Teut Michael, Warning Albrecht
Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie, CHAMP, Berlin, Deutschland.
Forsch Komplementmed. 2008 Oct;15(5):269-72. doi: 10.1159/000158875. Epub 2008 Oct 15.
Chronic pain is a serious problem for geriatric patients. Conventional pharmacotherapy with nonsteroidal anti-inflammatory drugs or opiates is often accompanied by serious side effects.
An 87-year-old woman with severe joint pain due to osteoarthritis of the knee presented with side effects from fentanyl therapy. She was subsequently treated in an inpatient setting with leeches, phytotherapy, physiotherapy and three single doses of metamizol.
Prospective single-case study.
Pain reduction was assessed with a numeric rating scale (0-10; 0 = minimum; 10 = maximum), mobility by walking distance, and activities of daily living by Barthel index. The association between complementary therapy and the changes observed in the patient under treatment were evaluated using cognition-based medicine.
Under complementary therapy, the patient experienced a clear reduction in pain (from 8 to 3 points on the numeric rating scale); regained the ability to walk (increase in walking distance from 0 to 70 m); and showed improvements in activities of daily living (increase in Barthel index from 45 to 65). An association between pain reduction and the complementary treatment setting seems likely.
The role of complementary pain therapy in geriatric patients should be evaluated systematically.
慢性疼痛是老年患者面临的一个严重问题。使用非甾体抗炎药或阿片类药物进行传统药物治疗常常伴有严重的副作用。
一名87岁因膝关节骨关节炎导致严重关节疼痛的女性患者出现了芬太尼治疗的副作用。随后她在住院环境中接受了水蛭疗法、植物疗法、物理疗法以及三次单剂量的安乃近治疗。
前瞻性单病例研究。
使用数字评分量表（0 - 10分；0分表示最小；10分表示最大）评估疼痛减轻情况，通过行走距离评估活动能力，通过巴氏指数评估日常生活活动能力。使用基于认知的医学方法评估辅助治疗与治疗中患者所观察到的变化之间的关联。
在辅助治疗下，患者疼痛明显减轻（数字评分量表从8分降至3分）；恢复了行走能力（行走距离从0米增加到70米）；日常生活活动能力有所改善（巴氏指数从45分增加到65分）。疼痛减轻与辅助治疗环境之间似乎存在关联。
应系统评估辅助性疼痛治疗在老年患者中的作用。
