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1.
慢性疼痛与器质性疼痛心理学特征的对照研究   总被引:1,自引:0,他引:1  
目的 旨在探讨慢性疼痛与器质性疼痛心理学特征的差异。方法 采用SCL-90、LES、SSRS、DSQ、HAMD、HAMA等尽理学量表对59例慢性疼痛(CP)与50例器质性疼痛(OP)患者进行对照研究,并用t检验对数据进行统计分析。结果 与OP组相比较,CP组有较多的生活支持相对缺乏,较易动用不成熟防御方式,有明显的抑郁、焦虑情绪。结论 慢性疼痛与心理社会因素密切相关。  相似文献   

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This experiment was directed toward determining the relative effectiveness of discrete and diffuse pain stimuli in influencing perception and behavior. Shocks to the footpads were use to activate the discrete pain pathways. In the first phase of this experiment, cats were trained to escape from foot shock in a shuttle box. Current applied to the feet was varied in ascending and descending sequences for each animal according to the psychophysical method of limits and each animal was trained until stable thresholds for escape responding were achieved. In the second phase of the experiment, the effect on behavior of simultaneous activation of both the discrete and diffuse pain systems was assessed. The principal finding in this experiment was that escape responding that was well established when foot shock was presented alone was routinely abolished on trials when tooth shock and foot shock were presented together. These results were interpreted as indicating that the diffuse pain system was prepotent in influencing behavior when both the discrete and diffuse pain systems were activated simultaneously.  相似文献   

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Introduction: Clinicians often assume that observations of pain behavior are adequate for assessment of patient pain perception during procedures. This has not been tested during a standardized electrodiagnostic experience. Methods: During a prospective trial including extensive, standardized electrodiagnostic testing on persons with lumbar stenosis, vascular claudication, and asymptomatic volunteers, the subjects and an observer rated levels of pain. Results: In 60 subjects, observers significantly under‐rated pain (Visual Analog Scale 3.17 ± 2.23 vs. 4.38 ± 2.01, t = −4.577, df = 59, P < 0.001). Perceived pain during testing related to bodily pain as measured by the visual analog, McGill, Pain Disability, and Quebec scales, but not age, duration of symptoms, Tampa kinesiphobia, Center for Epidemiological Studies Depression scale, or SF‐36 health quality of life. Conclusions: Persons with worse pain syndromes may perceive more pain during testing than others. Clinicians and researchers should understand that patients may have more pain than they recognize. Muscle Nerve 51 : 185–191, 2015  相似文献   

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Background

Dystonia is associated with disabling nonmotor symptoms like chronic pain (CP), which is prevalent in dystonia and significantly impacts the quality of life (QoL). There is no validated tool for assessing CP in dystonia, which substantially hampers pain management.

Objective

The aim was to develop a CP classification and scoring system for dystonia.

Methods

A multidisciplinary group was established to develop the Dystonia-Pain Classification System (Dystonia-PCS). The classification of CP as related or unrelated to dystonia was followed by the assessment of pain severity score, encompassing pain intensity, frequency, and impact on daily living. Then, consecutive patients with inherited/idiopathic dystonia of different spatial distribution were recruited in a cross-sectional multicenter validation study. Dystonia-PCS was compared to validated pain, mood, QoL, and dystonia scales (Brief Pain Inventory, Douleur Neuropathique-4 questionnaire, European QoL-5 Dimensions-3 Level Version, and Burke–Fahn–Marsden Dystonia Rating Scale).

Results

CP was present in 81 of 123 recruited patients, being directly related to dystonia in 82.7%, aggravated by dystonia in 8.8%, and nonrelated to dystonia in 7.5%. Dystonia-PCS had excellent intra-rater (Intraclass Correlation Coefficient - ICC: 0.941) and inter-rater (ICC: 0.867) reliability. In addition, pain severity score correlated with European QoL-5 Dimensions-3 Level Version's pain subscore (r = 0.635, P < 0.001) and the Brief Pain Inventory's severity and interference scores (r = 0.553, P < 0.001 and r = 0.609, P < 0.001, respectively).

