Effects of dorsal root ganglion pulsed radiofrequency combined with duloxetine on pain catastrophizing and depression in patients with refractory postherpetic neuralgia

Objective To investigate the effect of duloxetine combined with dorsal root ganglion pulsed radiofrequency therapy on depression and pain catastrophizing in patients with refractory postherpetic neuralgia (PHN). Methods From April 2024 to April 2026, 120 patients with refractory PHN were recruited and randomly divided into an observation group and a control group (n=60). The control group received oral administration of duloxetine hydrochloride entericcoated tablets, while the observation group received pulsed radiofrequency therapy targeting the dorsal root ganglion under CT guidance on the basis of the control group. Both groups were treated for 12 weeks. Compare the clinical efficacy, Pain Numeric Rating Scale (NRS), Pain Catastrophization Scale (PCS), Depression (HAMD-17), Quality of Life (SF-36), Sleep Quality (PSQI), and adverse reactions between the two groups. Results After 12 weeks of intervention, the total effective rate of the observation group (91.67%, 55/60) was significantly higher than that of the control group (78.33%, 47/60) ( χ ²=4.183, P = 0.041). After adjusting for pre-treatment scores using analysis of covariance (ANCOVA), the PCS, HAMD-17, NRS, and PSQI scores in the observation group were significantly lower than those in the control group, and the SF-36 score was significantly higher than that in the control group (all P < 0.05). There was no significant difference in the total incidence of drug-related adverse reactions between the two groups (8.33% vs 11.67%, P >0.05), and there were no adverse events related to operation in the observation group. Conclusion For patients with refractory PHN, the combination of dorsal root ganglion pulsed radiofrequency and duloxetine can significantly reduce pain, alleviate depression and catastrophizing, improve sleep quality and quality of life. The combination therapy may provide additional benefits without significantly increasing the risk of adverse reactions.