脊髓损伤患者慢性疼痛的治疗：一项调查研究。
Treatments for chronic pain in persons with spinal cord injury: A survey study.
作者信息
Cardenas Diana D, Jensen Mark P
机构信息
University of Washington, Department of Rehabilitation Medicine, Box 356490, Seattle, WA 98195, USA.
出版信息
J Spinal Cord Med. 2006;29(2):109-17. doi: 10.1080/10790268.2006.11753864.
BACKGROUND/OBJECTIVE: To determine the degree and duration of pain relief provided by specific pain treatments used by individuals with spinal cord injury (SCI) who have chronic pain.
DESIGN
Postal survey.
SETTING
Community.
PARTICIPANTS
Participants were 117 individuals who had traumatic SCI, were 18 years of age or older, and reported a chronic pain problem.
MAIN OUTCOME MEASURES
Questions assessing current or past use of 26 different pain treatments, the amount of relief each treatment provided, and the length of time that any pain relief usually lasts.
RESULTS
The medications tried most often were nonsteroidal anti-inflammatory drugs (tried by 71%) and acetaminophen (tried by 70%); these medications were still being used by more than one half of the patients who had tried them. Opioids produced the greatest degree of pain relief on average (mean, 6.27 +/- 3.05 [SD] on a 0-10 scale, with 0 = no relief and 10 = complete relief) but were unlikely to be continued by those who tried them. Although 38% of respondents with pain had tried gabapentin, only 17% were still using it, and average pain relief was only moderate (mean, 3.32 +/- 3.03 on the 0-10 relief scale). Seventy-three percent of the respondents had tried at least 1 of 7 alternative pain treatments, and the most frequently tried were massage, marijuana, and acupuncture. The most relief was provided by massage (mean, 6.05 +/- 2.47] on the 0-10 relief scale) and marijuana (mean, 6.62 +/- 2.54 on the 0-10 relief scale). The relief from the various treatments, including most medications, tended to last only minutes or hours; however, pain relief from alternative treatments such as massage, acupuncture, and hypnosis was reported to last for days in 25% to 33% of those who tried these treatments.
CONCLUSIONS
Many patients are not finding adequate pain relief from commonly prescribed medications. Alternative therapies should be considered as additional treatment options in this population.
背景/目的：确定脊髓损伤（SCI）所致慢性疼痛患者使用特定疼痛治疗方法后疼痛缓解的程度和持续时间。
设计
邮寄调查。
地点
社区。
参与者
117名创伤性SCI患者，年龄在18岁及以上，且报告有慢性疼痛问题。
主要观察指标
评估26种不同疼痛治疗方法当前或过去使用情况、每种治疗方法提供的缓解程度以及任何疼痛缓解通常持续的时间的问题。
结果
最常尝试的药物是非甾体抗炎药（71%的患者尝试过）和对乙酰氨基酚（70%的患者尝试过）；超过一半尝试过这些药物的患者仍在使用。阿片类药物平均产生的疼痛缓解程度最大（在0至10分的量表上，平均为6.27±3.05[标准差]，0分表示无缓解，10分表示完全缓解），但尝试使用的患者不太可能持续使用。尽管38%有疼痛的受访者尝试过加巴喷丁，但只有17%仍在使用，平均疼痛缓解程度仅为中度（在0至10分的缓解量表上，平均为3.32±3.03）。73%的受访者尝试过7种替代疼痛治疗方法中的至少一种，最常尝试的是按摩、大麻和针灸。按摩（在0至10分的缓解量表上，平均为6.05±2.47）和大麻（在0至10分的缓解量表上，平均为6.62±2.54）提供的缓解效果最佳。包括大多数药物在内的各种治疗方法的缓解往往只持续几分钟或几小时；然而，据报告，在尝试过按摩、针灸和催眠等替代治疗方法的患者中，25%至33%的患者疼痛缓解可持续数天。
结论
许多患者未从常用处方药中获得足够的疼痛缓解。替代疗法应被视为该人群的额外治疗选择。
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