ObjectiveTo analyze the relationship between the early pain, changes of psychological factors and risk of post-herpetic neuralgia(PHN).

MethodsThree hundred and seventy-seven patients with shingles were divided into the PHN group and control group according to whether or not the PHN was merged.The admission time, site of herpes, pain score, anxiety and depression scores were compared between the two groups.The indicators affecting PHN of patients were analyzed using the multivariate logistic regression analysis, and the ROC curve was used to compare the diagnostic value of related factors affecting PHN.

ResultsThe age, proportion of diabetes mellitus, autoimmune disease to malignant tumor, visit time, cumulative area, visual analogue scale(VAS) score, dermatology life quality index(DLQI) score, hospital anxiety and depression scale(HADS) score, combined A/G ratio and CD4⁺/CD8⁺ abnormality ratio in PHN group were higher than those in control group(P < 0.05 to P < 0.01).There was no statistical significance in gender, smoking history, drinking history, site of disease and type of herpes between the two groups(P>0.05).The results of multivariate logistic analysis showed that the advanced age, long visit time, large rash area, high VAS, DLQI and HADS scores were the independent risk factors of the development of PHN(P < 0.05 to P < 0.01), while the absence of diabetes mellitus was a protective factor of the development of PHN(P < 0.05).The results of ROC curve showed that the diagnostic efficacy of VAS and HADS scores in predicting PHN was significantly higher than that of age, visit time, DLQI score, diabetes mellitus and rash area alone(P < 0.05 to P < 0.01).

ConclusionsThe severe early pain, anxiety, depression and other negative psychological factors in patients with herpes zoster are the independent risk factors of the development of PHN, and the VAS combined with HADS score can effectively predict the PHN.