Combination therapy of gabapentin and Hegu-point catgut embedding provided superior short-term improvement in pain, sleep quality, serum biomarkers, and overall response rate compared to gabapentin alone in post-herpetic neuralgia patients.
Key Findings
Results
Both treatment groups showed significant reductions in pain intensity after 4 weeks, with greater improvement in the combination therapy group.
Pain was measured using the Visual Analogue Scale (VAS)
Both groups showed significant reduction in VAS scores after 4 weeks of treatment
The combination group (gabapentin + Hegu-point catgut embedding) demonstrated greater VAS score improvement than the control group (gabapentin alone) (P < 0.05)
Total sample size was 210 PHN patients equally divided into two groups of 105 each
Results
Sleep quality improved significantly in both groups after 4 weeks, with greater improvement observed in the combination therapy group.
Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI)
Both groups displayed significant reduction in PSQI scores after 4 weeks
The combination group showed more pronounced improvement in PSQI scores compared to the control group (P < 0.05)
Treatment duration was 4 weeks with catgut embedding administered weekly
Results
Serum levels of substance P, IL-6, and TNF-α decreased significantly in both groups, while β-endorphin levels increased significantly, with more pronounced changes in the combination group.
Both groups showed significant decreases in serum substance P, interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α)
β-endorphin levels showed a significant increase in both groups
All biomarker changes were more pronounced in the combination group compared to the control group (P < 0.05)
Only peripheral serum markers were assessed, limiting mechanistic interpretation
Results
The combination therapy group demonstrated a significantly higher overall response rate compared to the gabapentin-only control group.
Overall response rate was 92.38% in the combination group versus 80.00% in the control group
The difference in overall response rate was statistically significant (P < 0.05)
Each group consisted of 105 PHN patients in a randomized, assessor-blinded study design
Results
The combination therapy group experienced fewer adverse events compared to the gabapentin-only control group.
Adverse event rate was 12.38% in the combination group versus 26.67% in the control group
The difference in adverse event rates was statistically significant (P < 0.05)
The lower adverse event rate in the combination group suggests a potential safety advantage of the combined approach
Discussion
The study had notable limitations including assessment of only peripheral serum markers and the absence of longer-term outcome data.
Only peripheral serum markers were assessed, meaning the underlying mechanistic pathways could not be deciphered
Longer-term outcomes of therapy were not assessed, described as 'a major limitation of this study'
The study design was randomized and assessor-blinded
The treatment period was limited to 4 weeks
What This Means
This research suggests that combining the nerve pain medication gabapentin with a traditional acupuncture-related technique called Hegu-point catgut embedding may be more effective for treating post-herpetic neuralgia (long-lasting nerve pain after a shingles infection) than gabapentin alone. In a study of 210 patients treated for 4 weeks, those receiving the combined treatment reported greater reductions in pain and better sleep quality than those receiving only gabapentin. The combined treatment group also had a higher treatment success rate (92% versus 80%) and experienced fewer side effects (12% versus 27%).
The study also measured biological markers in patients' blood to understand possible mechanisms. Both groups showed reductions in inflammatory markers (IL-6 and TNF-α) and substance P, a chemical involved in pain signaling, while levels of β-endorphin, a natural pain-relieving substance, increased. These changes were more pronounced in the combination therapy group, suggesting the added treatment may work by both reducing inflammation and enhancing the body's own pain-relief systems.
This research suggests that adding Hegu-point catgut embedding to standard gabapentin treatment could offer short-term benefits for people suffering from post-herpetic neuralgia. However, the study only lasted 4 weeks and only measured markers in the blood rather than in the nervous system, so it is unclear how long the benefits last or exactly how the treatment works at a deeper biological level. Further research with longer follow-up periods would be needed to confirm these findings.
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Li L, Song Z, Zheng Y, Wu T, Li F, Huang Y. (2026). Pharmacodynamic basis of gabapentin combined with Hegu-point catgut embedding for post-herpetic neuralgia.. Pakistan journal of pharmaceutical sciences. https://doi.org/10.36721/PJPS.2026.39.5.152.1