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纤维肌痛患者的压痛阈值、条件性疼痛调制、临床状态和睡眠质量之间的关联:一项临床试验二次分析

The Association between Pressure Pain Thresholds, Conditioned Pain Modulation, Clinical Status, and Sleep Quality in Fibromyalgia Patients: A Clinical Trial Secondary Analysis.

作者信息

González-Álvarez María Elena, Riquelme-Aguado Víctor, Arribas-Romano Alberto, Fernández-Carnero Josué, Villafañe Jorge Hugo

机构信息

Escuela Internacional de Doctorado, Rey Juan Carlos University, 28008 Madrid, Spain.

Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, 28032 Madrid, Spain.

出版信息

J Clin Med. 2024 Aug 16;13(16):4834. doi: 10.3390/jcm13164834.

Abstract

: Fibromyalgia (FM) is a complex multidimensional disorder primarily characterized by chronic widespread pain, significantly affecting patients' quality of life. FM is associated with some clinical signs found with quantitative sensory testing (QST), sleep disturbance, or psychological problems. This study aims to explore the associations between pressure pain thresholds (PPTs), conditioned pain modulation (CPM), clinical status, and sleep quality in FM patients, offering insights for better clinical management and assessment tools. : This secondary analysis utilized data from a clinical trial involving 129 FM patients. Various assessments, including the Fibromyalgia Impact Questionnaire (FIQ), Pain Catastrophizing Scale (PCS), State-Trait Anxiety Inventory (STAI), and Jenkins Sleep Scale (JSS), were employed to evaluate the clinical and psychological status and sleep quality. PPTs and CPM were measured to understand their relationship with clinical parameters. : Our findings revealed that PPTs and CPM are not significantly associated with the clinical status or sleep quality of FM patients. Instead, pain catastrophizing and anxiety state showed a stronger correlation with the impact of fibromyalgia and sleep disturbances. These results highlight the importance of psychological and cognitive factors in managing FM. : The study suggests that while PPTs and CPM may not be reliable biomarkers for clinical status in FM, the use of comprehensive assessments including FIQ, PCS, STAI, and JSS can provide a more accurate evaluation of patients' condition. These tools are cost-effective, can be self-administered, and facilitate a holistic approach to FM management, emphasizing the need for personalized treatment plans.

摘要

纤维肌痛(FM)是一种复杂的多维度疾病,主要特征为慢性广泛性疼痛,严重影响患者的生活质量。FM与定量感觉测试(QST)发现的一些临床体征、睡眠障碍或心理问题相关。本研究旨在探讨FM患者的压痛阈值(PPTs)、条件性疼痛调制(CPM)、临床状态和睡眠质量之间的关联,为更好的临床管理和评估工具提供见解。:这项二次分析使用了一项涉及129名FM患者的临床试验数据。采用了各种评估方法,包括纤维肌痛影响问卷(FIQ)、疼痛灾难化量表(PCS)、状态-特质焦虑量表(STAI)和詹金斯睡眠量表(JSS),以评估临床和心理状态及睡眠质量。测量PPTs和CPM以了解它们与临床参数的关系。:我们的研究结果显示,PPTs和CPM与FM患者的临床状态或睡眠质量无显著关联。相反,疼痛灾难化和焦虑状态与纤维肌痛的影响及睡眠障碍显示出更强的相关性。这些结果凸显了心理和认知因素在管理FM中的重要性。:该研究表明,虽然PPTs和CPM可能不是FM临床状态的可靠生物标志物,但使用包括FIQ、PCS、STAI和JSS在内的综合评估可以更准确地评估患者的病情。这些工具具有成本效益,可以自行管理,并有助于采用整体方法管理FM,强调了个性化治疗计划的必要性。

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Fibromyalgia.纤维肌痛。
Ann Intern Med. 2020 Mar 3;172(5):ITC33-ITC48. doi: 10.7326/AITC202003030.

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