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本文引用的文献

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Perceived barriers to accessing physical therapy services in Florida among individuals with low back pain.佛罗里达州腰痛患者在获得物理治疗服务方面所察觉到的障碍。
Front Health Serv. 2022 Dec 8;2:1032474. doi: 10.3389/frhs.2022.1032474. eCollection 2022.
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CDC Clinical Practice Guideline for Prescribing Opioids for Pain - United States, 2022.美国疾病预防控制中心 2022 年《疼痛阿片类药物处方临床实践指南》。
MMWR Recomm Rep. 2022 Nov 4;71(3):1-95. doi: 10.15585/mmwr.rr7103a1.
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Trends and Geographic Patterns in Drug and Synthetic Opioid Overdose Deaths - United States, 2013-2019.2013-2019 年美国药物和合成阿片类药物过量死亡的趋势和地理模式。
MMWR Morb Mortal Wkly Rep. 2021 Feb 12;70(6):202-207. doi: 10.15585/mmwr.mm7006a4.
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Access to Multimodal Pain Management for Patients with Chronic Pain: an Audit Study.慢性疼痛患者获得多模式疼痛管理的情况:一项审计研究。
J Gen Intern Med. 2021 Mar;36(3):818-820. doi: 10.1007/s11606-020-05866-3. Epub 2020 May 6.
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Opioid prescribing patterns among medical providers in the United States, 2003-17: retrospective, observational study.美国医疗服务提供者的阿片类药物处方模式,2003-2017 年:回顾性、观察性研究。
BMJ. 2020 Jan 29;368:l6968. doi: 10.1136/bmj.l6968.
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Effectiveness of physical therapy and exercise on pain and functional status in patients with chronic low back pain: a randomized-controlled trial.物理治疗与运动对慢性下腰痛患者疼痛及功能状态的疗效:一项随机对照试验。
Turk J Phys Med Rehabil. 2017 Aug 9;64(1):52-58. doi: 10.5606/tftrd.2018.1238. eCollection 2018 Mar.
7
Trends and Patterns of Geographic Variation in Opioid Prescribing Practices by State, United States, 2006-2017.2006-2017 年美国各州阿片类药物处方实践的地域差异趋势和模式。
JAMA Netw Open. 2019 Mar 1;2(3):e190665. doi: 10.1001/jamanetworkopen.2019.0665.
8
Vital Signs: Changes in Opioid Prescribing in the United States, 2006-2015.生命体征:2006 - 2015年美国阿片类药物处方的变化
MMWR Morb Mortal Wkly Rep. 2017 Jul 7;66(26):697-704. doi: 10.15585/mmwr.mm6626a4.
9
Opioid Abuse in Chronic Pain--Misconceptions and Mitigation Strategies.慢性疼痛中的阿片类药物滥用——误解与缓解策略
N Engl J Med. 2016 Mar 31;374(13):1253-63. doi: 10.1056/NEJMra1507771.
10
Effectiveness and Implications of Alternative Placebo Treatments: A Systematic Review and Network Meta-analysis of Osteoarthritis Trials.替代安慰剂治疗的效果和意义:骨关节炎试验的系统评价和网络荟萃分析。
Ann Intern Med. 2015 Sep 1;163(5):365-72. doi: 10.7326/M15-0623.

慢性肌肉骨骼疼痛成人的阿片类药物暴露与相关数字疼痛评分

Opioid Exposure and Associated Numeric Pain Scores in Adults with Chronic Musculoskeletal Pain.

作者信息

Segebrecht Ray, Khan Abat, Wu Xiangni

机构信息

Assistant Professor, Division of Internal Medicine, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USA.

Department of Hematology and Medical Oncology, Memorial Healthcare System, Florida, USA.

出版信息

Mo Med. 2025 Jul-Aug;122(4):334-339.

PMID:40787033
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12331328/
Abstract

The opioid epidemic claims tens of thousands of lives annually in the United States (US) where opioids are prescribed more per capita than in any other country. Primary care providers contribute to nearly half of these prescriptions, often for chronic non-cancer pain conditions such as back, hip, and knee pain. Despite widespread use, evidence suggests that opioids do not improve pain control for chronic non-cancer musculoskeletal pain. This study aimed to assess whether an opioid prescription in the three months preceding internal medicine primary care appointments was associated with lower pain levels, as reported on a 1 to 10 scale during medical assistant check-ins, among patients with chronic non-cancer musculoskeletal pain. Using a cross-sectional design, we analyzed pain scores for adult patients who had been prescribed opioids versus those who had not. Our findings revealed no statistically significant difference in pain levels between the two groups, with both opioid and non-opioid users reporting similar median pain scores. These results align with existing evidence, reinforcing the notion that opioids offer no substantial advantage in pain management for chronic musculoskeletal pain.

摘要

在美国,阿片类药物泛滥每年导致数万人死亡,美国人均阿片类药物处方量高于其他任何国家。初级保健提供者开出了近一半的此类处方,通常用于治疗慢性非癌性疼痛,如背部、臀部和膝盖疼痛。尽管阿片类药物被广泛使用,但有证据表明,它们并不能改善慢性非癌性肌肉骨骼疼痛的疼痛控制情况。本研究旨在评估在内科初级保健预约前三个月开具的阿片类药物处方,与慢性非癌性肌肉骨骼疼痛患者在医疗助理登记时报告的1至10级疼痛水平降低是否相关。我们采用横断面设计,分析了开具阿片类药物的成年患者与未开具阿片类药物的成年患者的疼痛评分。我们的研究结果显示,两组患者的疼痛水平在统计学上没有显著差异,阿片类药物使用者和非阿片类药物使用者报告的疼痛中位数评分相似。这些结果与现有证据一致,强化了阿片类药物在慢性肌肉骨骼疼痛管理中没有实质性优势的观点。