The Factors Influencing the Efficacy of Pregabalin Combined With Lidocaine in the Treatment of Postherpetic Neuralgia Patients: An Analysis

OBJECTIVE: This study aims to analyze the primary factors influencing the therapeutic effect of pregabalin combined with lidocaine in patients with post-herpetic neuralgia (PHN). METHODS: Clinical data of 97 PHN patients admitted to our hospital from January 2022 to October 2024 were retrospectively analyzed. All patients received pregabalin combined with lidocaine treatment. Treatment efficacy was assessed using the numerical rating scale (NRS) for pain, dividing patients into effective (≥ 50% NRS reduction) and ineffective groups. Univariate and multivariate logistic regression analyses identified the main influencing factors. Pearson correlation analysis explored relationships between factors and therapeutic effect. Receiver operating characteristic (ROC) curves evaluated predictive values. RESULTS: Posttreatment, 77 patients (79.38%) were classified as responders, while 20 (20.62%) were nonresponders. Age (OR: 0.163, 95% CI: 0.036-0.535), illness duration (OR: 0.098, 95% CI: 0.015-0.369), pain severity (OR: 2.794, 95% CI: 1.362-6.566), and presence of concomitant immunosuppressive diseases (OR: 0.194, 95% CI: 0.030-0.742) were key determinants. Positive correlations were found between illness duration (r = 0.352), pain severity (r = -0.279), immunosuppressive diseases (r = 0.231), and treatment effectiveness (p < 0.05). Age showed a negative correlation (r = 0.301, p < 0.05). ROC curves indicated AUCs for age, illness duration, pain severity, and immunosuppressive diseases were 0.685, 0.716, 0.691, and 0.368, respectively. Combined, these factors had a higher predictive value (AUC = 0.734). CONCLUSION: Age ≥ 65 years, illness duration ≥ 3 months, severe pain, and the presence of concomitant diseases causing immunosuppression are the main factors influencing the effectiveness of combined pregabalin and lidocaine treatment for PHN.