Grunert B K, Devine C A, Sanger J R, Matloub H S, Green D
Department of Plastic and Reconstructive Surgery, Medical College of Wisconsin, Milwaukee.
J Hand Surg Am. 1990 Jul;15(4):615-8. doi: 10.1016/s0363-5023(09)90024-7.
Reflex sympathetic dystrophy syndrome is comprised of a variety of changes in vasomotor and trophic responsivity, as well as, stiffness, edema and severe pain. This study examined 20 patients with reflex sympathetic dystrophy syndrome who had failed to respond to a variety of techniques commonly used to treat this disorder. These patients had documented histories of reflex sympathetic dystrophy syndrome ranging from 18 to 60 months. All had been referred for psychological evaluation and provision of pain management. A combination of thermal biofeedback, relaxation training, and supportive psychotherapy were used to reduce subjective pain. The results indicate that patients were able to significantly increase their initial (p less than 0.0001) and postrelaxation (p less than 0.0001) hand temperatures, as well as to significantly reduce their subjective pain ratings (p less than 0.0001). This reduction in pain was maintained at 1-year telephone follow-up, with 14 of the 20 patients returning to work by that time. This intervention was effective as a pain reduction strategy for our patients with reflex sympathetic dystrophy syndrome who had failed to benefit from other treatments.
反射性交感神经营养不良综合征由血管舒缩和营养反应性的多种变化以及僵硬、水肿和剧痛组成。本研究检查了20例对常用于治疗该疾病的多种技术均无反应的反射性交感神经营养不良综合征患者。这些患者有记录的反射性交感神经营养不良综合征病史为18至60个月。所有人均被转介进行心理评估并接受疼痛管理。采用热生物反馈、放松训练和支持性心理治疗相结合的方法来减轻主观疼痛。结果表明，患者能够显著提高其初始（p<0.0001）和放松后的手部温度（p<0.0001），并显著降低其主观疼痛评分（p<0.0001）。这种疼痛减轻在1年的电话随访中得以维持，20例患者中有14例在那时恢复了工作。对于我们那些未能从其他治疗中获益的反射性交感神经营养不良综合征患者，这种干预作为一种减轻疼痛的策略是有效的。
