a total effective rate of 92.0%; the control group had a cure rate of only 28.0%, with a total effective rate of 56.0%. Statistical analysis revealed that the two groups’ therapeutic effects were statistically significant (p < 0.01). (Journal of Hunan Normal University, Medical Edition, 2008.5)

IV. Western Medicine Treatments (1) General Care

This disease is highly contagious; once a child is identified as infected, they should be immediately isolated until all rashes have formed scabs. During the fever phase, the child should rest in bed and consume easily digestible foods along with adequate hydration. The child’s skin should be kept clean, with nails trimmed short to prevent scratching and subsequent infections. In collective settings such as daycare centers, it is important to keep the living space clean, disinfect, and ventilated, utilizing ultraviolet light, sun exposure, and boiling bedding items. If care is not properly managed, secondary skin infections may occur, leading to pus formation and even joint inflammation.

(2) Medicinal Treatments

1. Symptomatic Treatment: For those with skin lesions, apply 10% Gentian Violet externally; for skin itching, use 2% Carbonic Acid Solution or Calamine Lotion, among others. If the blisters rupture, apply Neomycin Ointment. If the skin becomes infected or if complications such as pneumonia or sepsis develop, choose appropriate antibiotics such as sulfonamides or antibiotics. If encephalitis occurs, treat it according to the standard protocol for encephalitis caused by type B.

2. Local External Treatments: When the rashes break open and ooze fluid, sprinkle pine pollen over the affected area. If the rashes become ulcerated, apply Blue Indigo Oil Paste (60g of Indigo, 120g each of Calcined Gypsum and Talc, 30g of Phellodendron Amurense, 15g each of Camphor and Coptis Chinensis, ground into fine powders and mixed thoroughly, then applied with sesame oil).

Integrated Chinese and Western Medicine Practical Internal Medicine – Appendix: Herpes Zoster – I. Overview

Herpes Zoster is an acute inflammatory disease characterized by clustered vesicles appearing on the skin, accompanied by neuralgia. The rash typically follows the distribution of peripheral nerves on one side of the body, forming bands.

The general population is susceptible to infection; after contracting chickenpox [------]{.underline}, individuals can develop lasting immunity. However, the high levels of antibodies in the body cannot eliminate latent viruses residing in the spinal cord nerve ganglia. Years—or even decades—later, under certain triggers such as trauma, cold exposure, fatigue, various infectious diseases, leukemia, or after immunosuppressive therapy, or due to weakened physical condition, immune function may decline, allowing latent viruses to proliferate and cause illness. Often, before the onset of symptoms, local lymph nodes may become swollen and painful; initially, the rash frequently presents as sharp, dull, or burning pain along the dermatomal segments of the nerves, accompanied by mild systemic symptoms. Skin manifestations include inflammation, with vesicles located deep within the epidermis, containing clear serous fluid. Within the vesicles and their margins, large, balloon-like cells can be observed, indicative of degeneration in the cells. In the vesicles themselves, eosinophilic nuclear inclusions may be found in the epithelial cells. The most common form is intercostal herpes zoster, followed by the distribution area of the first branch of the trigeminal nerve in the head and face, as well as the neck, waist, abdomen, and limbs.

Some patients may experience only papules without the formation of vesicles, which eventually resolve; this is referred to as a subacute herpes zoster. Some vesicles may appear as bullous or hemorrhagic, or even show central necrosis, forming dark brown scabs—these are known as gangrenous herpes zoster. Elderly patients with lymphoma or other conditions may experience widespread rashes, resembling generalized chickenpox, known as disseminated herpes zoster, often accompanied by high fever and other systemic symptoms.

II. Diagnosis

(1) Diagnostic Criteria

On one side of the body, clusters of chickenpox-like rashes appear, arranged in bands along the nerves, asymmetrically, generally not extending beyond the midline of the body, with distinct neuralgia.