Postherpetic Neuralgia

Clinically, the treatment goals for PHYN are often set as a reduction in VAS scores of 50% or more, recovery of sleep duration, and maintenance of an NRS (Numerical Rating Scale) score of 4 or less. Structural repair of nerve damage is not fully guaranteed by any current treatment, and complete pain elimination is rare, especially in chronic patients with severe central sensitization. Even with drug treatments including pregabalin, gabapentin, and tricyclic antidepressants, the response rate for a reduction in NRS of 50% or more is only around 30–40%. A realistic approach is to focus on restoring quality of life by reducing the frequency, intensity, and duration of pain through integrated treatment. At Dongjedang, we provide honest guidance on treatment goals. For chronic PHN, we set the goal as "a state where pain does not interfere with daily life" rather than "zero pain," and we approach the treatment in stages. As blood stasis is resolved and Qi and blood circulation is restored, the frequency and intensity of pain decrease, and abnormal sensations become dulled. We evaluate the response after the first 8 to 12 weeks of treatment and proceed by adjusting goals and determining whether to continue maintenance therapy thereafter.