Abstract：Objective：To observe the clinical effect of filiform-fire needle combined with Pregabalin for postherpetic neuralgia (PHN) with qi stagnation and blood stasis syndrome. Methods：A total of 84 cases of PHN patients with qi stagnation and blood stasis syndrome were divided into the control group and the observation group according to the random number table method，with 42 cases in each group. The control group was treated with Pregabalin， and the observation group was treated with filiform- fire needle combined with Pregabalin. Both groups were treated for 14 days. The levels of pain mediators including serum prostaglandin E2 (PGE2)， substance P (SP) and 5- hydroxytryptamine (5- HT)， the scores of Pittsburgh Sleep Quality Index (PSQI) and 36-Item Short Form Health Survey (SF- 36) before and after treatment，as well as the incidence of adverse reactions and the clinical effects were compared between the two groups. Results：After treatment，the total effective rate of clinical effect was 95.24% in the observation group，higher than that of 80.95% in the control group (P＜0.05). The levels of PGE2，SP and 5-HT in serum in the two groups were decreased when compared with those before treatment (P＜0.05)， and the levels of PGE2，SP and 5-HT in serum in the observation group were lower than those in the control group (P＜0.05). The PSQI scores in the two groups were decreased when compared with those before treatment (P＜0.05)， and SF-36 scores were increased when compared with those before treatment (P＜0.05). The PSQI score in the observation group was lower than that in the control group (P＜ 0.05)，and SF- 36 score was higher than that in the control group (P＜0.05). The incidence of adverse reactions was 9.52% in the observation group and 16.67% in the control group，there being no significance in the difference (P＞0.05). Conclusion：Filiform-fire needle combined with Pregabalin for PHN with qi stagnation and blood stasis syndrome can effectively control pain，reduce levels of pain mediators，and improve sleep status and quality of life，with good safety.