What is shingles?
Herpes zoster is caused by the varicella zoster virus. This virus that can reside within the nervous system for decades. An initial infection of the virus will cause chickenpox. Some have estimated that a third of the population will get shingles at some point. But for those who live to 85, the risk increases to about 50 percent.
The activation of the Herpes zoster virus has been linked with weakened immunity. This can occur with toxicity, age, stress and other factors.
Shingles can be painful, especially in older adults. It can cause aching, tingling and stinging pain. It can also produce throbbing or numbness. After an initial upsurge of shingles pain and rash, blisters can form on the skin. This is often seen as a belt of blisters on one side of the body.
The blisters can become very uncomfortable. They can fill with blood and become red, and then crust and flake off. This can take a week or two to complete an episode cycle. The infection may then appear to reside, sometimes re-emerging later.
Depending upon the part of the nervous system it infects, the virus can cause complications in the eyes, ears or throat. It may also cause tooth loss and infect the brain and other organs.
Complications of the virus that include pain and other symptoms are often referred to as post-herpetic neuralgia.
Herbal formulation treats herpes zoster
For centuries, traditional healers from Asia have utilized an herbal formulation centered around the Japanese Gentian plant. The Latin name for the plant is Gentiana scabra Bunge. It is also called longdan in Japanese and Chinese medicine.
The formula is thus referred to as the Gentiana formula. The Gentiana formula is based upon the Chinese medicine formula called Long Dan Xie Gan Wan. For Herpes zoster, a modified version of the formula is used. More about this later.
Research from Melbourne’s RMIT University and the China-Australia International Research Center for Chinese Medicine investigated the use of the Gentiana formula in the treatment of Herpes zoster.
The researchers analyzed 26 clinical studies that involved 2,955 Herpes zoster patients. In many of the studies, the modified Gentiana formula was tested against pharmaceutical treatments such as antivirals. Many of the studies also utilized the modified Gentiana formula together with a topical herbal cream to help reduce the blisters.
The researchers found that treatment with the modified Gentiana formula combined with the topical cream reduced the risk of post-herpetic neuralgia by 86 percent. Pain reduction was the most significant result of the herbal medicine treatment.
The researchers say the herbs’ anti-inflammatory effects partly explain the effectiveness of the formula. They stated:
“Anti-inflammatory actions of key herbs of Gentiana formula may explain clinical benefit in hastening pain relief and decreasing post-herpetic neuralgia.”
The meta-analysis also found very few adverse events as a result of the Gentiana formula treatment.
Topical treatments varied, but anti-inflammatory herbs such as Sophora flavescens root and Lithospermum erythrorhizon root are often used for rashes and psoriasis
What is the Gentiana formula?
The basic Long Dan Xie Gan Wan formula is comprised of the following herbs:
• Gentiana scabra Bunge (Long Dan Cao – Gentian root)
• Rehmannia glutinosae (Sheng Di Huang – Rehmannia root)
• Glycyrrhiza glabra (Gan Cao – Licorice root)
• Bupleurum chinense (Chai Hu – Bupleurum root)
• Angelica sinensis (Dang Gui – Dong quai root)
• Alisma orientale (Ze Xie – Alisma stalk)
• Akebia trifoliata (Mu Tong – Akemia stem)
• Plantago major (Che Qian Zi – Plantian seed)
• Scutellaria baicalensis (Huang Qin – Scutellaria root)
• Gardenia jasminoides (Zhi Zi – Gardenia fruit)
This basic formula is said to remove heat, and help clear or drain. It also can calm or help relieve stressful mood. There are also antiviral/antibacterial properties among some of these herbs, specifically the Scutellaria can be very draining and drying, helping to dry out the blisters faster.
The four key herbs used in the modified Gentian formula include:
• Gentiana scabra
• Gentiana triflora
• Scutellaria baicalensis
• Gardenia jasminoides
This is not to say that the Long Dan Xie Gan Wan formula cannot be used. There are many clinical references where the full formula has been used successfully for Herpes zoster, as well as chickenpox and Herpes simplex.
