---
title: "Transcutaneous Auricular Vagus Nerve Stimulation for Acute Herpes Zoster Pain in Middle-Aged and E"
id: "pubmed-42736127"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42736127"
content_type: "clinical_feed_article"
specialty: "Pharmacology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42736127/"
doi: "10.3760/cma.j.cn112137-20260302-00587"
published_at: "2026-09-15T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Transcutaneous Auricular Vagus Nerve Stimulation for Acute Herpes Zoster Pain in Middle-Aged and E
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42736127
- **Specialty:** [Pharmacology](https://medichelpline.com/clinical-feed/pharmacology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42736127/)
- **DOI:** [10.3760/cma.j.cn112137-20260302-00587](https://doi.org/10.3760%2Fcma.j.cn112137-20260302-00587)
- **Published At:** 2026-09-15T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- This randomized controlled trial evaluated acute-phase **transcutaneous auricular vagus nerve stimulation (taVNS)** in 40 middle-aged and elderly patients with acute herpes zoster (HZ) and comorbid depressive and anxiety symptoms. - Participants were randomized 1:1 to receive either active taVNS (n=20) or sham stimulation (n=20) for 5 consecutive days; both groups received antiviral therapy and on-demand rescue analgesia. - Pain, mood, and sleep were measured with the **Visual Analog Scale (VAS)**, **PHQ-4** (4-item Patient Health Questionnaire), and **Insomnia Severity Index (ISI)** respectively; primary endpoint was incidence of subacute pain at 30 days after rash onset. - The incidence of subacute pain at 30 days was significantly lower in the taVNS group than in the sham group (5% vs 35%; risk difference -30.0%, P = 0.044), with reported risk ratio and 95% CI in the source. - At 2 weeks, improvements from baseline (Δ values) in **PHQ-4** and **ISI** scores were significantly greater in the taVNS group compared with sham, indicating better mood and sleep outcomes. - The taVNS group had fewer patients using lofentadine and lower cumulative lofentadine consumption at weeks 1 and 2 (both P < 0.05). - No serious adverse events were reported in either group; there was no statistically significant difference in the incidence of **postherpetic neuralgia (PHN)** at 90 days between groups. - The study was conducted at Xuanwu Hospital, Capital Medical University (plus one other center) between June 2024 and June 2025; authors declared no conflicts of interest. - The trial supports feasibility and short-term safety of acute-phase **taVNS** for reducing subacute HZ pain and improving emotional and sleep measures in this patient population, while longer-term PHN prevention was not demonstrated as significantly different in this sample.
## Clinical Analysis & Structured Key Points
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Affiliations Expand ### Affiliations * 1 Department of Dermatology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China. * 2 Department of Dermatology, Beijing Electric Power Hospital, State Grid Corporation of China, Beijing 100055, China. * PMID: **42736127** * DOI: [ 10.3760/cma.j.cn112137-20260302-00587 ](https://doi.org/10.3760/cma.j.cn112137-20260302-00587) Item in Clipboard Randomized Controlled Trial # [Efficacy and safety of acute-phase transcutaneous auricular vagus nerve stimulation for herpes zoster-related pain in middle-aged and elderly patients with comorbid depression and anxiety] [Article in Chinese] T T Zhou et al. Zhonghua Yi Xue Za Zhi. 2026. Show details Display options Display options Format Abstract PubMed PMID Zhonghua Yi Xue Za Zhi Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Zhonghua+Yi+Xue+Za+Zhi%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Zhonghua+Yi+Xue+Za+Zhi%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42736127/) . 