Objective  To explore the therapeutic effect of hyperbaric oxygen therapy (HBOT) and pregabalin combined with duloxetine therapy on patients with fibromyalgia after brain injury.

Methods  Patients with fibromyalgia syndrome (FMS) after traumatic brain injury (TBI) admitted to Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine from October 2023 to October 2024 were retrospectively selected and divided into HBOT group (HBOT combined with pregabalin and duloxetine) and drug intervention group (pregabalin and duloxetine) according to different treatment methods. The main outcome was subjective pain intensity, and the secondary events were fibromyalgia related symptom questionnaire, conditioned pain modulation (CPM), brain activity imaging and safety.

Results  A total of 68 patients were included, with 34 in each of the two groups, and there was no statistically significant difference between the two groups in terms of gender, age, time to TBI, cause of injury, and duration of FMS (P>0.05). Compared with the drug intervention group, the visual analog scale (VAS) score of patients in HBOT group was lower (P<0.05). Before treatment, there was no significant difference in symptom severity score (SSS), fibromyalgia impact questionnaire (FIQ), short form 36 health survey questionnaire (SF-36) and pressure pain threshold (PPT) between HBOT group and drug intervention group (P>0.05). After treatment, the scores of SSS and FIQ in HBOT group were lower, and the scores of SF-36 and PPT were higher compared with the drug intervention group (P<0.05). The left Brodmann region (BA) 9, right BA 38 and left BA 46 in HBOT group and drug intervention group had significant grouping interaction (P_FDR﹤0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05).

Conclusion  HBOT combined with pregabalin and duloxetine can improve the pain degree, clinical symptoms and quality of life of patients with FMS complicated by TBI, enhance the brain activity in frontal lobe area, and help to adjust the pain threshold.

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