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Complex Regional Pain Syndrome: Outpatient Pain Management in the Chronic Setting: A Case Report
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作者 Julie Chege Ngugi Kinyungu 《Open Journal of Anesthesiology》 2024年第5期137-144,共8页
Background: Complex Regional Pain Syndrome (CRPS), previously known as reflex sympathetic dystrophy and causalgia, is a neuropathic pain condition that usually develops after an injury to an extremity. CRPS can be a d... Background: Complex Regional Pain Syndrome (CRPS), previously known as reflex sympathetic dystrophy and causalgia, is a neuropathic pain condition that usually develops after an injury to an extremity. CRPS can be a debilitating condition with high levels of pain and reduced function. Aim: This case report aims to discuss the multimodal approach in the management of a patient who presented with ongoing poorly controlled pain secondary to CRPS from an injury that happened years prior. Case Presentation: A 45-year-old female was involved in a motor vehicle accident where her right leg was injured. She underwent several surgeries and developed CRPS that significantly reduced her mobility and quality of life. She presented to the pain clinic years after her initial injury and a multimodal regimen was started for her resulting in significantly improved function. Conclusion: CRPS can be a severely debilitating condition. While early diagnosis and management are important, ongoing management in the outpatient chronic pain setting is important in maintaining a good level of function. 展开更多
关键词 Chronic regional pain syndrome (crps) Multimodal Management Chronic pain SEQUELAE
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Traditional Chinese medicine for foot pain in a patient with complex regional pain syndrome: A case report
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作者 Woo-Chul Shin Hyungsuk Kim Won-Seok Chung 《World Journal of Clinical Cases》 SCIE 2023年第30期7424-7431,共8页
BACKGROUND Complex regional pain syndrome(CRPS)is characterized by pain as well as sensory,motor,and sudomotor disorders.Generally,it is classified into two types CRPS-I and CRPS-II.There is no single diagnostic test ... BACKGROUND Complex regional pain syndrome(CRPS)is characterized by pain as well as sensory,motor,and sudomotor disorders.Generally,it is classified into two types CRPS-I and CRPS-II.There is no single diagnostic test or treatment approach for CRPS,and a multidisciplinary approach is gaining attention to improve patients’symptoms and their quality of life.CASE SUMMARY A 35-year-old woman with an unremarkable medical history sought treatment for CRPS at a hospital of Korean medicine.During her first visit,she was wheelchairbound due to severe pain in her left lower extremity.She had edema and discoloration of the left foot.She was treated with a combination of traditional Chinese medicine(TCM)approaches,including acupuncture,moxibustion,pharmacopuncture,and herbal decoction,for approximately 20 sessions.The foot and ankle outcome score(FAOS)and visual analog scale(VAS)score for pain were evaluated,along with general signs and functions.Her symptoms,signs,FAOS,and VAS scores improved after treatment,with a significant 7-degree decrease in the VAS score and a 62-point increase in the FAOS score.Additionally,the foot swelling and discoloration gradually resolved.During the phone follow-up,5 mo after the last visit,additional improvements in outcomes were observed.CONCLUSION Combined TCM treatment may be a reasonable and safe option for alleviating symptoms and improving function in patients with CRPS. 展开更多
关键词 complex regional pain syndrome Traditional Chinese medicine ACUPUNCTURE MOXIBUSTION Herbal medicine Case report
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Pediatric Continuous Brachial Plexus Catheter for a Case of Complex Regional Pain Syndrome (CRPS) 被引量:3
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作者 Reda Tolba Rhamee Badr +1 位作者 Maged Guirguis Loran Mounir Soliman 《Open Journal of Anesthesiology》 2015年第1期1-6,共6页
