食物对类风湿关节炎患者主观疼痛感的影响研究

背景　类风湿关节炎（RA）在我国的患病人数逐年增多,诊疗逐渐规范。疼痛是患者就诊时的主要症状,受传统观念影响,患者普遍关心日常摄入的食物是否会对主观疼痛感产生影响。查阅文献发现近年相关研究较少,对患者进行健康教育时缺乏有效依据。因此有必要开展相关的调查研究。目的　调查分析食物对RA患者主观疼痛感是否产生影响,为进行RA患者健康教育提供依据。方法　选取2014年12月-2016年10月广西医科大学第一附属医院及广西医科大学第四附属医院门诊及住院已确诊的RA患者为调查对象,以问卷的形式进行调查,调查内容主要包括一般情况,食物对主观疼痛感的影响,即摄入哪些食物使关节疼痛加重或减轻。结果　共调查RA患者500例,206例（41.2%）患者认为食物对主观疼痛感有影响,294例（58.8%）患者认为食物对主观疼痛感无影响。认为食物对主观疼痛感有或无影响患者疾病活动度构成比较,差异无统计学意义（χ2=2.432,P=0.296）。患者认为使主观疼痛感加重的食物前三位为禽类〔45.9%（89/194）〕、红色肉类〔30.9%（60/194）〕、竹笋〔24.7%（48/194）〕,患者认为使主观疼痛感减轻的食物前三位为红枣〔50.0%（21/42）〕、桂圆〔28.6%（12/42）〕、生姜〔19.0%（8/42）〕。女性RA患者认为食物使主观疼痛感加重比例高于男性,沿海地区RA患者认为食物使主观疼痛感减轻比例高于丘陵地区（P<0.05）。结论　食物对部分RA患者主观疼痛感产生影响;部分RA患者食用禽类、红色肉类、竹笋使主观疼痛感加重,少数RA患者食用红枣、桂圆、生姜使主观疼痛感减轻。女性患者认为食物使主观疼痛感加重比例高于男性,沿海地区RA患者认为食物使主观疼痛感减轻比例高于丘陵地区。

Subjective Pain and Food Intake in Patients with Rheumatoid Arthritis

Background Rheumatoid arthritis(RA)prevalence is increasing,and its diagnosis and treatment are becoming standardized gradually.Pain is the chief complaint.Whether subjective pain is associated with food intake is a generally concerned problem in these patients due to influence of some traditional ideas,and it has been studied rarely in recent studies,leading to insufficient adequate information for conducting effective patient education.Therefore,it is necessary to carry out relevant research.Objective To investigate the effect of food intake on subjective pain in RA patients,providing evidence for health education for these patients.Methods The outpatients and inpatients with RA from the First Affiliated Hospital of Guangxi Medical University,and Fourth Affiliated Hospital of Guangxi Medical University were enrolled during December 2014 to October 2016,and were surveyed using a questionnaire covering demographic data,and the influence of food intake on subjective pain(changes in pain level after eating different foods).Results A total of 500 cases participated in the survey.Among them,206(41.2%)thought that food intake had effect on subjective pain,but others〔294(58.8%)〕did not think so.However,these two groups showed similar severity distribution of disease activity(χ^2=2.432,P=0.296).The top three foods that aggravated subjective pain were poultry〔45.9%(89/194)〕,red meat〔30.9%(60/194)〕and bamboo shoots〔24.7%(48/194)〕.The top three foods that alleviated subjective pain were Chinese red dates〔50.0%(21/42)〕,longan〔28.6%(12/42)〕and ginger〔19.0%(8/42)〕.The prevalence of opinions about food intake aggravating subjective pain level was higher in females than that of males(P<0.05).RA residents in coastal areas were more likely to believe that food intake could alleviate subjective pain compared with those from hilly areas(P<0.05).Conclusion The subjective pain level of some RA patients is influenced by food intake.Eating poultry,red meat and bamboo shoots are thought to be aggravating factors for pain level,whereas eating Chinese red dates,longan and ginger are considered to be alleviating factors of the pain.Females are more likely to think that food intake aggravates subjective pain.And those living in coastal areas are more likely to believe that food intake can reduce subjective pain compared with those living in hilly areas.