France R D
Specialty Services Unit, HCA, St. Mark's Hospital, Salt Lake City, Utah.
Clin J Pain. 1989;5 Suppl 2:S35-41; discussion S41-2. doi: 10.1097/00002508-198906002-00006.
Healing or successful intervention usually leads to the resolution of pain. However, in some patients biologic or psychologic symptoms associated with pain persist despite treatment or apparent healing. In cases in which the etiology is not known, persistent pain is categorized as a clinical syndrome known as "chronic pain." Organic, psychologic, and socioenvironmental factors contribute to the development of chronic pain. Major organic illnesses leading to chronic pain include headaches, back problems, arthritis, and cancer. Significant psychological reactions occur in many pain patients, with depression being the most common. Pain is often seen in patients with psychiatric disorders such as depression, anxiety, and somatization, as well as in substance abusers. Before successful management can begin, the major etiologic factors and sequelae of the chronic pain syndrome must be understood. Antidepressants, neuroleptics, anticonvulsants, nonsteroidal anti-inflammatory drugs, and hydroxyzine have been proven effective in the treatment of pain syndromes. The treatment of patients who present with chronic pain must be individualized based on a comprehensive understanding of the factors underlying the chronic pain syndrome of each patient.
愈合或成功干预通常会使疼痛得到缓解。然而，在一些患者中，尽管经过治疗或表面上已愈合，但与疼痛相关的生物学或心理症状仍然存在。在病因不明的情况下，持续性疼痛被归类为一种名为“慢性疼痛”的临床综合征。器质性、心理和社会环境因素都促成了慢性疼痛的形成。导致慢性疼痛的主要器质性疾病包括头痛、背部问题、关节炎和癌症。许多疼痛患者会出现明显的心理反应，其中抑郁最为常见。疼痛在患有精神疾病（如抑郁症、焦虑症和躯体化障碍）的患者以及药物滥用者中也很常见。在开始成功治疗之前，必须了解慢性疼痛综合征的主要病因和后遗症。抗抑郁药、抗精神病药、抗惊厥药、非甾体抗炎药和羟嗪已被证明对治疗疼痛综合征有效。对于患有慢性疼痛的患者，必须在全面了解每位患者慢性疼痛综合征潜在因素的基础上进行个体化治疗。
