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[多模式疼痛治疗:原则与适应症]

[Multimodal pain therapy: principles and indications].

作者信息

Arnold B, Brinkschmidt T, Casser H-R, Gralow I, Irnich D, Klimczyk K, Müller G, Nagel B, Pfingsten M, Schiltenwolf M, Sittl R, Söllner W

机构信息

Abteilung für Schmerztherapie, Klinikum Dachau, Krankenhausstr. 15, 85221, Dachau, Deutschland.

出版信息

Schmerz. 2009 Apr;23(2):112-20. doi: 10.1007/s00482-008-0741-x.

Abstract

Multimodal pain therapy describes an integrated multidisciplinary treatment in small groups with a closely coordinated therapeutical approach. Somatic and psychotherapeutic procedures cooperate with physical and psychological training programs. For chronic pain syndromes with complex somatic, psychological and social consequences, a therapeutic intensity of at least 100 hours is recommended. Under these conditions multimodal pain therapy has proven to be more effective than other kinds of treatment. If monodisciplinary and/or outpatient therapies fail, health insurance holders have a legitimate claim to this form of therapy.Medical indications are given for patients with chronic pain syndromes, but also if there is an elevated risk of chronic pain in the early stadium of the disease and aiming at delaying the process of chronification. Relative contraindications are a lack of motivation for behavioural change, severe mental disorders or psychopathologies and addiction problems. The availability of multimodal pain treatment centers in Germany is currently insufficient.

摘要

多模式疼痛疗法是指在小组中采用密切协调的治疗方法进行的综合多学科治疗。躯体治疗和心理治疗程序与身体和心理训练计划相结合。对于具有复杂躯体、心理和社会后果的慢性疼痛综合征,建议治疗强度至少为100小时。在这些情况下,多模式疼痛疗法已被证明比其他治疗方法更有效。如果单学科和/或门诊治疗失败,医疗保险持有人有权要求采用这种治疗形式。慢性疼痛综合征患者有医学适应症,但在疾病早期阶段慢性疼痛风险升高且旨在延缓慢性化进程时也适用。相对禁忌症包括缺乏行为改变的动机、严重精神障碍或精神病理学以及成瘾问题。目前德国多模式疼痛治疗中心的数量不足。

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