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脊髓损伤后慢性神经性疼痛:心理行为管理的有效性如何?

Chronic neuropathic pain of spinal cord injury: what is the effectiveness of psychocomportemental management?

机构信息

Centre de réadaptation Clémenceau, 45, boulevard Clémenceau, 67082 Strasbourg cedex, France.

出版信息

Ann Phys Rehabil Med. 2009 Mar;52(2):167-72. doi: 10.1016/j.rehab.2008.12.007. Epub 2009 Jan 24.

Abstract

OBJECTIVES

To determine the efficacy of treating neuropathic pain in spinal cord injury (SCI) patients by psychological, cognitive or behavioral therapies and suggest recommendations for clinical practices.

MATERIAL AND METHOD

The methodology used, proposed by the French Society of Physical Medicine and Rehabilitation (SOFMER), includes a systematic review of the literature, the gathering of information regarding current clinical practices and a validation by a multidisciplinary panel of experts.

RESULTS

Due to the dearth of literature on the subject only one study is found, evaluating the efficacy of these therapies on neuropathic pain but not on the chronic neuropathic pain of SCI patients. The results show a greater efficacy on the associated symptoms: anxiety and depression level, sleep disorders, rather than the pain itself.

CONCLUSION

There is no scientific evidence for validating this type of pain management care. However, the high level of evidence of the articles studying the efficacy of these therapies in patients with chronic pain suggest that it could be applied to SCI patients. These techniques must be developed in France and further studies should be conducted on SCI patients affected by neuropathic pain.

摘要

目的

通过心理、认知或行为疗法确定治疗脊髓损伤(SCI)患者神经性疼痛的疗效,并为临床实践提供建议。

材料和方法

法国物理医学与康复学会(SOFMER)提出的方法包括系统文献复习、收集当前临床实践信息以及由多学科专家小组进行验证。

结果

由于文献匮乏,仅找到一项研究,评估了这些疗法对神经性疼痛的疗效,但未评估 SCI 患者的慢性神经性疼痛。结果表明,这些疗法对相关症状(焦虑和抑郁水平、睡眠障碍)的疗效优于疼痛本身。

结论

没有科学证据可以验证这种类型的疼痛管理护理。然而,研究这些疗法在慢性疼痛患者中的疗效的文章具有较高的证据水平,这表明这些疗法可以应用于 SCI 患者。这些技术必须在法国开发,并应在患有神经性疼痛的 SCI 患者中进行进一步的研究。

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