Objective： To observe the clinical effect of syndrome differentiation and treatment of Chinese medicinecombined with gabapentin for herpes zoster neuralgia.Methods：Divided 70 cases of patients with herpes zoster into the control group and the treatment group randomly，35 cases in each group.The control group was given routine treatment of western medicine，while the treatment group was additionally given syndrome differentiation and treatment of Chinese medicine based on the routine treatment.Observed and compared the clinical effect， improvement of pain， number of application of analgesic drugs，amount of gabapentin and occurrence of adverse reaction in two groups.Results：The total effective rate was 91.43%in the treatment group，being evidently higher than 71.43%in the control group，difference being significant(P＜0.05).After treatment，Visual analogue scale(VAS)of in two groups were decreased when compared with those before treatment，differences being significant(P＜0.01，P＜0.05).Compared with the control group，VAS in the treatment group was much lower，difference being significant(P＜0.01).Compared with the control group，the number of application of analgesic drugs and amount of gabapentin in the treatment group were obviously less than those in the control group，differences being significant(P＜0.01).The total number of adverse reaction was 24 in the control group，account for 68.57%，while the total number of adverse reaction was 28 in the treatment group，account for 80.00%，difference being insignificant(P＜0.05).The cases of dizziness，sleepiness and gait instability in the treatment group were less than those in the control group，while the cases of abdominal pain and diarrhea were more than those in the control group，differences being insignificant(P＞ 0.05).Conclusion：The therapy of syndrome differentiation and treatment of Chinese medicine combined with gabapentin for herpes zoster neuralgia can significantly improve the pain symptoms，promote the curative effect，and reduce the application of analgesics drugs and gabapentin.