Kim Hee Jung, Yoon Kyung Bong, Kang Misun, Yang Yun Seok, Kim Shin Hyung
Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
Front Neurol. 2023 Feb 17;14:1137453. doi: 10.3389/fneur.2023.1137453. eCollection 2023.
Patients with zoster-associated pain exhibit a variety of sensory symptoms and forms of pain and complain of different pain patterns. The purpose of this study is to subgroup patients with zoster-associated pain who visited a hospital using painDETECT sensory symptom scores, analyze their respective characteristics and pain-related data, and compare similarities and differences among the groups.
The characteristics of 1,050 patients complaining of zoster-associated pain and pain-related data were reviewed retrospectively. To identify subgroups of patients with zoster-associated pain according to sensory symptom profiles, a hierarchical cluster analysis was performed based on the responses to a painDETECT questionnaire. Demographics and pain-related data were compared among all subgroups.
Patients with zoster-associated pain were classified into 5 subgroups according to the distribution of sensory profiles, with each subgroup exhibiting distinct differences in the expression of sensory symptoms. Patients in cluster 1 complained of burning sensations, allodynia, and thermal sensitivity, but felt numbness less strongly. Cluster 2 and 3 patients complained of burning sensations and electric shock-like pain, respectively. Cluster 4 patients complained of most sensory symptoms at similar intensities and reported relatively strong prickling pain. Cluster 5 patients suffered from both burning and shock-like pains. Patient ages and the prevalence of cardiovascular disease were significantly lower in cluster 1. Patients in clusters 1 and 4 reported longer pain duration compared with those in clusters 2 and 3. However, no significant differences were found with respect to sex, body mass index, diabetes mellitus, mental health problems, and sleep disturbance. Pain scores, distribution of dermatomes and gabapentinoid use were also similar among the groups.
Five different subgroups of patients with zoster-associated pain were identified on the basis of sensory symptoms. A subgroup of younger patients with longer pain duration showed specific and distinct symptoms, such as burning sensations and allodynia. Unlike patients with acute or subacute pain, patients with chronic pain were associated with diverse sensory symptom profiles.
带状疱疹相关性疼痛患者表现出多种感觉症状和疼痛形式，且主诉不同的疼痛模式。本研究的目的是使用疼痛DETECT感觉症状评分对到医院就诊的带状疱疹相关性疼痛患者进行亚组划分，分析其各自特征及疼痛相关数据，并比较各亚组之间的异同。
回顾性分析1050例主诉带状疱疹相关性疼痛患者的特征及疼痛相关数据。为根据感觉症状特征确定带状疱疹相关性疼痛患者的亚组，基于疼痛DETECT问卷的回答进行分层聚类分析。比较所有亚组的人口统计学和疼痛相关数据。
根据感觉特征分布，带状疱疹相关性疼痛患者被分为5个亚组，每个亚组在感觉症状表达上表现出明显差异。第1组患者主诉烧灼感、痛觉过敏和热敏感，但麻木感较弱。第2组和第3组患者分别主诉烧灼感和电击样疼痛。第4组患者以相似强度主诉大多数感觉症状，并报告有相对强烈的刺痛。第5组患者同时患有烧灼感和电击样疼痛。第1组患者年龄和心血管疾病患病率显著较低。与第2组和第3组患者相比，第1组和第4组患者报告的疼痛持续时间更长。然而，在性别、体重指数、糖尿病、心理健康问题和睡眠障碍方面未发现显著差异。各亚组之间的疼痛评分、皮节分布和加巴喷丁类药物使用情况也相似。
基于感觉症状确定了带状疱疹相关性疼痛患者的5个不同亚组。一组疼痛持续时间较长的年轻患者表现出特定且不同的症状，如烧灼感和痛觉过敏。与急性或亚急性疼痛患者不同，慢性疼痛患者伴有多种感觉症状特征。