Introduction: Complex regional pain syndrome (CRPS) is a disorder characterized by pain as well as a myriad of sensory, autonomic, and motor disturbances. We are reporting a case of child diagnosed with CRPS and succe... Introduction: Complex regional pain syndrome (CRPS) is a disorder characterized by pain as well as a myriad of sensory, autonomic, and motor disturbances. We are reporting a case of child diagnosed with CRPS and successfully treated with supraclavicular brachial plexus catheter infusion of local anesthetic. Case Report: An eight-year-old male underwent a left thoracotomy, repair of esophageal vascular ring, and translocation of the left subclavian to the left carotid artery. Post-operative course was relevant for severe intractable left shoulder and left arm pain associated with allodynia and hyperalgesia. A supraclavicular catheter was inserted, and an infusion of ropivacaine 0.2% was started. The child was sent for physical therapy as he gradually regained all functions of his left arm and resumed his regular activities. Conclusion: Continuous supraclavicular brachial plexus catheter infusion of local anesthetic is a valuable method of reducing pain in severe cases of upper extremity pediatric CRPS and may be safer and more effective than other invasive measures such as sympathetic blocks and epidural catheterization. Further research surrounding the diagnosis and treatment of pediatric CRPS is needed to allow early diagnosis and treatment and to improve outcome. 展开更多
关键词 complex regional pain syndrome (crps) SUPRACLAVICULAR BRACHIAL PLEXUS CATHETER PEDIATRIC
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Failure to fire after an electrical injury——A complex syndrome in a soldier: complex regional pain syndrome(CRPS)
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作者 F.M.H.Ahmad K.V.S.Hari Kumar 《Journal of Medical Colleges of PLA(China)》 CAS 2015年第1期28-31,共4页
Complex regional pain syndrome(CRPS) is a disorder characterized by an intractable, disabling pain of the affected limb. It is triggered by various injuries and is often resistant to standard therapy. We report a youn... Complex regional pain syndrome(CRPS) is a disorder characterized by an intractable, disabling pain of the affected limb. It is triggered by various injuries and is often resistant to standard therapy. We report a young soldier with CRPS of the right hand sustained from an electrical injury, who had improvement in resting pain with Zoledronic acid. In this report, we discuss the therapeutic options and the role of bisphosphonates in CRPS. 展开更多
关键词 complex regional pain syndrome BISPHOSPHONATES Electrical injury regional osteoporosis
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Beliefs and Clinical Practice for Complex Regional Pain Syndrome (CRPS) Managed by Physiotherapists on the South Island of New Zealand
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作者 Tracey Pons Edward A. Shipton Roger T. Mulder 《International Journal of Clinical Medicine》 2017年第1期42-54,共13页
On the South Island of New Zealand, Anaesthetists and other Medical Professionals, frequently refer their patients with Complex Regional Pain Syndrome (CRPS) for physiotherapy management. Beliefs about what is importa... On the South Island of New Zealand, Anaesthetists and other Medical Professionals, frequently refer their patients with Complex Regional Pain Syndrome (CRPS) for physiotherapy management. Beliefs about what is important for the management of patients with CRPS are lacking across all medical and allied health disciplines. Difficulties are no gold standard for diagnosis and evidence for intervention methods is moderate or can be conflicting. This paper explores what Physiotherapists believe to be important in a clinical setting for their management of CRPS, as well as documenting and evaluating their interventional methods used in everyday clinical practice across the region of the South Island of New Zealand. This has not been recorded