红外热图Hash值评估度洛西汀治疗持续性躯体形式疼痛障碍的效用评价

Efficacy of Hash value in infrared thermogram in assessment of duloxetine for persistent somatoform pain disorder

目的对医用红外热图分析中的差异哈希算法(Hash function,Hash值)评估度洛西汀治疗持续性躯体形式疼痛障碍(persistent somatoform pain disorder,PSPD)的效用进行再评价。方法选取2022年2-12月在我科门诊诊断为PSPD并接受度洛西汀药物治疗的70例患者,收集治疗前,治疗后4、8、12周的红外热图Hash值、疼痛视觉模拟评分(visual analogue scale,VAS)、汉密尔顿焦虑量表14项评分(hamilton anxiety scale-14,HAMA-14)、HAMD-17、匹兹堡睡眠质量指数量表评分(Pittsburgh sleep quality index,PSQI)、健康问卷躯体症状群量表15项评分(patient health questionnaire-15,PHQ-15)、症状自评量表90项评分(symptom checklist-90,SCL-90),采用Spearman分析红外热图Hash值与VAS、HAMA-14、HAMD-17、PSQI、PHQ-15、SCL-90量表评分的相关性,同时记录对比各时间点疼痛缓解率、药物不良反应等。结果70例PSPD患者经度洛西汀治疗后4、8、12周疼痛缓解率分别为31.43%、67.14%、78.57%。与治疗前比较,红外热图Hash值随治疗时间的进展呈上升趋势(P=0.000),而VAS、HAMA-14、HAMD-17、PSQI、PHQ-15和SCL-90量表评分均随治疗时间的进展呈下降趋势(P=0.000)。治疗前及治疗后4、8、12周的红外热图Hash值与VAS评分的相关系数r分别为-0.457、-0.313、-0.609、-0.696,与HAMA-14评分的相关系数r分别为-0.597、-0.433、-0.524、-0.629,与HAMD-17评分的相关系数r分别为-0.677、-0.315、-0.319、-0.448,与PSQI评分的相关系数r分别为-0.462、-0.284、-0.361、-0.446,与PHQ-15评分的相关系数r分别为-0.542、-0.357、-0.455、-0.620,与SCL-90评分的相关系数r分别为-0.485、-0.402、-0.483、-0.516。治疗12周后与治疗前红外热图Hash值差值及VAS、HAMA-14、HAMD-17、PSQI、PHQ-15、SCL-90量表评分差值的相关系数r分别为-0.734、-0.429、-0.461、-0.314、-0.369、-0.293。结论红外热图Hash值可以作为一种辅助诊断PSPD和治疗后效果评价的客观指标。

Objective To investigate the efficacy of Hash value in medical infrared thermogram analysis for assessing the therapeutic effect of duloxetine on persistent somatoform pain disorder(PSPD).Methods A total of 70 PSPD patients treated with duloxetine medication in our outpatient clinic from February 2022 to December 2022 were enrolled in this study.Hash value in infrared thermogram,visual analogue scale(VAS)score,and results of Hamilton Anxiety Scale-14(HAMA-14),Hamilton Depression Scale-17(HAMD-17),Pittsburgh Sleep Quality Index(PSQI),Patient Health Questionnaire-15(PHQ-15)and Symptom Checklist-90(SCL-90)were collected before and 4,8 and 12 weeks after treatment.Spearman correlation analysis was used to analyze the correlation between the Hash value with the scores of above scales and questionnaires.The pain relief rate and adverse reactions were also recorded and analyzed.Results The pain relief rate was 31.43%,67.14%and 78.57%,respectively in 4,8 and 12 weeks after duloxetine treatment.In comparison with the values before treatment,the Hash value was in a trend of increasing with the progression of treatment time(P=0.000),while the results of VAS,HAMA-14,HAMD-17,PSQI,PHQ-15 and SCL-90 all showed a decreasing trend during the period(P=0.000).The correlation coefficient r between the Hash value in infrared thermogram and VAS score was-0.457,-0.313,-0.609 and-0.696,respectively before and 4,8 and 12 weeks after treatment;And the correlation coefficient r with HAMA-14 score was-0.597,-0.433,-0.524 and-0.629,respectively;that with HAMD-17 score was-0.677,-0.315,-0.319 and-0.448 respectively;that with PSQI score was-0.462,-0.284,-0.361 and-0.446 respectively;that with PHQ-15 score was-0.542,-0.357,-0.455 and-0.620 respectively;and that with SCL-90 score was-0.485,-0.402,-0.483 and-0.516,respectively at the corresponding time points.The correlation coefficient r of the difference between the infrared thermogram Hash value and the score difference of VAS,HAMA-14,HAMD-17,PSQI,PHQ-15 and SCL-90 in 12 weeks after treatment and before treatment was-0.734,-0.429,-0.461,-0.314,-0.369 and-0.293,respectively.Conclusion Hash value in infrared thermogram can be used as an objective indicator in the adjuvant diagnosis of PSPD and evaluation of treatment efficacy.