Adjunctive therapeutic effect of natural alkaloid acetylaconitine for postherpetic neuralgia and the analgesic and anti-inflammatory mechanism

This study aimed to assess the adjunctive therapeutic effect of natural alkaloid acetylaconitine for postherpetic neuralgia (PHN) and the action mechanism.Eighty PHN patients were divided into control and observation groups, whichreceived pregabalin monotherapy and combination of acetylaconitine and pregabalin for three months, respectively.Compared with the control group, the observation group had a significantly higher total effective rate, lower Visual Analogue Scale and Pittsburgh SleepQuality Index scores, reduced Hamilton Anxiety Rating Scale and Hamilton Depression Rating Scale scores, decreased blood substance P, tumor necrosis factor α, interleukin 6 and interleukin 1β levels and increased blood β-endorphin level (all p>0.05). The incidence of adverse reactions was similar between groups. In conclusion, acetylaconitine enhances the therapeutic efficacy of pregabalin in PHN, providing superior pain relief, improved sleep quality, reduced emotional distress, and favorable safety profile. The action mechanism may involve both analgesic and anti-inflammatory pathways.