before. Eighty-one Physiotherapists replied to questions on their usual treatment interventions for the management of CRPS, their frequency of use of these treatment interventions, and what they believed to be important in the management of pain and improvement of function. The results demonstrated that CRPS is not a common condition seen regularly by Physiotherapists;that there is a high level of variation between the physiotherapy interventions used and that Physiotherapists’ beliefs regarding interventions used for pain management and functional restoration differ. Education was reported as the most frequently used intervention method. Those physiotherapists seeing CRPS patients more frequently are more likely to use evidence based intervention methods like graded motor imagery or sensory motor training. 展开更多
关键词 PHYSIOTHERAPY Anaesthetists in pain MANAGEMENT complex regional pain syndrome (crps) BELIEFS MANAGEMENT Intervention Methods Outcomes
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Impact of adolescent complex regional pain syndrome on the psychopathology of young men ahead of military service: A retrospective cohort analysis of Korean conscription data 被引量:1
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作者 Shin-Heon Lee Myeong-Jin Ko +2 位作者 Taek-Kyun Nam Jeong-Taik Kwon Yong-Sook Park 《Military Medical Research》 SCIE CSCD 2021年第3期363-372,共10页
Background: The relationship between physical and psychopathological features in complex regional pain syndrome(CRPS) has been a subject of constant interest, but no data are available in adolescents. Therefore, we ai... Background: The relationship between physical and psychopathological features in complex regional pain syndrome(CRPS) has been a subject of constant interest, but no data are available in adolescents. Therefore, we aimed to identify the factors associated with psychopathology in adolescents with CRPS ahead of military service.Methods: We retrospectively reviewed all conscription examinees who had completed a Military Personality Inventory(MPI) during a period between February 2013 and December 2016. A total of 63 persons with a history of CRPS(19-years of age for all) were enrolled. Basic demographic and pain-related data were analyzed to examine their association with MPI results. The mean FGR score as well as the 8 subdomain scores were compared between those with pain duration at <15 months(n=30) vs. ≥15 months(n=33). Binary MPI results(normal-abnormal) were also compared between the two groups.Results: In multivariate analysis, abnormal MPI was associated with pain duration, with an odds ratio(OR) at 1.05 for every 1-month increase [95% confidence interval(CI) 1.02–1.08;P=0.002]. Subjects with pain duration at ≥15 months have lower faking good response score(P<0.001 vs. those with pain duration at <15 months), and higher abnormal MPI result rate, faking bad response, inconsistency, anxiety, depression, somatization, paranoid, personality disorder cluster A, and personality disorder cluster B scores(P<0.05). Pain duration was significantly associated with the MPI variables.Conclusions: Pain duration is associated with psychopathology in adolescents with CRPS. Psychopathologic features increased as the disease duration increased. A comprehensive understanding of time-dependent psychopathological factors could support the planning of multimodal approaches for managing adolescent CRPS. 展开更多
关键词 Chronic pain complex regional pain syndromes PSYCHOPATHOLOGY Personality inventory ADOLESCENT Military personnel
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Resolution of Crohn's disease and complex regional pain syndrome following treatment of paratuberculosis
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作者 J Todd Kuenstner William Chamberlin +11 位作者 Saleh A Naser Michael T Collins Coad Thomas Dow John M Aitken Stuart Weg Grzegorz Telega Kuruvilla John David Haas Torsten M Eckstein Maher Kali Christine Welch Thomas Petrie 《World Journal of Gastroenterology》 SCIE CAS 2015年第13期4048-4062,共15页
