Bulls Hailey W, Freeman Emily L, Anderson Austen Jb, Robbins Meredith T, Ness Timothy J, Goodin Burel R
Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA.
Department of Biology, Samford University, Birmingham, AL, USA.
J Pain Res. 2015 Jun 29;8:311-20. doi: 10.2147/JPR.S84607. eCollection 2015.
It has been suggested that increased pain sensitivity and disruption of endogenous pain inhibitory processes may account, at least in part, for the greater prevalence and severity of chronic pain in women compared to men. However, previous studies addressing this topic have produced mixed findings. This study examined sex differences in pain sensitivity and inhibition using quantitative sensory testing (QST), while also considering the influence of other important factors such as depressive symptoms and sleep quality. Healthy men (n=24) and women (n=24) each completed a QST battery. This battery included an ischemic pain task (IPT) that used a submaximal effort tourniquet procedure as well as a conditioned pain modulation (CPM) procedure for the assessment of endogenous pain inhibition. Prior to QST, participants completed the Center for Epidemiologic Studies Depression Scale and the Pittsburgh Sleep Quality Index. Analyses revealed significant sex differences for the ischemic pain task and the conditioned pain modulation procedure, such that women tolerated the ischemic pain for a shorter amount of time and demonstrated less pain inhibition compared with men. This remained true even when accounting for sex differences in depressive symptoms and sleep quality. The results of this study suggest that women may be more pain sensitive and possess less-efficient endogenous pain inhibitory capacity compared with men. Whether interventions that decrease pain sensitivity and enhance pain inhibition in women ultimately improve their clinical pain outcomes is an area of research that deserves additional attention in the future.
有人提出,疼痛敏感性增加和内源性疼痛抑制过程的破坏可能至少部分解释了与男性相比,女性慢性疼痛的患病率更高、病情更严重的原因。然而,以往针对该主题的研究结果不一。本研究使用定量感觉测试(QST)来检查疼痛敏感性和抑制方面的性别差异,同时还考虑了抑郁症状和睡眠质量等其他重要因素的影响。健康男性(n = 24)和女性(n = 24)均完成了一组QST测试。该测试组包括一项缺血性疼痛任务(IPT),其采用次最大强度的止血带程序,以及一项用于评估内源性疼痛抑制的条件性疼痛调制(CPM)程序。在进行QST之前,参与者完成了流行病学研究中心抑郁量表和匹兹堡睡眠质量指数。分析显示,在缺血性疼痛任务和条件性疼痛调制程序方面存在显著的性别差异,即与男性相比,女性忍受缺血性疼痛的时间更短,且疼痛抑制能力更弱。即使考虑到抑郁症状和睡眠质量方面的性别差异,情况依然如此。本研究结果表明,与男性相比,女性可能对疼痛更敏感,且内源性疼痛抑制能力较低效。减少女性疼痛敏感性并增强其疼痛抑制能力的干预措施最终是否能改善她们的临床疼痛结局,是未来值得进一步关注的研究领域。
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