Post-Herpetic Neuralgia - Liver Channel Heat Pattern

Dr. Li Wei, DACM

Post-Herpetic Neuralgia · Liver Channel Heat Pattern

Updated: June 23, 2026

Reviewed by: Dr. Li Wei, DACM

Reading Time: 7 min

Body Area: Whole Body

Pattern Overview

Liver Channel Heat is a common pattern in post-herpetic neuralgia, characterized by neuropathic burning pain, redness, irritability, and bitter taste. The core pathogenesis is accumulation of Liver Channel Heat following herpes zoster infection, causing residual heat in the nerves, burning pain, and hyperalgesia.

Key Symptoms and Differentiation Points

| Differentiation Dimension | Manifestations |

| :— | :— |

| Primary Symptoms | Burning pain in the affected dermatome, redness, heat sensation |

| Associated Symptoms | Irritability, bitter taste, red eyes, headache, tinnitus |

| Tongue and Pulse | Red tongue with yellow coating, wiry and rapid pulse |

| Pathogenesis | Liver Channel Heat accumulating in the affected nerves |

| Etiology | Herpes zoster infection with residual heat, viral neuroinflammation |

Acupuncture Point Prescription

| Point | Location | Function |

| :— | :— | :— |

| LR3 Taichong | Dorsum of the foot, between the 1st and 2nd metatarsals | Source point of Liver meridian; clears Liver Heat |

| LR2 Xingjian | Dorsum of the foot, between the 1st and 2nd metatarsals, proximal to the web margin | Spring point of Liver meridian; drains Liver Fire |

| LI11 Quchi | Lateral end of the elbow crease | He-Sea point of Large Intestine meridian; clears Heat and detoxifies |

| Ashi points | Tender spots in the affected dermatome | Local clearing of Heat and pain relief |

Clinical Recommendation: Filiform needle, reducing method; may combine with pricking and cupping at Ashi points to drain Heat.

Herbal Formula

Base Formula: Long Dan Xie Gan Tang (龙胆泻肝汤)

Composition:

Gentian Root (Long Dan Cao), Scutellaria (Huang Qin), Gardenia (Zhi Zi), Bupleurum (Chai Hu), Alisma (Ze Xie), Akebia (Mu Tong), Angelica (Dang Gui), Rehmannia (Sheng Di), Plantago (Che Qian Zi), Licorice (Gan Cao)

Action: Clears Liver Channel Heat, drains Fire, and detoxifies.

Modifications

| Associated Symptoms | Additions/Subtractions |

| :— | :— |

| Severe burning pain | Add Jin Yin Hua, Lian Qiao to clear Heat and detoxify |

| Irritability | Add Zhi Zi, Dan Pi to clear Heat and calm the spirit |

| Headache | Add Ju Hua, Xia Ku Cao to clear Liver Heat and brighten the eyes |

Western Mechanism Reference

Neuropathic burning pain with activation of TRPV1 channels, neurogenic inflammation, and elevated inflammatory cytokines. Liver Channel Heat corresponds to post-herpetic neuralgia with prominent burning pain and neurogenic inflammation, where residual viral-induced inflammation and TRPV1 sensitization contribute to hyperalgesia.

References

  1. Textbook Standard.

  2. WHO. (2023). Post-herpetic neuralgia fact sheet. World Health Organization.

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