McGill疼痛问卷在三叉神经痛诊断和治疗中的应用

目的:通过采用McGill疼痛问卷(McGill pain questionnaire,MPQ)鉴别三叉神经痛,并观察射频热凝术的疗效,研究MPQ在面痛诊断上的重要性。方法:本研究共观察159例三叉神经痛患者,其中136例患有典型三叉神经痛(CTN),23例患有混合型三叉神经痛(MTN)。采用MPQ评估患者的疼痛,并观察其中124例术后患者疼痛的缓解情况。结果:CTN组的平均现有疼痛强度(PPI)值为4.20±0.34,MTN组的平均PPI值为3.50±0.57,明显低于CTN组(P0.001);与MTN患者相比,CTN患者在疼痛分级指数(PRI)-感觉项上报告了更高的强度(P0.001);两组间PRI-情感和PRI-评价项上有明显区别,CTN组的得分更高(P0.001);RFT术后CTN患者显示了高的立即疼痛缓解率,达到93.6%。MTN患者的结果没有CTN组的好,只有58.8%的患者疼痛明显缓解。结论:MPQ可以很好鉴别不同类型的三叉神经痛,鉴于射频热凝治疗两种三叉神经痛疗效的差异,使用MPQ在面痛诊断中有重要意义。

The application of McGill pain questionnaire in diagnosis and treatment of trigeminal neuralgia

AbstractObjective: To observe the application of McGill pain questionnaire (MPQ) in discrimination and diagnosis of trigeminal neuralgia and assessment of therapeutic effect of radiofrequency thermocoagulation(RFT) on trigeminal neuralgia.Method: There were 159 trigeminal neuralgia patients enrolled in this study, of which 136 classic trigeminal neuralgia (CTN) patients and 23 mixed trigeminal neuralgia (MTN) patients. MPQ was used to identify the pain, and observe the pain relieving after RFT in 124 patients of which.Result: The mean present pain index(PPI) of CTN group was 4.20±0.34, and that of MTN group was 3.50±0.57(P<0.001); In pain rating index(PRI)-sensory subscale, the patients with CTN reported higher pain intensity in terms of sensory experience than patients with MTN (P<0.001); The PRI-affective and PRI-evaluative dimensions of pain were significantly different between two groups, the scores were higher in CTN group (P<0.001). Overall, 103(93.6%) patients in CTN group responded to RFT with higher immediate improvements in self-report. In MTN group, only 10(58.8%) patients in MTN group responded to RFT with significant improvements in self-report.Conclusion: The application of MPQ could discriminate different type of trigeminal neuralgia well. In view of the different effectiveness in two type of trigeminal neuralgia after RFT, MPQ played an important role in diagnosis, discrimination and therapeutic effect assessment of trigeminal neuralgia.