性别对健康成人内脏和体表痛阈的影响

GENDER-RELATED DIFFERENCES OF VISCERAL AND SOMATIC PAIN THRESHOLD IN HEALTHY ADULTS

目的 :研究性别对健康成人内脏和体表痛阈的影响。方法 :男女两组 (n =30 )健康人群 ,通过直肠充气扩张评价内脏痛阈 ,电刺激评价体表痛阈 ,并进行精神心理评分。结果 :直肠充气扩张时 ,男、女两组的第一感觉阈值分别为 137± 5 6 .3ml和 90± 2 1.1ml,排便阈值分别为 186± 6 3.9ml和116± 2 8.5ml,疼痛阈值分别为 2 4 9± 86 .4ml和 16 0± 4 7.1ml,女性显著低于男性 (P <0 .0 5 )。体表痛阈男女之间无明显差异 ,但不同电流刺激时视觉模拟评分 (VAS)女性明显高于男性。男女之间的精神心理评分无差异。结论 :女性的内脏感觉阈和痛阈明显低于男性 ,体表对疼痛的敏感性高于男性。这种差别不能用精神心理因素来解释 ,而是可能与内在的神经感觉机制有关。

Objective: To study the gender related differences in pain threshold. Methods: Age matched healthy 15 males and 15 females were selected as volunteers. The mean age was 26±5.4 and 27±4.5 years old respectively( P >0.1); all females have normal menstrual cycle and was not in menorrhea when tested. Rectal sensitivity was evaluated with rectal balloon distension and cutaneous sensitivity with electric stimuli. The psychological score was evaluated. Results: The volume threshold of the first sensation, stool sensation and pain in females were 90±21.1ml, 116±28.5ml, and 160±47.1 ml, and in males were 137±56.3ml, 186±63.9ml, and 249±86.4ml, respectively. The threshold in females was significantly lower than that in males( P <0.05). The cutaneous pain threshold was not different between females and males, but the visual analogue scale (VAS) of females was significantly higher than that in males. There was no difference in psychological scores between females and males. Conclusion: Females are more sensitive to balloon distension than males, and females have higher VAS in cutaneous stimuli than males. These differences couldnot be explained with psychological factors, but might be resultant from the intrisic neural sensory mechanism.