A cohort of family members with various chronic diseases including Crohn's disease, asthma, complex regional pain syndrome, hypothyroidism, type 1 diabetes mellitus, and lymphangiomatosis and/or evidence of infect... A cohort of family members with various chronic diseases including Crohn's disease, asthma, complex regional pain syndrome, hypothyroidism, type 1 diabetes mellitus, and lymphangiomatosis and/or evidence of infection by Mycobacterium avium subsp. paratuberculosis(MAP) are described in this series of case reports. MAP was cultured from the blood of three members affected by the first five diseases and there was accompanying elevated anti-MAP Ig G in two members. The patient affected by the sixth disease has a markedly elevated anti-MAP titer. The two patients affected by the first four diseases have been treated with a combination of anti-MAP antibiotics and ultraviolet blood irradiation therapy with resolution of the disease symptomatology and inability to culture MAP in post treatment blood samples. These case reports of patients with MAP infections provide supportive evidence of a pathogenic role of MAP in humans. 展开更多
关键词 Crohn’s disease complex regional pain syndrome Lym
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Loss of Surround Inhibition and After Sensation as Diagnostic Parameters of Complex Regional Pain Syndrome
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作者 Marie Wojcik Wolanin Robert J. Schwartzman +1 位作者 Guillermo Alexander John Grothusen 《Neuroscience & Medicine》 2012年第4期344-353,共10页
Complex Regional Pain Syndrome (CRPS) is a severe chronic pain condition. Patients with CRPS experience allodynia, hyperalgesia, autonomic dysfunction, movement difficulties and dystrophic changes. However other chara... Complex Regional Pain Syndrome (CRPS) is a severe chronic pain condition. Patients with CRPS experience allodynia, hyperalgesia, autonomic dysfunction, movement difficulties and dystrophic changes. However other characteristics that may be unique to the pain in CRPS require further study. This study evaluated pain parameters in ninety five subjects composed of three groups: healthy pain free controls, patients with radiculopathy and CRPS patients. Healthy subjects were tested in all four extremities, whereas radiculopathy and CRPS patients were tested only on the most affected extremity. All subjects were tested for the following pain parameters: thermal allodynia, mechanical static and dynamic allodynia, windup, and a hyperalgesic mechanical stimulus. All subjects were also evaluated for autonomic dysfunction, movement disorder and dystrophic skin changes. Statistically significant differences were found between both pain groups and the healthy control subjects as well as between the two pain groups. The finding that statistically differentiated CRPS from radiculopathy and normal controls was pain spread following an algesic mechanical and cold stimulus as well as after sensations to these stimuli. The study demonstrated a simple bedside test that discriminated between CRPS, radiculopathy and healthy control subjects. 展开更多
关键词 crps complex regional pain syndrome RADICULOPATHY pain AFTER SENSATION SPREAD Chronic pain
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Systemic Complications of Complex Regional Pain Syndrome
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作者 Robert J. Schwartzman 《Neuroscience & Medicine》 2012年第3期225-242,共18页
Complex Regional Pain Syndrome (CRPS) is a neuropathic pain disorder that is characterized by: 1) Severe pain beyond the area of injury;2) Autonomic dysregulation;3) Neuropathic edema;4) A movement disorder, atrophy a... Complex Regional Pain Syndrome (CRPS) is a neuropathic pain disorder that is characterized by: 1) Severe pain beyond the area of injury;2) Autonomic dysregulation;3) Neuropathic edema;4) A movement disorder, atrophy and dystrophy. It is most often caused by a fracture, soft-tissue injury or surgical procedure and is divided into Type I, in which no nerve lesion is identified (classic reflex sympathetic dystrophy), and Type II where a specific nerve has been damaged (causalgia). In addition to the peripheral manifestations, there are many internal medical complications whose etiology is often not appreciated. This article will examine how CRPS affects the systems of: cognition;constitutional, cardiac, and respiratory complications;systemic autonomic dysregulation;neurogenic edema;musculoskeletal, endocrine and dermatological manifestations;as well as urological and gastrointestinal function. 展开更多
