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关节炎、复杂性区域疼痛综合征、纤维肌痛综合征及无痛志愿者的感觉功能和疼痛体验:一项横断面研究。

Sensory Function and Pain Experience in Arthritis, Complex Regional Pain Syndrome, Fibromyalgia Syndrome, and Pain-Free Volunteers: A Cross-Sectional Study.

机构信息

University of the West of England, Bristol.

Resolve Your Pain.

出版信息

Clin J Pain. 2019 Nov;35(11):894-900. doi: 10.1097/AJP.0000000000000751.

Abstract

OBJECTIVES

This study aimed to identify relationships between sensory function and pain in 3 common pain conditions (arthritis, Complex Regional Pain Syndrome [CRPS] and fibromyalgia syndrome [FMS]) and pain-free participants. Sensory abnormalities are known to be concomitant with some types of chronic pain but comparison across pain conditions using existing research is difficult due to methodological differences. Pragmatic Quantitative Sensory Testing (QST) methods were used.

MATERIALS AND METHODS

Hot and cold sensitivity, light touch threshold (LTT), two-point discrimination and pain threshold were assessed in 143 participants (n=37 pain-free, n=34 arthritis, n=36 CRPS, n=36 FMS). Outcomes were assessed in the index ("affected" or right) and contralateral arm. Participants also completed the Brief Pain Inventory and the McGill Pain Questionnaire.

RESULTS

There were statistically significant differences between groups for all QST outcomes except two-point discrimination. Relative to pain-free participants, FMS displayed heat hyperesthesia in both arms and cold hyperesthesia in the contralateral arm. CRPS demonstrated no changes in thermal sensitivity. Both CRPS and FMS exhibited bilateral pressure hyperalgesia. LTT hypoesthesia was observed bilaterally for CRPS but only in the contralateral arm for FMS. CRPS and FMS had pressure hyperalgesia in the index arm relative to arthritis patients. There were no differences between arthritis and pain-free participants for any QST outcome. In CRPS, there were significant correlations between LTT and pain outcomes bilaterally.

DISCUSSION

People with FMS and CRPS demonstrate extensive sensory dysfunction. Arthritis patients had sensory profiles closer to pain-free participants. LTT may provide a clinically relevant and accessible assessment for CRPS.

摘要

目的

本研究旨在识别三种常见疼痛病症(关节炎、复杂性区域疼痛综合征[CRPS]和纤维肌痛综合征[FMS])和无痛参与者中感觉功能与疼痛之间的关系。已知感觉异常与某些类型的慢性疼痛同时存在,但由于方法学差异,使用现有研究比较不同疼痛病症比较困难。使用实用定量感觉测试(QST)方法。

材料和方法

对 143 名参与者(无痛组 n=37、关节炎组 n=34、CRPS 组 n=36、FMS 组 n=36)的热和冷敏感性、轻触阈值(LTT)、两点辨别和疼痛阈值进行了评估。评估结果在指数(“受累”或右侧)和对侧手臂中进行。参与者还完成了简明疼痛量表和麦吉尔疼痛问卷。

结果

除两点辨别外,所有 QST 结果在组间均存在统计学差异。与无痛参与者相比,FMS 在双侧手臂中表现出热过敏,在对侧手臂中表现出冷过敏。CRPS 未表现出热敏感性变化。CRPS 和 FMS 均表现出双侧压力痛觉过敏。CRPS 双侧 LTT 感觉减退,而 FMS 仅在对侧手臂出现。与关节炎患者相比,CRPS 和 FMS 在指数手臂中表现出压力痛觉过敏。关节炎和无痛参与者在任何 QST 结果方面均无差异。在 CRPS 中,LTT 与双侧疼痛结果之间存在显著相关性。

讨论

FMS 和 CRPS 患者表现出广泛的感觉功能障碍。关节炎患者的感觉特征更接近无痛参与者。LTT 可能为 CRPS 提供一种具有临床相关性和可及性的评估方法。

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