School of Nursing, University of Connecticut, Storrs, CT.
Department of Pain and Translational Symptom Science, University of Maryland School of Nursing, Baltimore, MD.
Clin J Pain. 2022 Jul 1;38(7):492-501. doi: 10.1097/AJP.0000000000001046.
OBJECTIVE: The aim of this study was to investigate if somatosensory profiles can differentiate pain and psychophysiological symptoms among young adults with irritable bowel syndrome (IBS). METHODS: We performed a cluster analysis of data collected from a randomized clinical trial of 80 IBS patients and 21 age-matched healthy controls (HCs) to stratify pain and symptoms among young adults with IBS by their peripheral sensory profiles. Data of quantitative sensory testing and IBS-related pain and symptoms were collected at baseline and 6-week and 12-week follow-ups. RESULTS: Using the K-means method, IBS patients were classified into 2 clusters, the "IBS normal threshold" (IBS-NT) and the "IBS increased threshold" (IBS-IT). The IBS-NT cluster had a similar pain threshold as the HCs, and the IBS-IT cluster had an increased threshold of somatic pain perception (lower cold pain threshold, higher heat pain threshold, and higher pressure pain threshold, all P<0.001) than HCs. Compared with the IBS-NT cluster, the IBS-IT cluster reported higher levels of IBS-related pain intensity, anxiety, fatigue, and sleep disturbance over the 3 visits (all P<0.05). DISCUSSION: Young adults with IBS fell into 2 clusters, one with a similar sensory threshold as the HCs and another with an increased pain threshold, who reported higher pain intensity and more severe symptoms. Somatic sensory profiles should be integrated into further personalized self-management intervention among patients with IBS.
目的:本研究旨在探讨躯体感觉特征是否可以区分肠易激综合征(IBS)年轻患者的疼痛和心理生理症状。
方法:我们对 80 例 IBS 患者和 21 名年龄匹配的健康对照者(HCs)的随机临床试验数据进行了聚类分析,以根据其外周感觉特征对年轻 IBS 患者的疼痛和症状进行分层。在基线、6 周和 12 周随访时收集定量感觉测试和 IBS 相关疼痛及症状的数据。
结果:使用 K-均值方法,将 IBS 患者分为 2 个簇,即“IBS 正常阈值”(IBS-NT)和“IBS 增加阈值”(IBS-IT)。IBS-NT 簇的疼痛阈值与 HCs 相似,而 IBS-IT 簇的躯体痛觉感知阈值升高(冷痛阈值较低,热痛阈值较高,压痛阈值较高,均 P<0.001)。与 IBS-NT 簇相比,IBS-IT 簇在 3 次就诊时报告的 IBS 相关疼痛强度、焦虑、疲劳和睡眠障碍水平更高(均 P<0.05)。
讨论:年轻的 IBS 患者分为 2 个簇,一个簇的感觉阈值与 HCs 相似,另一个簇的疼痛阈值升高,他们报告的疼痛强度更高,症状更严重。躯体感觉特征应纳入 IBS 患者的进一步个性化自我管理干预中。
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