Objective

2

To explore the efficacy and safety of

Qingre Chushi Decoction

（清热除湿汤， QCD） in the treatment of herpes zoster with constraint heat in the liver channel syndrome.

Methods

2

A prospective， multicenter， single-blind， randomized controlled trial was designed. A total of 114 herpes zoster participants with constraint heat in the liver channel syndrome were randomly assigned to a treatment group and a control group， with 57 cases in each group. The control group was treated with valacyclovir tablets， mecobalamin tablets， and vitamin B1， while the treatment group was given oral QCD， one dose per day. Both groups received treatment for 7 days. After the treatment course， the clinical efficacy of both groups was observed. If the patient's pain did not alleviate， and the patients in the treatment group were still diagnosed by the physician as having constraint heat in the liver channel syndrome， QCD was continued with modifications； the control group continued with oral mecobalamin tablets and vitamin B1 until pain relief was achieved. The visual analog scale （VAS） scores for pain were recorded for two groups before treatment， after 7 days of treatment， and at 14-， 21-， 30-， and 90-day follow-up. The occurrence of postherpetic neuralgia （PHN） was recorded at 30- and 90-day follow-up. The blister cessation time， time to full scab formation， time to shed scabs， and time for pain relief were recorded， and safety was evaluated. A subgroup analysis was performed based on different age groups （＜50 years， ≥50 years）， gender， and disease duration （0-3 days， 4-7 days） to evaluate the pain VAS scores at different time points before and after treatment， as well as the occurrence of PHN at the 30-day and 90-day follow-up.

Results

2

A total of 51 patients in the treatment group and 49 patients in the control group were included in the statistical analysis. The overall clinical efficacy rate in the treatment group （72.55%， 37/51） was significantly higher than that in the control group （51.02%， 25/49）， with a statistically significant difference （

P

＜0.05）. The pain VAS scores in the treatment group were significantly lower than those in the control group at 14-， 21-， 30- and 90-day follow-up （

P

＜0.05）. The treatment group had shorter blister cessation time， time to full scab formation， time to shed scabs， and time for pain relief than the control group （

P

＜0.05）. At the 30- and 90-day follow-up， the treatment group had lower occurrence of PHN than the control group （

P

＜0.05）. There were 3 cases of mild adverse events in either groups. The patients' blood routine， urine routine， and liver and kidney function indicators were all within the normal range before and after treatment. Subgroup analysis revealed that in patients aged ≥50 years， females， and those with a disease duration of 4 to 7 days， QCD demonstrated more pronounced advantages in alleviating pain and reducing the occurrence of PHN.

Conclusion

2

The clinical efficacy of QCD in the treatment of herpes zoster with constraint heat in the liver channel syndrome is positive， which can significantly reduce pain， promote rash healing， shorten the course of the disease and reduce the occurrence of PHN， and has good safety.