慢性疼痛与情绪障碍及其干预治疗效应

目的:分析慢性疼痛与情绪障碍之间的关系,探讨心理及药物治疗对慢性疼痛的干预作用。资料来源:应用计算机检索Medline1989-01/2004-05和Embase1989-01/2004-05有关慢性疼痛与情绪障碍关系的文献,检索词“Chronicache,emotionaldisorder,treament”,并限定文章语言种类为English。观察对象为疼痛持续时间超过6个月以上的患者。资料选择:选取有关慢性疼痛与情绪障碍关系及其治疗干预的文献,进行初审,删除陈旧及重复的文献,然后查找余下的文献全文。质量评价主要考察资料的真实性,调查设计是否严密,实施过程是否严格,统计学处理是否合理。资料提炼:共检索到20篇关于慢性疼痛与情绪障碍关系及其治疗干预的文献,11篇文献符合纳入标准。排除的9篇试验中,7篇系重复的同一研究,2篇是Meta分析。资料综合:11篇文献均包括观察组和对照组,其中观察组应用镇痛药合并心理治疗及抗抑郁药,对照组应用镇痛药但未合并心理治疗及抗抑郁药,对两组患者的疗效进行比较分析。结论:慢性疼痛与情绪障碍同时存在,应用镇痛药合并心理治疗及抗抑郁药可以显著缓解患者的疼痛,干预效果优于单纯应用镇痛药者。

Chronic pain and emotional disorders as well as the effect of interventional treatment

OBJECTIVE: To analyze the relationship between chronic pain and painprone meutal disorders and investigate the effect of psychological intervention and medication.DATA SOURCES: Related literatures about the relationship between chronic pain and pain-prone mental disorders were searched on computer in Medline and Embase from January 1989 to May 2004 with the retrieval word of "Chronic pain, emotional disorder, treatment", the language was limited to English. The subjects were patients who suffered from chronic pain for above 6 months.STUDY SELECTION: Related literatures about the relationship between chronic pain and pain-prone mental disorders and its therapeutic interventions were carried on primary trial to delete those obsolete and repetitive literatures, and the others were used to search in the full text. The quality was appraised mainly on the basis of the data authenticity, preciseness of the designation, strictness of the implementation and reasonability of the statistical analysis.DATA EXTRACTION: Altogether 20 literatures were obtained and 11literatures were proved accordant with the inclusion standard. 9 literatures were excluded because 7 were repetitive experiments and two were Meta analyses.DATA SYNTHESIS: 11 literatures include experimental group and control group, patients in the experimental group were treated with analgetic combined with psychological intervention and antidepressant while those in the control group were only given analgetic; the outcomes of the two groups were compared.CONCLUSION: Chronic pain may co-exist with emotional disorders. It can be remarkably alleviated by the administration of analgetic combined with psychological intervention and antidepressant, which proves better than single analgetic medication.