关键词 complex regional pain syndrome crps crps-1 crps-2 Chronic pain REFLEX SYMPATHETIC DYSTROPHY RSD
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Two Cases of Double Crush Syndrome Progressing to Complex Regional Pain Syndrome
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作者 Carmine Vincifora Troy Buck 《Open Journal of Anesthesiology》 2015年第7期183-186,共4页
The double crush syndrome is described as an increased risk of distal nerve injury after a more proximal injury. This was a case series of two patients who developed Complex Regional Pain Syndrome under circumstances ... The double crush syndrome is described as an increased risk of distal nerve injury after a more proximal injury. This was a case series of two patients who developed Complex Regional Pain Syndrome under circumstances when a double crush phenomenon could have occurred. Both initially had spinal stenosis and subsequent spinal surgery. Both later had crush injuries to a unilateral lower extremity, which progressed to CRPS. There is no documented correlation between double crush syndrome and CRPS;however, these cases raise awareness about a heightened propensity for CRPS in such patients, which will lead to earlier, accurate diagnosis and treatment. 展开更多
关键词 complex regional pain syndrome crps Double-Crush syndrome SPINAL STENOSIS SPINAL Surgery
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Septic Arthritis of the Hand during Treatment of Complex Regional Pain Syndrome
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作者 Kentaro Tsuji Hiroshi Takahashi +1 位作者 Ryoichi Fukano Masayuki Sekiguchi 《Open Journal of Orthopedics》 2018年第8期317-321,共5页
Complex regional pain syndrome (CRPS) complicated with septic arthritis of the hand has not previously been described. We treated a patient in whom swelling of the wrist recurred during treatment of CRPS and septic ar... Complex regional pain syndrome (CRPS) complicated with septic arthritis of the hand has not previously been described. We treated a patient in whom swelling of the wrist recurred during treatment of CRPS and septic arthritis of the hand was induced by group G hemolytic streptococcus. There are case reports of tuberculous arthritis of the hand during treatment of CRPS;however, the causal relationship of wrist joint inflammation with CRPS is unclear. Careful follow-up is necessary for wrist joint inflammation if a patient with CRPS relapses with swelling of the wrist. 展开更多
关键词 SEPTIC ARTHRITIS complex regional pain syndrome (crps) HAND
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Frequency and Risk Factors of Complex Regional Pain Syndrome in Cotonou (Benin)
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作者 Martin Avimadje Zavier Zomalheto +1 位作者 Hilaire Dossou-Yovo Marcelle Gounongbe 《Open Journal of Rheumatology and Autoimmune Diseases》 2014年第2期93-96,共4页
Aim: To determine the frequency and the risk factors of Complex Regional Pain syndrome (CRPS) in Cotonou (Benin). Patients and Méthod: This has been a transversal study carried out over 22 years on files of CRPS ... Aim: To determine the frequency and the risk factors of Complex Regional Pain syndrome (CRPS) in Cotonou (Benin). Patients and Méthod: This has been a transversal study carried out over 22 years on files of CRPS infected patients and submitted to rheumatologic consultation in the National Hospital University of Cotonou. Results: 73 out of 17,342 patients examined (0.42%) were suffering from CRPS. Those 73 patients (40 women, 54.8% and 