中枢性脑卒中后疼痛的多方面评估

Pain Research Pub Date : 2020-06-30 DOI:10.11154/pain.35.99
N. Mori, K. Hosomi, M. Shibata, H. Kishima, Y. Saitoh
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摘要

目的:治疗慢性疼痛的目标越来越侧重于改善日常生活能力和生活质量,而不是疼痛本身。在这项研究中,我们通过多方面评估来评估中心性卒中后疼痛(CPSP)患者,并检查与ADL和生活质量相关的因素。方法:从41例CPSP患者中获得患者背景、中风信息、运动和感觉障碍、疼痛部位和持续时间、疼痛量表(VAS和简式麦吉尔疼痛问卷2;SF–MPQ 2)、疼痛灾难量表、医院焦虑和抑郁量表(HADS)、疼痛残疾评估量表(PDAS)、EQ–5 D–5L。通过单变量和多变量分析研究了与PDAS和EQ–5 D–5 L相关的因素。结果:单因素分析显示,PDAS与运动障碍量表(SIAS–运动:r=-0.67,p<0.01)和疼痛量表(VAS:r=0.32,p=0.04;SF–MPQ 2:r=0.31;p=0.04)相关,而QOL值(EQ–5D–5L)与运动障碍度表相关(SIAS-运动:r=0.55,p<0.01),疼痛量表(SF–MPQ 2:r=−0.54,p<0.01;VAS:r=−0.48,p<01)、感觉障碍程度(p<0.01)和情绪状态(HADS抑郁项目:r=–0.56,p<0.001;HADS焦虑项目:r=−0.37,p<0.1)。在多变量分析中,PDAS在很大程度上受SIAS–运动和SF–MPQ 2的影响,QOL值受SIAS-运动、SF–MPQ2、感觉障碍程度和HADS抑郁项目等多个因素的影响。结论:CPSP患者的ADL和QOL不仅反映疼痛,还反映运动和感觉障碍以及情绪状态,在评估时应注意这一点。
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Multifaceted evaluation of central post–stroke pain
Objective: The goal of treating chronic pain is becoming more focused on improving ADL and QOL than on pain itself. In this study, we evaluated patients with central post–stroke pain (CPSP) by a multifaceted evaluation and examined factors related to ADL and QOL. Methods: Patient background, stroke information, motor and sensory disturbance, pain site and duration, pain scales (VAS and Short–form McGill Pain Questionnaire 2 ; SF–MPQ 2 ), Pain Catastrophizing Scale, Hospital Anxiety and Depression Scale (HADS), Pain Disability Assessment Scale (PDAS), EQ– 5 D– 5 L were obtained from 41 patients with CPSP. The factors related to PDAS and EQ– 5 D– 5 L were investigated by univariate and multivariate analyses. Results: The univariate analysis showed that the PDAS was associated with motor disturbance scale (SIAS–motor: r=− 0 . 67 , p< 0 . 01 ) and pain scales (VAS: r= 0 . 32 , p= 0 . 04 ; SF–MPQ 2 : r= 0 . 31 ; p= 0 . 04 ), while the QOL value (EQ– 5 D– 5 L) was associated with motor disturbance scale (SIAS–motor: r= 0 . 55 , p< 0 . 01 ), pain scales (SF–MPQ 2 : r=− 0 . 54 , p< 0 . 01 ; VAS: r=− 0 . 48 , p< 0 . 01 ), degree of sensory disturbance (p< 0 . 01 ), and mood status (HADS depression item: r=− 0 . 56 , p< 0 . 01 ; HADS anxiety item: r=− 0 . 37 , p< 0 . 01 ). In multivariate analysis, the PDAS was largely affected by SIAS–motor and SF–MPQ 2 , and the QOL value was affected by multiple factors such as the SIAS–motor, SF–MPQ 2 , degree of sensory disturbance and HADS depression item. Conclusions: The ADL and QOL in patients with CPSP reflect not only pain, but also motor and sensory impairments, and mood status, which should be noted when assessing.
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Pain Research
Pain Research CLINICAL NEUROLOGY-
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