Conclusions

Dystonia-PCS is a reliable tool to categorize and quantify CP impact in dystonia and will help improve clinical trial design and management of CP in patients affected by this disorder. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.  相似文献   

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Introduction: We report a retrospective case study of combined treatment of cancer‐related pain and chronic low back and lower extremity pain related to postlaminectomy syndrome (PLS) with one spinal cord stimulation (SCS) system. Methods: The patient underwent an uneventful SCS trial with percutaneous placement of two temporary eight‐electrode leads (Medtronic Inc., Minneapolis, MN) placed at the level of T8‐T9‐T10 and T5‐T6‐T7. Results: After successful trial, he was implanted with permanent leads and generator, reporting sustained pain relief at 12‐month follow‐up visit. Discussion: SCS is a trialable, reversible, and interactive therapy permitting patients to control the level of stimulation they feel based on their degree of pain. Conclusion: SCS provides an effective, alternative treatment for select patients with cancer‐related chest wall pain and pain related to PLS who have failed conservative treatment.  相似文献   

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Spinal cord stimulation (SCS) has traditionally been applied to the treatment of neuropathic pain with good to excellent outcomes. Visceral pain syndromes can be just as debilitating and disabling as somatic and neuropathic pain, however, there seems to be a general lack of consensus on appropriate treatment strategies for these disorders. We present here several case studies to demonstrate the viscerotomal distribution of abdominal visceral pain pathways and the application of traditional SCS techniques for its management. Nine patients, experiencing abdominal visceral pain due to various conditions including chronic nonalcoholic pancreatitis, post‐traumatic splenectomy, and generalized abdominal pain secondary to laparotomies, were treated with SCS. Efficacy of treatment was evaluated using the Visual Analog Scale (VAS) for pain intensity and a reduction, if any, in opioid intake. There was an overall mean reduction of 4.9 points in the VAS score for pain intensity and a substantial (> 50%) decrease in narcotic use. All patients were followed for more than one year with excellent outcomes and minimal complications. We conclude, based on these case reports, that SCS might be an effective, nondestructive, and reversible treatment modality for abdominal visceral pain disorders.  相似文献   

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Neuropathic pain may be caused by a variety of lesions or diseases of both the peripheral and central nervous system. The most common and best known syndromes of peripheral neuropathic pain are painful diabetic neuropathy, trigeminal and post-herpetic neuralgia, persistent post-operative and post-traumatic pain, complex regional pain syndrome, cancer-related neuropathic pain, HIV-related neuropathic pain and pain after amputation. The less common central pain comprises primarily central post-stroke pain, pain after spinal cord injury, central pain in Parkinson disease or in other neurodegenerative diseases, pain in syringomyelia and in multiple sclerosis.A multidisciplinary team of Polish experts, commissioned by the Polish Association for the Study of Pain and the Polish Neurological Society, has reviewed the literature on various types of neuropathic pain, with special focus on the available international guidelines, and has formulated recommendations on their diagnosis and treatment, in accordance with the principles of evidence-based medicine (EBM). High quality studies on the efficacy of various medicines and medical procedures in many neuropathic pain syndromes are scarce, which makes the recommendations less robust.  相似文献   

10.
Objectives: Intrathecal infusion pumps are increasingly used to deliver analgesics for chronic intractable pain. This trial evaluated the accuracy and efficacy of the new Prometra® Programmable Pump System for intrathecal administration of morphine sulfate to treat chronic intractable pain. Methods: One hundred and ten patients were given continuous intrathecal morphine sulfate and assessed monthly for up to six months. Accuracy was determined as the ratio of delivered to programmed drug volume (DP ratio). Efficacy was assessed using the visual analog and numeric rating scales and the Oswestry Disability Index. Results: The mean accuracy of the Prometra pump was 97.1%, with a 90% confidence interval of 96.2–98.0%. Decreases in pain and disability were reported at 68.4% of patient visits. No unanticipated adverse events or device complications were reported. Conclusions: The Prometra pump provides an accurate, effective, and safe system for intrathecal administration of morphine sulfate for treatment of chronic intractable pain.  相似文献   

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