神经病理性疼痛的社会心理临床调查

Social psychology clinical investigation of neuropathic pain

目的探讨神经病理性疼痛(NP)对患者生活质量、睡眠质量、抑郁状态的影响及临床特征及其治疗方法。方法选取2016年3月~2017年5月我院门诊及住院的35例NP患者,对调查资料进行整理分析。结果研究发现35例NP患者中有19例男性(54.3%),16例女性(45.7%),平均年龄(61.52±13.35)岁;患者疼痛持续时间为6个月~30年,平均(4.55±2.10)年;12例患者疼痛原因是糖尿病(DM),23例为自发性疼痛;5例(14.3%)睡眠质量正常,30例(85.7%)睡眠质量较差,匹兹堡平均睡眠质量指数评分为(12.54±3.73)分;16例(45.7%)情绪正常,19例(54.3%)有不同程度的抑郁,Beck抑郁评分平均为(12.76±7.50)分;患者疼痛强度在一个相对较高的值VAS平均值(7.10±1.92);在8项健康调查参数中,除情绪健康和社会功能外,其余参数得分均低于50分。结论疼痛的生物心理社会学方法涉及心理、社会文化因素和生物医学/生理方面,因此,NP治疗应包括针对NP的心理、情感和社会文化特征的综合治疗。

Objective To investigate the effect of NP on quality of life, sleep quality and depression in patients and the clinical characteristics of NP and to explore the treatment method of NP. Methods 35 NP patients during outpatient service and hospitalization from March 2016 to May 2017 were selected and the survey data were analyzed. Results The study found that there were 19 males（54.3%）, 16 women（45.7%） of 35 NP patients, with the mean age of（61.52±13.35）years old. The pain duration of patients was 6 months to 30 years（4.55±2.10 years）. The cause of pain in 12 patients was diabetes mellitus（DM）, with spontaneous pain in 23 patients, normal sleep quality in 5 patients（14.3%）, poor sleep quality in 30 patients（85.7%）. Pittsburgh mean sleep quality index was（12.54±3.73） points. 16 cases（45.7%） had normal mood, and 19 cases（54.3%） had different degrees of depression. The average Beck depression score was（12.76±7.50） points. The patient＇s pain intensity was at a relatively high value, with the VAS average value of（7.10±1.92）. In the eight health survey parameters, all parameters scored lower than 50 points, except emotional health and social function. Conclusion The biopsychosocial methods of pain involves psychosocial, sociocultural factors and biomedical/physiological aspects. Therefore, NP therapy should include NP＇s psychological, emotional, and socio-cultural characteristics comprehensive treatment.