33 men, 45.2%) were in average 54.66 years old and enjoyed an average duration of evolution of 5.79 months. The trauma (41 cases, 56.1%), the stroke (19 cases, 25%), the diabetes (8 cases, 11.3), were the main risk factors that were observed. CRPS was preferably located at the shoulder-hand (34.2%), shoulder (28.8%), wrist-hand (16.4%) and knee (11%). Inflammatory pain was observed in 55 cases. The treatment was dominated by griseofulvina (41 cases, 56.1%), antiinflammatory drugs (38 cases, 52%), analgesic (20 cases, 27, 3%), joint injection by betamethasone (17 cases, 27%). Conclusion: CRPS is not rare in our country. The first risk factor remains the trauma in rheumatologic consultation in Cotonou. 展开更多
关键词 complex regional pain syndrome Risk FACTOR BENIN
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Complex regional pain syndrome: From diagnosis to rehabilitation
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作者 Alexandra Lecours Mathieu Piché 《World Journal of Anesthesiology》 2014年第1期46-60,共15页
Complex regional pain syndrome(CRPS) is a debilitating pathology characterised by intense chronic pain associated with vasomotor, sensory and motor dysfunction of the affected limb. Although the pathophysiology of CRP... Complex regional pain syndrome(CRPS) is a debilitating pathology characterised by intense chronic pain associated with vasomotor, sensory and motor dysfunction of the affected limb. Although the pathophysiology of CRPS is not fully understood, it is recognised that inflammatory processes and autonomic dysfunction are involved. These processes are associated with peripheral and central sensitisation as well as changes in brain structure and function, and are reflected in the clinical presentation of CRPS. CRPS management requires an interdisciplinary team and requires the therapeutic approach to be individualised. With regard to pharmacological treatment, bisphosphonates, corticosteroids, ketamine and anticonvulsants have been demonstrated to be effective for CRPS management. Psychotherapy, including cognitive-behavioural therapy, has produced promising results but more studies are needed to confirm its efficacy. Among rehabilitation interventions, there is evidence of the efficacy of physiotherapy and occupational therapy in diminishing CRPS symptoms and achieving a higher level of functioning. In this regard, the rehabilitation modality that seems the most promising according to the actual literature is graded motor imagery, which can help to reverse the maladaptive neuroplasticity occurring in CRPS. 展开更多
关键词 complex regional pain syndrome AUTONOMIC Inflammation PLASTICITY REHABILITATION
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角质形成细胞Wnt5a调控MMP9参与CRPS-Ⅰ型外周敏化机制研究
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作者 朱贺 闻蓓 +1 位作者 许力 黄宇光 《协和医学杂志》 CSCD 北大核心 2024年第2期335-343,共9页
目的探究皮肤角质形成细胞Wnt5a通过靶向调控基质金属蛋白酶9(matrix metalloproteinase⁃9,MMP9)的表达参与复杂区域疼痛综合征(complex regional pain syndrome,CRPS)⁃Ⅰ型外周敏化的机制,寻找该慢性疼痛的潜在治疗策略。方法本研究分... 目的探究皮肤角质形成细胞Wnt5a通过靶向调控基质金属蛋白酶9(matrix metalloproteinase⁃9,MMP9)的表达参与复杂区域疼痛综合征(complex regional pain syndrome,CRPS)⁃Ⅰ型外周敏化的机制,寻找该慢性疼痛的潜在治疗策略。方法本研究分为两部分,第一部分为体外实验。体外培养人永生化角质形成细胞HaCaT进行氧糖剥夺/复氧(oxygen⁃glucose deprivation/reoxygenation,OGD/R)处理,初步观察OGD/R早期(24 h内)线粒体损伤及膜电位变化,并探究给予不同浓度Wnt5a抑制剂Box5对MMP9的影响。第二部分为动物实验。将大鼠随机分为慢性缺血后疼痛(chronic postischemia pain,CPIP)组、Box5(20)组、Box5(40)组和对照组,每组8只,CPIP组、Box5(20)组、Box5(40)组先建立大鼠患肢缺血再灌注CPIP模型,模拟CRPS⁃Ⅰ型病理生理过程,Box5(20)组和Box5(40)组在此基础上分别足底注射20μmol/L和40μmol/L Box5溶液100μL,对照组和CPIP组则分别注射生理盐水100μL。通过疼痛行为学测定观察4组大鼠2周内不同时间点(D1,D2,D4,D10,D14)机械痛和热痛阈值变化情况。HE染色观察大鼠皮肤炎症浸润及角化情况,免疫荧光染色观察4组MMP9的表达情况,ELISA检测4组背根神经节(dorsal root ganglion,DRG)的IL⁃1β及肿瘤坏死因子α(tumor necrosis factor⁃α,TNF⁃α)水平。结果体外实验:HaCaT细胞进行OGD/R处理后,MMP9平均荧光强度显著增加(P<0.001);透射电镜下观察到OGD/R组出现线粒体明显萎缩,线粒体膜电位检测显示,与对照组相比,OGD/R组提示线粒体膜电位下降明显(P=0.027)。动物实验:与OGD/R组相比,仅Box5(40)组线粒体膜电位上升具有统计学差异(P=0.046)。行为学检测发现CPIP组大鼠术后各时间点(D1,D2,D4,D10,D14)机械痛阈值和热痛阈值均显著降低(P均<0.05)。HE染色提示CPIP组大鼠患足真皮层出现大量炎症细胞浸润,表皮出现过度角化,颗粒层及棘层厚度显著增加(P<0.001)。免疫荧光试验显示,CPIP组角质形成细胞MMP9荧光强度显著增加(P<0.001);与CPIP组相比,Box5(20)组(P=0.002)和Box5(40)组(P<0.001)MMP9荧光强度均显著下降。ELISA检测结果显示,CPIP组IL⁃1β(P=0.048)和TNF⁃α浓度(P=0.002)显著升高;与CPIP组相比,Box5(40)组IL⁃1β(P=0.047)和TNF⁃α浓度(P=0.047)显著下降。结论外周局部缺血再灌注损伤可导致角质形成细胞MMP9过度表达,引起CRPS⁃Ⅰ型外周敏化。靶向抑制Wnt5a/MMP9可逆转CPIP大鼠疼痛行为,为临床治疗慢性痛提供了参考依据。 展开更多
