The incidence of shingles is on the rise year by year, and the incidence of PHN(postherpetic neuralgia) increases with age. With the aging of the population, ordinary drug treatment is often ineffective in elderly patients with underlying diseases. Based on the propensity score matching theory, a multivariate model was established to prevent PHN in patients with acute herpes zoster neuralgia treated at Jiangsu Provincial Traditional Chinese Medicine Hospital, and a retrospective clinical efficacy difference analysis was conducted. The research results show that at 6 months after treatment, the digital score and incidence of PHN in the early nerve block group are lower than those in the non nerve block treatment group (P < 0.05), while the complete remission rate is significantly higher than that in the non nerve block treatment group (P < 0.05). Using multivariate regression analysis, it is found that early nerve block is a protective factor for the incidence of PHN in 396 patients with ZRN(zoster related neuralgia). For ZRN patients with moderate to severe pain, early nerve block treatment can achieve good long-term efficacy and may prevent the transition from acute herpes zoster neuralgia to chronic pain. The research results have certain reference value for improving the clinical efficacy of ZRN and preventing PHN.