Behavioral Research, Association of Dutch Burn Centers, P.O. Box 1015, Beverwijk, Netherlands; Clinical Psychology, Utrecht University, Utrecht, Netherlands.
Burn Center, Maasstad Hospital, Maasstadweg 21, 3079DZ Rotterdam, Netherlands.
Psychoneuroendocrinology. 2018 Oct;96:1-5. doi: 10.1016/j.psyneuen.2018.05.037. Epub 2018 May 30.
Pain and traumatic stress symptoms often co-occur. Evidence suggests that the neuropeptide oxytocine and pro-inflammatory cytokines are associated with both stress and pain. The aim of this pilot study was to explore relations between self-reported pain and traumatic stress, oxytocin and three cytokines in burn wounds.
An observational study in three burn centres was performed. Patients were invited to participate in the study when deep dermal injury was suspected. Patients completed the Impact of Event Scale (IES), a self-report questionnaire assessing traumatic stress symptoms, and they rated their pain the day prior to surgery. During surgery, eschar (i.e., burned tissue) was collected and stored at -80 ° C until analysis. When the data collection was complete, oxytocin and cytokine levels were analysed.
Eschar from 53 patients was collected. Pain and stress scores were available from 42 and 36 patients respectively. Spearman correlational analyses showed an association between lower oxytocin levels at wound site and a higher total IES score (r = -0.37) and pain (r = -0.32). Mann-Whitney U tests comparing groups scoring high or low on pain or stress confirmed these associations.
These analyses lend support to a hormonal pathway that may explain how psychological distress affects pain at skin level in patients with traumatic stress symptoms.
疼痛和创伤后应激症状常同时出现。有证据表明，神经肽催产素和促炎细胞因子与应激和疼痛均有关。本初步研究旨在探索烧伤创面患者报告的疼痛与创伤后应激、催产素和三种细胞因子之间的关系。
在三个烧伤中心进行了一项观察性研究。当怀疑存在真皮深层损伤时，邀请患者参与研究。患者在手术前一天完成创伤后应激症状自评量表（IES），该量表评估创伤后应激症状，他们还对疼痛进行了评分。在手术过程中，采集焦痂（即烧伤组织）并在-80°C 下储存，直至分析。当数据收集完成后，分析催产素和细胞因子水平。
共采集了 53 名患者的焦痂。分别有 42 名和 36 名患者提供了疼痛和应激评分。Spearman 相关分析显示，创面处催产素水平较低与 IES 总分（r = -0.37）和疼痛（r = -0.32）较高之间存在关联。对疼痛或应激评分较高或较低的组进行 Mann-Whitney U 检验证实了这些关联。
这些分析支持了一种激素途径，该途径可能解释了创伤后应激症状患者的心理困扰如何影响皮肤水平的疼痛。