关键词 复杂区域疼痛综合征 角质形成细胞 WNT5A MMP9 外周敏化
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High-intensity swimming alleviates nociception and neuroinflammation in a mouse model of chronic postischemia pain by activating the resolvin E1-chemerin receptor 23 axis in the spinal cord 被引量:2
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作者 Xin Jia Ziyang Li +3 位作者 Xiafeng Shen Yu Zhang Li Zhang Ling Zhang 《Neural Regeneration Research》 SCIE CAS CSCD 2023年第11期2535-2544,共10页
Physical exe rcise effectively alleviates chronic pain associated with complex regional pain syndrome type-Ⅰ.However,the mechanism of exe rcise-induced analgesia has not been clarified.Recent studies have shown that ... Physical exe rcise effectively alleviates chronic pain associated with complex regional pain syndrome type-Ⅰ.However,the mechanism of exe rcise-induced analgesia has not been clarified.Recent studies have shown that the specialized pro-resolving lipid mediator resolvin E1 promotes relief of pathologic pain by binding to chemerin receptor 23 in the nervous system.However,whether the resolvin E1-chemerin receptor 23 axis is involved in exercise-induced analgesia in complex regional pain syndrome type-Ⅰ has not been demonstrated.In the present study,a mouse model of chronic post-ischemia pain was established to mimic complex regional pain syndrome type-Ⅰ and subjected to an intervention involving swimming at different intensities.Chronic pain was reduced only in mice that engaged in high-intensity swimming.The resolvin E1-chemerin receptor 23 axis was clearly downregulated in the spinal cord of mice with chronic pain,while high-intensity swimming restored expression of resolvin E1 and chemerin receptor 23.Finally,shRNA-mediated silencing of chemerin receptor 23in the spinal cord reve rsed the analgesic effect of high-intensity swimming exercise on chronic post-ischemic pain and the anti-inflammato ry pola rization of microglia in the dorsal horn of the spinal cord.These findings suggest that high-intensity swimming can decrease chronic pain via the endogenous resolvin E1-chemerin receptor 23 axis in the spinal cord. 展开更多
关键词 central sensitization chemerin receptor 23 chronic post-ischemia pain complex regional pain syndrome exercise-induced analgesia microglia NEUROINFLAMMATION resolvin E1 spinal cord SWIMMING
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腰交感神经节射频热凝联合普瑞巴林治疗CRPS的临床观察 被引量:4
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作者 顾丽丽 张学学 +3 位作者 章勇 刘小健 曹新添 张达颖 《重庆医学》 CAS 北大核心 2015年第10期1347-1348,1351,共3页
目的观察腰交感神经节射频热凝联合普瑞巴林(PGB)治疗复合性局部疼痛综合征(CRPS)的临床疗效和安全性。方法选择26例下肢CRPS患者,给予腰交感神经节射频热凝术联合口服PGB。采用视觉模拟评分(VAS)和睡眠质量评分(QS)评估并记录治疗前及... 目的观察腰交感神经节射频热凝联合普瑞巴林(PGB)治疗复合性局部疼痛综合征(CRPS)的临床疗效和安全性。方法选择26例下肢CRPS患者,给予腰交感神经节射频热凝术联合口服PGB。采用视觉模拟评分(VAS)和睡眠质量评分(QS)评估并记录治疗前及治疗后1、7、14、28、56d的疼痛变化,并记录患肢皮肤温度变化及不良反应的发生情况。结果与治疗前相比,患者治疗后VAS和QS评分明显下降(P<0.05),患肢皮肤温度明显升高(P<0.05),治疗后28、56d总有效率为88.46%、96.15%。不良反应主要为头晕和嗜睡,均无血管、神经及腹腔脏器损伤等严重并发症的发生。结论腰交感神经节射频热凝联合PGB治疗CRPS可迅速缓解患者疼痛,改善患者睡眠质量和生活质量。 展开更多
关键词 腰骶丛 交感神经节 射频热凝 普瑞巴林 复合性局部疼痛综合征
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腰交感神经阻滞联合盐酸沙格雷酯治疗下肢CRPS-Ⅰ型 被引量:1
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作者 熊志宏 《大理大学学报》 CAS 2019年第2期49-51,共3页
目的:观察腰交感神经阻滞联合盐酸沙格雷酯治疗下肢复杂性局部疼痛综合征(CRPS)的临床效果。方法:将下肢CRPS-Ⅰ型152例,随机分为Ⅰ、Ⅱ两组,每组76例。Ⅰ组行单纯腰交感神经阻滞治疗,Ⅱ组行腰交感神经阻滞联合盐酸沙格雷酯治疗。在治... 目的:观察腰交感神经阻滞联合盐酸沙格雷酯治疗下肢复杂性局部疼痛综合征(CRPS)的临床效果。方法:将下肢CRPS-Ⅰ型152例,随机分为Ⅰ、Ⅱ两组,每组76例。Ⅰ组行单纯腰交感神经阻滞治疗,Ⅱ组行腰交感神经阻滞联合盐酸沙格雷酯治疗。在治疗前、治疗后1个月及6个月对疼痛视觉模拟评分及疗效评定进行评价。结果:治疗后1个月和治疗后6个月观察,两组比较症状改善程度与有效率差异均有统计学意义(P<0.05)。两组均无并发症发生。结论:腰交感神经阻滞联合盐酸沙格雷酯对下肢CRPS-Ⅰ型的患者起到有效缓解疼痛和痛觉过敏,改善下肢乏力、冰冷、发汗障碍等营养不良症状,是CRPS-Ⅰ型患者的一种有效治疗方法。 展开更多
关键词 复杂性局部疼痛综合征 腰交感神经阻滞 盐酸沙格雷酯
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镜像疗法对脑卒中后Ⅰ型复杂区域性疼痛综合征患者上肢功能及大脑皮质活动效果的随机对照试验
