Postherpetic Neuralgia

The 90-day period following the onset of shingles is a critical treatment window for preventing progression to PHN. During this time, the key is ① suppressing residual nerve inflammation and ② preventing central sensitization. While antiviral medications are most effective when administered within 72 hours, the early introduction of steroids or antineuropathic drugs (pregabalin and gabapentin) even after the rash has disappeared can reduce the progression to PHN. There is evidence that performing nerve blocks (intercostal nerve block, epidural block) early lowers the incidence of PHN. The one-month mark marks a turning point where acute heat toxins still remain in the meridians and blood stasis begins to solidify. At Dongjedang, we focus on treatment during this period that simultaneously cools and releases heat and toxins while restoring circulation to accumulated blood stasis. This approach aims to clear out toxic residues and prevent the deepening of blood stasis. The first stage involves rapidly resolving Qi and blood stagnation around the affected ganglion using acupuncture and pharmacopuncture, and cleansing the internal environment with initial herbal medicine. A positive response at this stage significantly increases the likelihood of preventing chronicity.