[Staging-based integrative treatment strategies of traditional Chinese and Western Medicine for zoster-associated pain].

Zoster-associated pain (ZAP) is a neuropathic pain syndrome caused by the reactivation of the varicella-zoster virus. Based on disease course, it can be classified into three stages: acute herpetic neuralgia (AHN), subacute herpetic neuralgia (SHN), and postherpetic neuralgia (PHN). Among these, PHN is the most common and the most difficult complication to treat, characterized by severe pain and prolonged duration, often leading to emotional disorders such as anxiety and depression. Its incidence is significantly higher in elderly individuals and immunocompromised patients. Western medicine management is centered on early antiviral therapy, anti-inflammatory treatment, neurotrophic support, and stepwise analgesia. For refractory pain, minimally invasive interventional approaches such as nerve block and spinal cord stimulation are recommended. In traditional Chinese medicine (TCM), this condition falls under category of "snake-string sores" (she chuan chuang). Treatment emphasizes stage-based differentiation: In the acute stage, the focus is on clearing damp-heat from the liver and gallbladder; in the subacute stage, strengthening the spleen and eliminating dampness; and in the chronic stage, tonifying qi and promoting blood circulation. These are combined with external therapies such as acupuncture, fire needle therapy, and moxibustion to unblock meridians and relieve pain. Clinical practice has demonstrated that whole-course management integrating TCM and Western medicine has significant advantages. In the acute stage, combining antiviral drugs with TCM heat-clearing and detoxifying therapies can significantly reduce the incidence of PHN. For patients with established PHN, combining TCM therapies that promote blood circulation and remove stasis with Western analgesics and minimally invasive interventions can effectively improve prognosis. Additionally, for elderly and immunocompromised patients, comprehensive measures such as nutritional support and psychological intervention are essential. Further research is needed to elucidate the synergistic mechanisms between TCM and Western medicine and to optimize treatment strategies, thereby improving clinical outcomes.