Post-Herpetic Neuralgia - Qi Stagnation with Blood Stasis Pattern

Dr. Li Wei, DACM

Post-Herpetic Neuralgia · Qi Stagnation with Blood Stasis Pattern

Updated: June 23, 2026

Reviewed by: Dr. Li Wei, DACM

Reading Time: 7 min

Body Area: Whole Body

Pattern Overview

Qi Stagnation with Blood Stasis is a common pattern in post-herpetic neuralgia (PHN), characterized by post-viral nerve damage, sharp fixed pain, and aggravation at night. The core pathogenesis is stagnation of Qi and Blood in the affected nerve collaterals following herpes zoster infection, leading to persistent pain, numbness, and impaired nerve repair.

Key Symptoms and Differentiation Points

| Differentiation Dimension | Manifestations |

| :— | :— |

| Primary Symptoms | Sharp, stabbing pain in the affected dermatome, fixed location, worse at night |

| Associated Symptoms | Numbness, tingling, tenderness, dark complexion, purple-dark lips |

| Tongue and Pulse | Purple-dark tongue with petechiae, thin white coating, hesitant pulse |

| Pathogenesis | Qi stagnation and Blood stasis obstructing the nerve collaterals |

| Etiology | Herpes zoster infection, post-viral inflammation, prolonged nerve damage |

Acupuncture Point Prescription

| Point | Location | Function |

| :— | :— | :— |

| BL17 Geshu | Lower back, 1.5 cun lateral to T7 | Back-Shu point of the Blood; invigorates Blood and resolves stasis |

| LR3 Taichong | Dorsum of the foot, between the 1st and 2nd metatarsals | Soothes Liver Qi and regulates Qi flow |

| Ashi points | Tender spots in the affected dermatome | Local blood invigoration and pain relief |

Clinical Recommendation: Filiform needle, reducing method; cupping at Ashi points may be used to enhance blood stasis resolution. Electro-acupuncture may be added to modulate nerve pain.

Herbal Formula

Base Formula: Xue Fu Zhu Yu Tang (血府逐瘀汤)

Composition:

Peach Kernel (Tao Ren), Safflower (Hong Hua), Angelica (Dang Gui), Chuanxiong (Chuan Xiong), Red Peony (Chi Shao), Rehmannia (Sheng Di), Bupleurum (Chai Hu), Platycodon (Jie Geng), Licorice (Gan Cao)

Action: Invigorates blood, resolves stasis, regulates Qi, and relieves pain.

Modifications

| Associated Symptoms | Additions/Subtractions |

| :— | :— |

| Severe pain | Add Ru Xiang, Mo Yao to relieve pain |

| Numbness | Add Ji Xue Teng, Dan Shen to improve circulation |

| Night aggravation | Add Yan Hu Suo, Wu Ling Zhi to invigorate blood and relieve pain |

Western Mechanism Reference

Post-viral nerve damage with microcirculatory disturbance, local inflammation, and impaired nerve repair. Qi Stagnation with Blood Stasis corresponds to post-herpetic neuralgia with significant nerve damage, where chronic inflammation and impaired microcirculation contribute to persistent pain and sensory disturbance.

References

  1. Database + Textbook.

  2. Zeng, L., et al. (2014). Acupuncture for post-herpetic neuralgia. Pain Medicine, 15(6), 986-993.

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

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