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作者 文翠凤 娅茹 +2 位作者 黄昊 廖雪梅 白玉龙 《中国康复理论与实践》 CSCD 北大核心 2024年第10期1203-1214,共12页
目的 探讨镜像疗法对脑卒中后Ⅰ型复杂区域性疼痛综合征(CRPS)上肢功能及大脑皮质活动的影响。方法 2017年10月至2022年2月,在上海中医药大学附属第三康复医院招募脑卒中后Ⅰ型CRPS患者72例,随机分为对照组(n=36)和镜像组(n=36)。对照... 目的 探讨镜像疗法对脑卒中后Ⅰ型复杂区域性疼痛综合征(CRPS)上肢功能及大脑皮质活动的影响。方法 2017年10月至2022年2月,在上海中医药大学附属第三康复医院招募脑卒中后Ⅰ型CRPS患者72例,随机分为对照组(n=36)和镜像组(n=36)。对照组给予常规康复训练,镜像组在对照组基础上给予镜像疗法,共6周。治疗前、治疗3周后、治疗6周后分别对患者进行疼痛视觉模拟量表(VAS)、改良Barthel指数(MBI)、水肿容积和Brunnstrom分期评定。采用NirSmart 32通道功能性近红外光谱(fNIRS)采集静息态440 s。结果 治疗后,两组VAS评分均明显改善,且治疗6周后明显优于治疗3周后(P <0.01);治疗6周后镜像组优于对照组(P <0.05)。两组MBI评分均显著改善,且治疗6周后显著优于治疗3周后(P <0.001)。两组水肿均显著改善(Z> 30.113, P <0.001),且治疗6周后镜像组明显优于对照组(Z=-3.347, P=0.001);镜像组患者的水肿容积在治疗3周后、6周后均明显减少(Z <-0.667, P <0.01),且治疗6周后效果更优(Z=-0.667,P=0.005)。两组Brunnstrom分期均显著改善(Z> 29.714, P <0.001),治疗6周后镜像组优于对照组(Z=-2.046, P=0.041)。治疗后对照组右侧M1与右侧初级体感皮质连接强度较强,镜像组左侧M1与右侧M1、右侧初级体感皮质、右侧皮质运动前区和辅助运动区连接强度较强。镜像组左右侧初级体感皮质、左侧皮质运动前区和辅助运动区与右侧M1区、右侧皮质运动前区和辅助运动区与左侧初级体感皮质、左侧M1区与左侧初级体感皮质、左侧初级体感皮质与右侧M1区的连接强度强于对照组(|t|> 3.402,P <0.01)。结论 镜像疗法有助于改善脑卒中后Ⅰ型CRPS患者患手的疼痛、水肿和上肢运动功能。镜像疗法可加强健侧感觉区与患侧感觉运动区的连接,促进感觉运动皮质重组。 展开更多
关键词 脑卒中 复杂区域性疼痛综合征 镜像疗法 上肢 大脑皮质 随机对照试验
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1例利多卡因治疗未成年人复杂性区域性疼痛综合征的用药分析
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作者 任倩 郭琳 《药学研究》 CAS 2024年第8期820-822,832,共4页
复杂区域疼痛综合征通常继发于原发性创伤和骨折术后可能出现严重难治性、多性疼痛的综合征或者无意识的轻微创伤,以营养不良和功能失调为特征。目前临床主要治疗是多模式疼痛管理,然而长期多种药物联合应用可能产生较大的副作用。本文... 复杂区域疼痛综合征通常继发于原发性创伤和骨折术后可能出现严重难治性、多性疼痛的综合征或者无意识的轻微创伤,以营养不良和功能失调为特征。目前临床主要治疗是多模式疼痛管理,然而长期多种药物联合应用可能产生较大的副作用。本文重点对1例利多卡因局部皮下注射的治疗复杂性区域性疼痛综合征的合理用药分析,运用循证药学的思维对该患者用药分析讨论,提供用药建议和用药教育,促进临床特殊人群镇痛药物的合理使用。 展开更多
关键词 复杂性区域性疼痛综合征 利多卡因 加巴喷丁 合理用药 未成年人
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Pain management of hemiplegic shoulder pain post stroke in patients from Nanjing,China 被引量:14
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作者 Yi Zhu Bin Su +1 位作者 Ning Li Hongzhu Jin 《Neural Regeneration Research》 SCIE CAS CSCD 2013年第25期2389-2398,共10页
We selected 106 hemiplegic patients with shoulder pain hospitalized after stroke from three hospi- tals in Nanjing, China between February 2007 and January 2012. All patients had complete clinical data sets and accoun... We selected 106 hemiplegic patients with shoulder pain hospitalized after stroke from three hospi- tals in Nanjing, China between February 2007 and January 2012. All patients had complete clinical data sets and accounted for 45.5% of the inpatients because of stroke. Results showed that the number of patients with hemiplegic shoulder pain post stroke increased yearly, attacking mainly males 50-69 years of age. Of 106 patients, there were 60 cases (56.6%) of adhesive capsulitis, 19 (17.9%) of shoulder subluxation, 14 (13.2%) of complex regional pain syndrome, and 13 (12.6%) of central pain. The main symptoms were shoulder pain (100%), limit of shoulder mobility (98.1%), and adhesion of the scapula (56.6%). MRI of the shoulder showed tendon and ligament lesions (57.1%) and rotator cuff tear (38.1%). 53.8% of central pain was related to the thalamus, in addition to the basal ganglia, brain stem, and cerebellopontine angle. Shoulder pain, upper limb motor function, and function independence were significantly improved after comprehensive rehabilitation. In par- ticular, electroacupuncture based on basic physical therapy exhibited efficacy on shoulder subluxa- tion and complex regional pain syndrome. Multiple linear regression results showed a negative re- lationship of efficacy of pain management with the attack period of shoulder pain, involvement of the posterior limb of the internal capsule, and duration between onset and rehabilitation treatment, but a positive correlation with pain-related education, pain regression period, and pain diagnosis. 展开更多
关键词 neural regeneration brain injury hemiplegia post stroke shoulder pain adhesive capsulitis shoulder subluxation complex regional pain syndrome grants-supported paper NEUROREGENERATION
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