Objective To investigate the clinical efficacy of ultrasound therapy with different intensities combined with gabapentin in the treatment of neuropathic pain and its effect on the expression of miR-132 and miR-34a.Methods A total of 180 patients with neuropathic pain who were admitted to Affiliated Hospital of Hebei University from December 2018 to December 2019 were enrolled. According to the intensity of ultrasound therapy， they were divided into low-， medium-， and high-intensity ultrasound groups， with 60 patients in each group. All three groups were given ultrasound therapy combined with gabapentin， with a course of treatment of 3 months. The three groups were compared in terms of sleep disturbance， Numerical Rating Scale （NRS） pain score， levels of pain mediators （prostaglandin E2， 5-hydroxytryptamine endothelin substance P）， recurrence， clinical outcome， and the expression levels of miR-132 and miR-34a before and after treatment.Results Before treatment， there were no significant differences among the three groups in sleep disturbance score， NRS pain score， the levels of pain mediators， and the expression levels of miR-132 and miR-34a （P>0.05）. After treatment， all three groups had significant reductions in the above indicators （P<0.05）， and the high-intensity ultrasound group had significantly lower values than the low- and medium-intensity ultrasound groups （P<0.05）. The overall response rate was 98.3% in the high-intensity ultrasound group， 93.3% in the medium-intensity ultrasound group， and 86.7% in the low-intensity ultrasound group， and there was a significant difference in overall response rate among the three groups （P<0.05）. The incidence rate of adverse events was 8.3% in the low-intensity ultrasound group， 11.7% in the medium-intensity ultrasound group， and 13.3% in the high-intensity ultrasound group， with no significant difference among the three groups （P>0.05）. Follow-up investigation showed a recurrence rate of 0% in the high-intensity ultrasound group， 5.0% in the medium-intensity ultrasound group， and 13.3% in the low-intensity ultrasound group （P<0.05）.Conclusions Ultrasound therapy with different intensities combined with gabapentitin has a marked therapeutic effect on neuropathic pain， and the effect of this combination treatment increases with the increase in the intensity of ultrasound. High-intensity ultrasound can effectively improve sleep quality， significantly reduce the expression levels of miR-132 and miR-34a expression， and significantly improve the degree of pain. ［Journal of International Neurology and Neurosurgery, 2023, 50(2): 6-11］