Yu Wei, Lu Jinzhao
Department of Pain, The Second Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong Province, China.
Medicine (Baltimore). 2025 Aug 8;104(32):e43698. doi: 10.1097/MD.0000000000043698.
This study evaluates the comparative effectiveness and safety of pharmacologic and non-pharmacologic therapies in managing postherpetic neuralgia (PHN), aiming to refine clinical pain management approaches. A retrospective analysis was conducted on 60 patients diagnosed with PHN and treated between June 2022 and June 2024. Based on differences in prior treatment approaches, patients were matched and allocated into pharmacologic (n = 30) and non-pharmacologic (n = 30) treatment groups using propensity score matching to reduce baseline confounding. All participants were followed for 24 months. Primary endpoints included pain intensity (assessed via the visual analogue scale, VAS), health-related quality of life (measured by the SF-36 questionnaire), and sleep quality (evaluated using the Pittsburgh sleep quality index, PSQI). Adverse events were systematically recorded throughout the follow-up period. Both groups demonstrated statistically significant improvements in VAS, SF-36, and PSQI scores from baseline (P < .05). The pharmacologic group exhibited superior pain reduction at 12 months (mean VAS 4.5 ± 1.2 vs 5.0 ± 1.5; P < .05) and greater quality-of-life enhancement (SF-36 60.2 ± 7.9 vs 57.4 ± 8.4; P < .05). Sleep quality improvements favored pharmacologic therapy at 3 months (PSQI 12.0 ± 3.4 vs 13.4 ± 3.6; P < .05), though this difference attenuated by 12 months (P > .05). Adverse events were mild: pharmacologic interventions were associated with higher rates of dizziness (16.7%) and somnolence (10.0%), whereas non-pharmacologic methods primarily caused localized skin reactions (6.7%). Pharmacologic management demonstrated a faster short-term analgesic effect and was associated with improvements in quality of life in this study, while non-pharmacologic approaches appeared to offer potential benefits for long-term supportive care. These findings suggest that a combined therapeutic strategy could be a promising direction for optimizing PHN treatment.
本研究评估药物治疗和非药物治疗在管理带状疱疹后神经痛（PHN）方面的比较有效性和安全性，旨在优化临床疼痛管理方法。对2022年6月至2024年6月期间诊断为PHN并接受治疗的60例患者进行了回顾性分析。根据先前治疗方法的差异，使用倾向得分匹配将患者匹配并分配到药物治疗组（n = 30）和非药物治疗组（n = 30），以减少基线混杂因素。所有参与者均随访24个月。主要终点包括疼痛强度（通过视觉模拟量表，VAS评估）、健康相关生活质量（通过SF - 36问卷测量）和睡眠质量（使用匹兹堡睡眠质量指数，PSQI评估）。在整个随访期间系统记录不良事件。两组的VAS、SF - 36和PSQI评分与基线相比均有统计学显著改善（P < .05）。药物治疗组在12个月时疼痛减轻更显著（平均VAS 4.5±1.2 vs 5.0±1.5；P < .05），生活质量提高更明显（SF - 36 60.2±7.9 vs 57.4±8.4；P < .05）。睡眠质量改善在3个月时药物治疗更具优势（PSQI 12.0±3.4 vs 13.4±3.6；P < .05），但这种差异在12个月时减弱（P > .05）。不良事件较轻：药物干预与较高的头晕发生率（16.7%）和嗜睡发生率（10.0%）相关，而非药物方法主要引起局部皮肤反应（6.7%）。本研究中，药物治疗显示出更快的短期镇痛效果并与生活质量改善相关，而非药物方法似乎为长期支持性护理提供了潜在益处。这些发现表明，联合治疗策略可能是优化PHN治疗的一个有前景的方向。
