To evaluate the therapeutic efficacy of myofascial trigger point acupuncture combined with gabapentinoids compared with gabapentinoid therapy alone in patients with postherpetic neuralgia, and to identify clinical factors influencing treatment response. A total of 494 patients with postherpetic neuralgia were randomly assigned to receive either gabapentinoids alone (control group, n = 247) or combined myofascial trigger point acupuncture and gabapentinoids (experimental group, n = 247). Pain intensity was assessed using the Numerical Rating Scale (NRS) at baseline, week 3, and week 6, and changes from baseline (ΔNRS) were calculated to reflect short-term pain improvement. Regression analyses were performed to identify prognostic factors associated with the magnitude of pain reduction rather than to estimate causal treatment effects. Both groups improved significantly, but the experimental group showed greater pain reduction at week 3 and week 6 ( P < .001). Multivariate analysis revealed that older age and higher body mass index were independently associated with poorer treatment response at both time points, while pain location was associated with variability in pain reduction at week 6 (patients with thoracic chest/back pain showed the greatest improvement). Myofascial trigger point acupuncture combined with gabapentinoids may provide additional short-term pain relief compared with pharmacological therapy alone, with thoracic pain showing the most favorable response; however, baseline imbalance and the absence of sham control limit causal inference. Age and body mass index were associated with poorer efficacy, highlighting the need for individualized strategies. Longer-term randomized trials, including an acupuncture-only arm and multidimensional pain assessments, are warranted to confirm and extend these findings.
Bi et al. (Fri,) studied this question.