From the Division of Gastroenterology, Hepatology, and Nutrition, The Ohio State University Wexner Medical Center, Columbus, OH.
Center for Child Health, Behavior and Development, Seattle Children's Research Institute.
Pancreas. 2024 Jan 1;53(1):e34-e41. doi: 10.1097/MPA.0000000000002271. Epub 2023 Nov 3.
Pain, the hallmark symptom of chronic pancreatitis (CP), remains difficult to assess. To capture the variability of pain that patients can experience day to day, this study used pain diaries to describe daily pain experiences and identify pain phenotypes.
This study is a secondary data analysis from a pilot trial examining cognitive behavioral therapy for pain treatment in CP. Before treatment, patients completed an online daily pain diary using the Brief Pain Inventory for 7 days. Using indicators of pain magnitude, pain variability, pain synchrony along with least, worst, and average pain intensity levels, we identified pain patterns using K-means clustering.
Of 30 patients in the pilot trial, a total of 27 patients (mean age of 49.8 years, 80% women) had complete data to include in this report. Four clusters were identified: cluster 1, lowest pain magnitude (n = 3); cluster 2, moderate pain magnitude and high pain variability (n = 4); cluster 3, moderate pain magnitude and low pain variability (n = 9); and cluster 4, highest pain magnitude and lowest pain variability (n = 11).
Daily pain diaries offer a novel way of evaluating the dynamic pain experiences in CP. Although 4 distinct pain patterns were identified, further studies are needed to validate these findings.
疼痛是慢性胰腺炎（CP）的主要症状，仍然难以评估。为了捕捉患者每天可能经历的疼痛变化，本研究使用疼痛日记来描述日常疼痛体验并确定疼痛表型。
这是一项使用认知行为疗法治疗 CP 疼痛的初步试验的二次数据分析。在治疗前，患者使用 Brief Pain Inventory 在网上完成了为期 7 天的日常疼痛日记。我们使用疼痛幅度、疼痛变异性、疼痛同步性以及最小、最严重和平均疼痛强度水平的指标，使用 K-均值聚类来识别疼痛模式。
在初步试验的 30 名患者中，共有 27 名（平均年龄为 49.8 岁，80%为女性）患者有完整的数据可供报告。确定了 4 个聚类：聚类 1，疼痛幅度最低（n = 3）；聚类 2，疼痛幅度中等且疼痛变异性高（n = 4）；聚类 3，疼痛幅度中等且疼痛变异性低（n = 9）；聚类 4，疼痛幅度最高且疼痛变异性最低（n = 11）。
每日疼痛日记为评估 CP 中的动态疼痛体验提供了一种新方法。尽管确定了 4 种不同的疼痛模式，但仍需要进一步研究来验证这些发现。
