Higa Shohei, Oba Miho, Saito Shingo, Itoh Kazunori
Graduate School, Meiji University of Integrative Medicine, Nantan, Japan.
Department of Acupuncture and Moxibustion, Meiji University of Integrative Medicine, Nantan, Japan.
Med Acupunct. 2023 Dec 1;35(6):311-318. doi: 10.1089/acu.2023.0010. Epub 2023 Dec 13.
INTRODUCTION: Patients with chronic pain and high-level catastrophic thoughts often do not respond to acupuncture. This may be related to hypofunctioning of the dorsolateral prefrontal cortex and the descending pain inhibitory system. Therefore, we examined the relationship between the level of catastrophic thinking and the analgesic effect of electroacupuncture using the pain catastrophizing scale (PCS). We also evaluated the descending pain inhibitory system using conditioned pain modulation (CPM) and offset analgesia (OA). The relationship between catastrophic thinking and the descending pain inhibitory system was also examined. MATERIALS AND METHODS: After testing the hospital anxiety and depression scale and the PCS in 14 healthy adults, the current pain threshold (CPT), CPM, and OA were measured, in order, before the intervention. Thereafter, electroacupuncture was applied to 3 limbs (the dominant hand and both lower extremities) at 4 Hz, and to the scalp at 100 Hz, for 30 minutes, and the CPT was measured again immediately after the intervention. The difference in the CPT before and after the intervention was taken as the analgesic effect. RESULTS: The participants were divided into 2 groups, the H-PCS group (≥16 points) and the L-PCS group (≤15 points), according to the PCS score, and the analgesic effects of electroacupuncture were significantly different ( = 0.04). However, no relationship was found between the PCS score and the CPM ( = -0.02, = 0.94) and OA effects ( = -0.19, = 0.49). CONCLUSION: It was suggested that people with high-level catastrophic thinking may find it difficult to obtain the analgesic effects of electroacupuncture.
引言:慢性疼痛且伴有高度灾难性思维的患者通常对针灸无反应。这可能与背外侧前额叶皮质和下行性疼痛抑制系统功能低下有关。因此,我们使用疼痛灾难化量表(PCS)研究了灾难化思维水平与电针镇痛效果之间的关系。我们还使用条件性疼痛调制(CPM)和抵消镇痛(OA)评估了下行性疼痛抑制系统。同时也研究了灾难化思维与下行性疼痛抑制系统之间的关系。 材料与方法:在对14名健康成年人进行医院焦虑抑郁量表和PCS测试后,依次测量干预前的当前疼痛阈值(CPT)、CPM和OA。此后,以4Hz对3个肢体(优势手和双下肢)以及以100Hz对头皮进行30分钟的电针治疗,并在干预后立即再次测量CPT。干预前后CPT的差值作为镇痛效果。 结果:根据PCS评分,参与者被分为两组,即高PCS组(≥16分)和低PCS组(≤15分),电针的镇痛效果存在显著差异(P = 0.04)。然而,未发现PCS评分与CPM(P = -0.02,r = 0.94)及OA效果(P = -0.19,r = 0.49)之间存在相关性。 结论:提示具有高度灾难性思维的人可能难以获得电针的镇痛效果。
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