Paolaggi J B
Service de Rhumatologie, Hôpital Ambroise Paré, Boulogne.
Bull Acad Natl Med. 1996 May;180(5):1033-49; discussion 1049-52.
Despite Low Back Pain (LBP) major health impact, its nosology, etiology and natural history remain ill defined in most cases. The studies of our team explored the clinical and psychological features of non specific low back pain on unselected populations of patients. Our first study was conducted in a department of rheumatology. Using multivariate statistical methods we were able to identify three major groups of subjects: --a first group called "purely organic", --a second group called "purely psychiatric", --a third group with both organic and psychiatric features. These last two groups gathered 41% of the subjects. An other complementary study was conducted in primary care practice. Using the General Health Questionnaire 38% patients--a close to the above reported percentage--were classified as having a psychological disorder. In order to describe the natural course of acute low back pain an inception cohort study was conducted in primary care practice. A high rate of fast recovery was found. A critical look of the present knowledge on Low Back Pain shows several unsatisfactory chapters. Further studies on the natural history of LBP, studies on the precise etiology of each variety and researches on their pathophysiology are needed to complete the description of nosologically well defined entities and to pave the way for relevant well designed therapeutic trials.
尽管腰痛（LBP）对健康有重大影响，但在大多数情况下，其疾病分类学、病因学和自然史仍不明确。我们团队的研究探讨了非特异性腰痛在未经过挑选的患者群体中的临床和心理特征。我们的第一项研究在一个风湿病科进行。通过多变量统计方法，我们能够识别出三大类受试者：——第一类称为“纯粹器质性”；——第二类称为“纯粹精神性”；——第三类具有器质性和精神性特征。后两类受试者占总受试者的41%。另一项补充研究在初级保健实践中进行。使用一般健康问卷，38%的患者——与上述报告的百分比相近——被归类为患有心理障碍。为了描述急性腰痛的自然病程，在初级保健实践中进行了一项队列起始研究。研究发现快速康复率很高。对目前关于腰痛的知识进行批判性审视会发现有几个不尽人意的章节。需要进一步研究腰痛的自然史、每种类型的确切病因以及它们的病理生理学，以完善对疾病分类明确的实体的描述，并为相关的精心设计的治疗试验铺平道路。
