Objective:To investigate the efficacy and mechanism of Fuqingzhu Huodan Shenfang in the treatment of moderate to severe herpes zoster (liver meridian). Method:A total of 180 patients with severe herpes zoster treated in our hospital were randomly divided into the treatment group (90 cases) and the control group (90 cases) by the random number table. Another 90 healthy cases were also selected as the normal control group. Patients in control group were given oral acyclovir tablets

methylcobalamin dispersions

and liquid nitrogen cryotherapy. In addition to the above therapy

patients in observation group were also given modified Fuqingzhu Huodan Shenfang. A course of treatment was 14 days. The efficacy and the incidence of postherpetic neuralgia were compared between two groups. Th1 factor[interleukin (IL)-2 and interferon (IFN)-γ]

and Th2 factor (IL-4 and IL-10) expressions were observed by enzyme-linked immunosorbent assay. T lymphocyte subsets were measured by Flow cytometry. p38 mitogen-activated protein kinases (MAPK)

extracellular-signal regulated protein kinase (ERK)1/2 and c-Jun NH2-terminalprotein kinase (JNK) gene expressions were detected by Real-time PCR. Adverse reactions were compared. Result:The clinical efficiency of treatment group was significantly higher than control group (P<0.05). After 6 months of treatment

the incidence of postherpetic neuralgiathe in the treatment group was 41.1%

while that of the control group was 48.9%. There was no significant difference in the incidence of postherpetic neuralgia between two groups. VAS score in the PHN patients of treatment group was significantly lower than control group (P<0.05). After treatment

CD3+

CD4+

CD4+/CD8+ levels in treatment group were higher than before treatment

while CD8+ level was lower than before treatment (P<0.05). After treatment

IL-2 and IFN-γ levels in treatment group were higher than before treatment

while IL-4 and IL-10 levels were lower than before treatment (P<0.05). After treatment

p38 MAPK and JNK mRNA expressions in two group were significantly lower than before treatment (P<0.05). And there were statistically significant differences in p38 MAPK and JNK mRNA expressions between the treatment group and control group after treatment (P<0.05). Conclusion:Fuqingzhu Huodan Shenfang has a better clinical efficacy in treatment of moderate to severe herpes zoster (liver meridian)

and can significantly reduce the occurrence of post-zoster pain. Its mechanism may be related to regulation of the imbalance Th1/Th2 cells

improvement of immune function and antiviral activity

inhibition of gene activities p38 MAPK and its downstream factor JNK

regulation of the activation of MAPK signal transduction pathway

inhibition of the expression of inflammatory cytokines in the body

and relief of neuritic pathology injury.