In a study from Taiwan’s Kaohsiung Medical University, researchers found that the Long Dan Xie Gan Wan formula inactivated Herpes simplex-1 and Herpes simplex-2 in a dose-dependent fashion. They stated:
“In summary, the water extract of Long Dan Xie Gan Wan was concluded to inhibit HSV-1 and HSV-2 infection at different magnitudes of potency, and our observations also suggested that the effect was likely mediated by directly inactivating the virus infectivity.”
Herbal formulas plus acupuncture beats pharma drugs
Two studies from 2014 and 2015 tested similar herbal formulations against pharma drugs.
In one, researchers from the Hubei University of Chinese Medicine treated 85 shingles patients. They received either acyclovir or herbs plus acupuncture.
The researchers found that acupuncture plus herbs had a 17 percent greater effective rate than the acyclovir treatment.
The herbal formula given to the patients was modified depending upon the symptoms of each patient. The main formula contained two of the same herbs in the Long Dan Xie Gan Wan formulation.
In another study, researchers from China’s Dongfeng General Hospital gave patients another formulation plus acupuncture for 15 days. The researchers found the combination treatment resulted in a 98.6 percent effective rate. This was better than the 90 percent effective rate achieved by acyclovir treatment.
The formula used also contained one of the key herbs in the Long Dan Xie Gan Wan formula.
In both studies above, acupuncture was administered to the Hua Tuo Jia Ji and Ashi acupoints. Other studies have shown that combined moxibustion and acupuncture are also effective for reducing post-herpetic neuralgia.
Conclusion
The modified Gentian formula (Long Dan Xie Gan Wan) was able to reduce post-herpetic neuralgia by 86 percent. This is a significant result, and 26 clinical studies provide clear evidence for this effectiveness.
The 2014 and 2015 studies illustrate that acupuncture can be used in combination with the herbs. They also indicate that the practitioner may modify the formulation depending upon the patient’s symptoms.
Talk with your health professional before embarking on any self-treatment.
REFERENCES:
Wang K, Coyle ME, Mansu S, Zhang AL, Xue CC. Gentiana scabra Bunge. Formula for Herpes Zoster: Biological Actions of Key Herbs and Systematic Review of Efficacy and Safety. Phytother Res. 2017 Jan 12. doi: 10.1002/ptr.5769.
Cheng HY, Huang HH, Yang CM, Lin LT, Lin CC. Anti-herpes simplex virus with Long Dan Xie Gan Tan, a prescription of traditional Chinese medicine. Chemotherapy. 2008;54(2):77-83. doi: 10.1159/000119705.
Wei JD, Chen JM, Wang LS. Clinical Observation of Surround Acupuncture and Simiaoyon’an Decoction on Herpes Zoster. Journal of Hubei University of Chinese Medicine. 2014; 16(2).
Yi JK, Tang ZZ, Yang JL. Efficacy and Safety of TCM Combined with Acupuncture Treatment for Herpes Zoster Neuralgia. 2015; 31(8).
Shen LL, Wu HS, Wang XY. The efficacy of long-dan-xie-gan-tang for herpes zoster: a clinical trial and animal experimental data. J Tongji Med Univ. 1986;6(2):109-11.
Deng S, May BH, Zhang AL, Lu C, Xue CC. Topical herbal formulae in the management of psoriasis: systematic review with meta-analysis of clinical studies and investigation of the pharmacological actions of the main herbs. Phytother Res. 2014 Apr;28(4):480-97. doi: 10.1002/ptr.5028.
Yoo Min Choi, Seok Hee Kim, Ju Yong Kim, Sang Hun Park, Tae Han Yook, Jong Uk Kim. A Review on Clinical Studies of Acupuncture and Moxibustion Therapy for Acute Herpes Zoster. Acupuncture 2015; 32(3): 147-161.