Lin Tso-Chou, Ho Shung-Tai, Ger Luo-Ping, Liou Huei-Han, Hwang Shu-Ling
Department of Anesthesiology, Tri-Service General Hospital Department of Anesthesiology, Taipei Veterans General Hospital, National Defense Medical Center, Taipei Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung Center for General Education, National Defense Medical Center, Taipei, Taiwan.
Medicine (Baltimore). 2018 May;97(21):e10805. doi: 10.1097/MD.0000000000010805.
Research regarding sex or gender difference in chronic pain proliferated in this decade. This study was to analyze gender difference in Taiwan patients receiving long-term opioids for chronic noncancer pain.An observational cross-sectional survey was conducted among the registered outpatients by the Taiwan Food and Drug Administration. Participants completed a self-report questionnaire, including the Taiwanese version of Brief Pain Inventory and enquiry regarding sexual activities, depressive symptoms, and misuse behaviors.In total, 68 female and 142 male patients were analyzed. Both pain intensity and daily function interference reduced comparably (around 50%) between women and men after taking opioids in the past 1 week. The opioid-related adverse effects, including constipation, decreased sexual desire and satisfaction, and misuse behaviors were not significantly different. Women were exceedingly diagnosed with depression (67.7% vs 49.3%, P = .012) and had a higher mean depressive symptom score in the past 1 month, especially among those age <40 years (23.3 vs 11.9, P = .009), as compared with men. In addition, women had a lower mean self-rated health score (37.9 vs 44.3, P = .047). The mean morphine equivalent dose was significantly lower in women (131.6 vs 198.2 mg/day, P = .008), which was not correlated with their depressive scores.Gender differences in the effectiveness and adverse effects of long-term opioids were not found among Taiwan registered outpatients with chronic noncancer pain. However, more female patients inclined to have a coexisting depression diagnosis, depressive symptoms, and a lower perceived health score, needing regular screening and closer monitoring.
关于慢性疼痛中性别差异的研究在这十年中大量涌现。本研究旨在分析台湾地区接受长期阿片类药物治疗慢性非癌性疼痛患者的性别差异。台湾食品药品管理局对注册门诊患者进行了一项观察性横断面调查。参与者完成了一份自我报告问卷，包括台湾版简明疼痛量表以及关于性活动、抑郁症状和滥用行为的询问。
总共分析了68名女性和142名男性患者。在过去1周服用阿片类药物后，女性和男性的疼痛强度和日常功能干扰程度均有类似程度的降低（约50%）。与阿片类药物相关的不良反应，包括便秘、性欲和满意度下降以及滥用行为，并无显著差异。与男性相比，女性被诊断患有抑郁症的比例极高（67.7%对49.3%，P = 0.012），且在过去1个月的平均抑郁症状评分更高，尤其是在年龄<40岁的女性中（23.3对11.9，P = 0.009）。此外，女性的平均自评健康评分更低（37.9对44.3，P = 0.047）。女性的平均吗啡等效剂量显著更低（131.6对198.2mg/天，P = 0.008），这与她们的抑郁评分无关。
在台湾地区注册的慢性非癌性疼痛门诊患者中，未发现长期阿片类药物在疗效和不良反应方面存在性别差异。然而，更多女性患者倾向于同时被诊断患有抑郁症、出现抑郁症状且自评健康评分较低，需要定期筛查和密切监测。
