Teo K, Johnson M H, Truter S, Pandanaboyana S, Windsor J A
Department of Surgery, School of Medicine, Faculty of Medical and Health Sciences, University of Auckland, New Zealand.
Department of Psychological Medicine, School of Medicine, Faculty of Medical and Health Sciences, University of Auckland, New Zealand.
Pancreatology. 2016 Nov-Dec;16(6):931-939. doi: 10.1016/j.pan.2016.09.006. Epub 2016 Sep 14.
Patients with chronic pancreatitis (CP) frequently report chronic abdominal pain that adversely impacts their quality of life. Assessment of pain in CP is required for clinical management and clinical studies. International consensus guidelines recognized a lack of specific and validated pain assessment tools for CP. Therefore, the aim of this systematic review is to identify and compare all clinical studies that assessed pain in the context of a treatment for pain in CP.
A systematic literature search was performed in PubMed, Cochrane Library and Ovid MEDLINE. The search identified all intervention studies for pain in CP and the pain assessment tools used based on pre-defined inclusion and exclusion criteria.
Of 341 articles identified, 137 studies were included. Pain assessment tools were both general and CP-specific. The latter were used in only 22 (16%) studies. Despite recommendations the aspects of pain assessed were limited and variable between tools. Validation of these tools in CP patients was limited to quality of life measures. None of the pain assessment tools evaluated duration of pain and postprandial pain.
There are no published pain assessment tools for CP that includes all relevant aspects of pain. There is the need to develop a comprehensive and validated pain assessment tool for patients with CP to standardised pain assessment, identify likely underlying pain mechanisms, help select appropriate treatments, report outcomes from interventions, improve clinical communication and aid the allocation of patients to clinical trials.
慢性胰腺炎（CP）患者常报告慢性腹痛，这对他们的生活质量产生不利影响。CP疼痛评估对于临床管理和临床研究至关重要。国际共识指南认识到缺乏针对CP的特定且经过验证的疼痛评估工具。因此，本系统评价的目的是识别和比较所有在CP疼痛治疗背景下评估疼痛的临床研究。
在PubMed、Cochrane图书馆和Ovid MEDLINE中进行系统的文献检索。检索根据预先定义的纳入和排除标准确定了所有针对CP疼痛的干预研究以及所使用的疼痛评估工具。
在识别出的341篇文章中，纳入了137项研究。疼痛评估工具既有通用的，也有针对CP的。后者仅在22项（16%）研究中使用。尽管有相关建议，但所评估的疼痛方面有限，且工具之间存在差异。这些工具在CP患者中的验证仅限于生活质量测量。没有一种疼痛评估工具评估疼痛持续时间和餐后疼痛。
目前尚无已发表的针对CP的疼痛评估工具涵盖疼痛的所有相关方面。需要为CP患者开发一种全面且经过验证的疼痛评估工具，以标准化疼痛评估、识别可能的潜在疼痛机制、帮助选择合适的治疗方法、报告干预结果、改善临床沟通并协助将患者分配到临床试验中。
