神经病理性疼痛与抑郁和焦虑精神症状的相关性

Correlation of neuropathic pain with depression disorder and anxiety disorder

目的探讨神经病理性疼痛与焦虑和抑郁精神症状之间的相关性。方法选择神经病理性疼痛初诊患者36例(病例组),根据病情需要分别采用阿米替林、阿片类药物和神经阻滞药物进行镇痛治疗,治疗前进行视觉模拟疼痛评分(VAS)、Zung焦虑评分(SAS)和Zung抑郁评分(SDS),治疗后2和4周再进行SAS和SDS评分。同时选15名健康志愿者作为对照,进行SAS和SDS评分。结果病例组患者神经病理性疼痛病程均超过3个月,其疼痛程度与焦虑和抑郁情绪的发生率成正相关(P<0.01),其焦虑和抑郁情绪的发生率均显著高于对照组(P<0.01);治疗后2周和4周病例组患者疼痛均得到有效缓解(P<0.05),但疼痛程度与焦虑、抑郁情绪仍呈正相关(P<0.05),且其焦虑和抑郁情绪的发生率仍显著高于对照组(P<0.05)。结论神经病理性疼痛患者往往伴随焦虑和抑郁情绪,两者密切相关。随着疼痛的缓解,焦虑和抑郁症状均可不同程度缓解,但无法完全消除。

Objective To investigate the correlation of neuropathic pain with depression disorder and anxiety disorder. Methods Thirty-six patients who were initially diagnosed as neuropathic pain were included （ case group）, and were treated with amitriptyline, opioids and nerve block in necessities. Assessment with visual analogue scale （VAS）, Zung self-rating anxiety scale （SAS） and Zung self-rating depression scale （SDS） was performed before treatment and 2 weeks and 4 weeks after treatment. Besides, 15 healthy volunteers were served as controls, and assessment with SAS and SDS was conducted. Results The duration of neuropathic pain of all patients in case group was more than 3 months. The degree of pain was positively related to the prevalences of depression disorder and anxiety disorder in case group （ P 〈 0. 01）, and the prevalences of depression disorder and anxiety disorder in case group were significantly higher than those in control group （P 〈 O. 01）. Two weeks and 4 weeks after treatment in case group, the pain was effectively relieved （ P 〈 0.05）, the degree of pain was also positively related to the prevalences of depression disorder and anxiety disorder （P 〈 O. 05）, and the prevalences of depression disorder and anxiety disorder were also significantly higher than those in control group （ P 〈 0.05）. Conclusion Patients with neuropathic pain are usually found to experience anxiety disorder and depression disorder. With the relief of pain, anxiety disorder and depression disorder may be relieved, but can not be completely eliminated.