2026 Sep 15;106(34):3646-3653. doi: 10.3760/cma.j.cn112137-20260302-00587. ### Authors [T T Zhou](https://pubmed.ncbi.nlm.nih.gov/?term=Zhou+TT&cauthor_id=42736127)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42736127/#short-view-affiliation-1 "Department of Dermatology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China."), [Y Hou](https://pubmed.ncbi.nlm.nih.gov/?term=Hou+Y&cauthor_id=42736127)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42736127/#short-view-affiliation-1 "Department of Dermatology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China."), [X Li](https://pubmed.ncbi.nlm.nih.gov/?term=Li+X&cauthor_id=42736127)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42736127/#short-view-affiliation-2 "Department of Dermatology, Beijing Electric Power Hospital, State Grid Corporation of China, Beijing 100055, China."), [H P Zhang](https://pubmed.ncbi.nlm.nih.gov/?term=Zhang+HP&cauthor_id=42736127)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42736127/#short-view-affiliation-1 "Department of Dermatology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.") ### Affiliations * 1 Department of Dermatology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China. * 2 Department of Dermatology, Beijing Electric Power Hospital, State Grid Corporation of China, Beijing 100055, China. * PMID: **42736127** * DOI: [ 10.3760/cma.j.cn112137-20260302-00587 ](https://doi.org/10.3760/cma.j.cn112137-20260302-00587) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID ## Abstract in [ English, ](https://pubmed.ncbi.nlm.nih.gov/42736127/#eng-abstract) [ Chinese ](https://pubmed.ncbi.nlm.nih.gov/42736127/#zho-abstract) **Objective:** To evaluate the efficacy and safety of transcutaneous auricular vagus nerve stimulation (taVNS) during the acute phase in middle-aged and elderly patients with herpes zoster (HZ) comorbid depressive and anxiety states. **Methods:** This was a randomized controlled trial. Forty middle-aged and elderly patients with acute-phase HZ who attended the Department of Dermatology at Xuanwu Hospital, Capital Medical University, from June 2024 to June 2025 were enrolled and randomly assigned in a 1∶1 ratio using a random number table to receive either taVNS (_n_ =20) or sham stimulation (_n_ =20) for 5 consecutive days. Both groups received antiviral therapy and on-demand rescue analgesia. Pain, anxiety/depression, and sleep quality were evaluated using the Visual Analog Scale (VAS), the 4-item Patient Health Questionnaire (PHQ-4), and the Insomnia Severity Index (ISI), respectively. The primary outcome was the incidence of subacute pain at 30 days post-rash onset. Secondary outcomes included cumulative analgesic consumption at 1 and 2 weeks after treatment, the changes from baseline (Δ values) in PHQ-4 and ISI scores at 2 weeks, and the incidence of postherpetic neuralgia (PHN) at 90 days post-rash onset. **Results:** In the taVNS group, 7 patients (35%) were female, with a mean age of (64.1±9.7) years; in the sham group, 10 patients (50%) were female, with a mean age of (61.5±8.5) years. There were no statistically significant differences between the two groups in baseline VAS, PHQ-4, or ISI scores (all _P_ >0.05). The incidence of subacute pain was significantly lower in the taVNS group than in the sham group [5% (1/20) vs 35% (7/20), _RD_ =-30.0% (95%_CI_ :-52.1%--4.9%); _RR_ =0.14 (95%_CI_ : 0.02-1.06); _P_ =0.044]. At 2 weeks after treatment, the Δ values of PHQ-4 and ISI in the taVNS group were significantly greater than those in the sham group. The proportion of patients taking Lofentadine and the cumulative Lofentadine consumption at weeks 1 and 2 were both lower in the taVNS group than in the sham group (all _P_ 0.05). **Conclusions:** Acute-phase taVNS appears to be feasible and safe in middle-aged and elderly patients with HZ and comorbid depressive and anxiety, effectively reducing subacute pain and improving emotional and sleep outcomes. **目的：** 评价急性期经皮耳迷走神经电刺激（taVNS）治疗合并抑郁焦虑状态的中老年带状疱疹（HZ）患者的效果和安全性。 **方法：** 随机对照试验。纳入2024年6月至2025年6月在首都医科大学宣武医院皮肤科就诊的40例急性期中老年HZ患者，采用随机数字法1∶1随机分为taVNS组（ _n_ =20）和假刺激组（ _n_ =20），分别接受连续5 d的taVNS或假刺激，同时两组均接受抗病毒、按需救援性镇痛治疗。使用疼痛视觉模拟评分（VAS）、4项患者健康问卷（PHQ-4）、失眠严重程度指数（ISI）分别评估治疗前后疼痛、焦虑抑郁和睡眠情况。主要观察指标是皮疹出现后30 d亚急性疼痛发生率，次要观察指标是治疗后1、2周累计镇痛药用量，治疗2周后PHQ-4和ISI较治疗前评分的差值（Δ值），以及皮疹出现90 d后带状疱疹后神经痛（PHN）的发生率。 **结果：** taVNS组：女7例（35%），年龄（64.1±9.7）岁，假刺激组：女10例（50%），年龄（61.5±8.5）岁，两组治疗前VAS、PHQ-4和ISI评分差异均无统计学意义（均 _P_ >0.05）。taVNS组亚急性期疼痛发生率低于假刺激组［5%（1/20）比35%（7/20）， _RD_ =-30.0%（95%_CI_ ：-52.1%~-4.9%）， _RR_ =0.14（95%_CI_ ：0.02~1.06）， _P_ =0.044］。治疗2周后，taVNS组PHQ-4和ISI的Δ值大于假刺激组，taVNS组治疗第1周和第2周服用洛芬待因的患者比例和洛芬待因消耗量均低于假刺激组（均 _P_ 0.05）。 **结论：** 急性期taVNS用于合并抑郁焦虑状态的中老年HZ患者，具有较好可行性和安全性，可以减少亚急性期疼痛并改善情绪和睡眠质量。. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Conflict of interest statement 所有作者声明不存在利益冲突 ## Similar articles * [ [Effect of transcutaneous auricular vagus nerve stimulation combined with patient-controlled intravenous analgesia on postoperative pain in patients with total knee arthroplasty]. ](https://pubmed.ncbi.nlm.nih.gov/40059053/) Huang HX, Wang XH, Zhang Y, Zhang J, Li T, Wang ZH, Zhu YZ, Wang LW.Huang HX, et al.Zhen Ci Yan Jiu. 2025 Feb 25;50(2):190-196. doi: 10.13702/j.1000-0607.20231101.Zhen Ci Yan Jiu. 2025.PMID: 40059053Clinical Trial.Chinese. * [ Repetitive Transcranial Magnetic Stimulation at Different Frequencies for Postherpetic Neuralgia: A Double-Blind, Sham-Controlled, Randomized Trial. ](https://pubmed.ncbi.nlm.nih.gov/31337172/) Pei Q, Wu B, Tang Y, Yang X, Song L, Wang N, Li Y, Sun C, Ma S, Ni J.Pei Q, et al.Pain Physician. 2019 Jul;22(4):E303-E313.Pain Physician. 2019.PMID: 31337172Clinical Trial. * [ [Efficacy and safety of thoracic paravertebral block combined with thoracic nerve block for acute herpes zoster neuralgia involving upper thoracic dermatomes in middle-aged and elderly patients]. ](https://pubmed.ncbi.nlm.nih.gov/42706086/) Qin MY, Zhao DL, Wang R, Lu LJ.Qin MY, et al.Zhonghua Yi Xue Za Zhi. 2026 Sep 1;106(32):3380-3384. doi: 10.3760/cma.j.cn112137-20251217-03345.Zhonghua Yi Xue Za Zhi. 2026.PMID: 42706086Clinical Trial.Chinese. * [ Transcutaneous Auricular Vagus Nerve Stimulation for Postpartum Contraction Pain During Elective Cesarean Delivery: A Randomized Clinical Trial. ](https://pubmed.ncbi.nlm.nih.gov/40880089/) Xiong X, Tao M, Zhao W, Tan W, Jiang Y, Sun Z, Wang Y, Lin Y, Li C, Yang J, Han Y, Zhang H, Zhang S, Liu H, Cao JL.Xiong X, et al.JAMA Netw Open. 2025 Aug 1;8(8):e2529127. doi: 10.1001/jamanetworkopen.2025.29127.JAMA Netw Open. 2025.PMID: 40880089Free PMC article.Clinical Trial. * [ Nerve Block Efficacy and Safety for Acute Thoracic Herpes Zoster: A Systematic Review and Meta-analysis. ](https://pubmed.ncbi.nlm.nih.gov/40168557/) Chuang CM, Lin CR, Hsieh YL.Chuang CM, et al.Pain Physician. 2025 Mar;28(2):83-96.Pain Physician. 2025.PMID: 40168557 [ See all similar articles ](https://pubmed.ncbi.nlm.nih.gov/?linkname=pubmed_pubmed&from_uid=42736127) ## 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> MedicHelpline content is structured for research, educational, and professional discovery purposes. It does not constitute individual medical advice, clinical diagnosis, or treatment recommendations.
> Always verify dosing, contraindications, and regulatory alerts against official product labeling and primary regulatory sources before clinical decision-making.