Risk factors associated with pain and pain relief in patients with chronic pancreatitis.

IF 3.6 4区医学 Q1 MEDICINE, GENERAL & INTERNAL

Postgraduate Medical Journal Pub Date : 2025-01-22 DOI:10.1093/postmj/qgae185

Bingqing Li, Yuning Chu, Xiaowei Wang, Pin Meng, Liang Fang, Zi-Bin Tian, Xiaoyu Li

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引用次数: 0

Abstract

Background: Abdominal pain is one of the most prominent symptoms in patients with chronic pancreatitis (CP) and can manifest intermittently or persistently. The mechanism of pain is not yet clear, and no effective treatment is currently available. This study aimed to explore the risk factors for pain in patients with CP, which may provide new insights for developing effective pain control modalities.

Methods: This clinical study was based on a single-centre research database that included 570 patients with CP. We compared the differences in baseline data, clinical characteristics, and psychophysiology traits between patients with and without pain. Subsequently, patients will be followed up to assess changes in their risk factors and explore their relationship with pain.

Results: In the final risk factor model, young age (P = .031; odds ratio [OR] = 0.986 [0.973, 0.999]), prolonged disease duration (P < .001; OR = 1.307 [1.127, 1.516]), heavy smoking (P = .014; OR = 1.331 [1.060, 1.617]), alcohol consumption (P = .003; OR = 1.419 [1.127, 1.788]), low body mass index (P < .001; OR = 0.786 [0.703, 0.879]), pancreatic exocrine insufficiency (P = .040; OR = 1.683 [1.024, 2.767]), acute pancreatitis attacks (P = .027; OR = 1.759 [1.067, 2.902]), anxiety, and depression (P = .016; OR = 1.047 [1.009, 1.088]; P = .014; OR = 1.068 [1.013, 1.126]) were associated with CP pain. Reducing tobacco and alcohol intake (P = .001; OR = 2.367 [1.525, 4.637]; P = .024; OR = 2.011 [1.085, 3.199]), increasing the body mass index (P = .005; OR = 1.968 [1.265, 3.805]), and improving anxiety (P = .001; OR = 1.164 [1.081, 1.340]) were identified to be beneficial for pain relief. Compared to the effects on persistent pain, pancreatic enzyme supplementation (P = .004; OR = 1.794 [1.186, 2.502]) had a clear effect on intermittent pain in patients with CP.

Conclusion: We identified a multifactorial model of pain risk factors for CP and confirmed that modifying these risk factors could influence patient pain symptoms.

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慢性胰腺炎患者疼痛和疼痛缓解的相关危险因素

背景：腹痛是慢性胰腺炎（CP）患者最突出的症状之一，可间歇性或持续性表现。疼痛的机制尚不清楚，目前也没有有效的治疗方法。本研究旨在探讨CP患者疼痛的危险因素，为制定有效的疼痛控制方式提供新的见解。方法：本临床研究基于一个包含570例CP患者的单中心研究数据库。我们比较了有疼痛和无疼痛患者的基线数据、临床特征和心理生理特征的差异。随后，将对患者进行随访，评估其危险因素的变化，并探讨其与疼痛的关系。结果：在最终的危险因素模型中，年龄小(P = .031；优势比[OR] = 0.986[0.973, 0.999])、病程延长(P < 0.001；OR = 1.307[1.127, 1.516])，重度吸烟(P = 0.014；OR = 1.331[1.060, 1.617])，饮酒(P = 0.003；OR = 1.419[1.127, 1.788])，低体重指数(P < .001；OR = 0.786[0.703, 0.879])，胰腺外分泌功能不全(P = 0.040；OR = 1.683[1.024, 2.767])，急性胰腺炎发作(P = 0.027；OR = 1.759[1.067, 2.902])、焦虑和抑郁(P = 0.016；Or = 1.047 [1.009, 1.088]；P = 0.014；OR = 1.068[1.013, 1.126])与CP疼痛相关。减少烟酒摄入(P = .001；Or = 2.367 [1.525, 4.637]；P = 0.024；OR = 2.011[1.085, 3.199])，增加体重指数(P = 0.005；OR = 1.968[1.265, 3.805])，改善焦虑(P = .001；OR = 1.164[1.081, 1.340])有利于缓解疼痛。与对持续性疼痛的影响相比，胰酶补充(P = 0.004；OR = 1.794[1.186, 2.502])对CP患者间歇性疼痛有明显的影响。结论：我们确定了CP疼痛危险因素的多因素模型，并证实改变这些危险因素可以影响患者的疼痛症状。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Postgraduate Medical Journal 医学-医学：内科

CiteScore

8.50

自引率

2.00%

发文量

131

审稿时长

2.5 months

期刊介绍： Postgraduate Medical Journal is a peer reviewed journal published on behalf of the Fellowship of Postgraduate Medicine. The journal aims to support junior doctors and their teachers and contribute to the continuing professional development of all doctors by publishing papers on a wide range of topics relevant to the practicing clinician and teacher. Papers published in PMJ include those that focus on core competencies; that describe current practice and new developments in all branches of medicine; that describe relevance and impact of translational research on clinical practice; that provide background relevant to examinations; and papers on medical education and medical education research. PMJ supports CPD by providing the opportunity for doctors to publish many types of articles including original clinical research; reviews; quality improvement reports; editorials, and correspondence on clinical matters.