慢性肌肉骨骼疼痛患者的生物社会心理因素和中枢敏感化

T. Alagappan
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摘要

中枢致敏(CS)是一种神经系统的敏感现象,使患者感觉到更多的疼痛和更广泛的不适。然而,与感知现象相关的生物社会心理因素仍在继续探索,并进一步加深了目前对慢性肌肉骨骼疼痛患者CS的认识。本研究的主要目的是确定慢性肌肉骨骼疼痛患者的中枢神经系统敏化和生物社会心理测量之间的关联程度。背景和设计:一项观察性横断面研究在一家三级护理医院的门诊部进行。方法与材料:对200例慢性肌肉骨骼疼痛患者进行横断面研究。完成中枢致化量表(CSI)、坦帕运动恐惧症量表(TSK)、疼痛灾变指数(PCI)、失眠严重程度指数(ISI)、广泛疼痛指数(WPI)、症状严重程度评分(SS)、Kessler心理困扰量表(K10 Score)和疲劳严重程度量表(FSS)等问卷调查。结果:生物心理社会因素与CSI评分、FSS呈轻度至中度相关(r=0.432);啧啧(r = 0.432);K10评分(r=0.450)、PCI评分(r=0.465);总(WPI+SS)评分(r=0.467)和ISI评分(r=0.249)。在有统计学意义的层次回归模型中,这些生物心理社会因素在CSI评分上的方差为37.9% (F- 31.39;P< 0.001),其中运动恐惧症和失眠不满足模型拟合。结论:尽管运动恐惧症与生物社会心理因素有显著的相关性,但它在方差贡献中排除了运动恐惧症和失眠。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Bio Psychosocial Factors and Central Sensitization in Patients with Chronic Musculoskeletal Pain
Introduction: Central sensitization (CS) is a neurological sensitivity phenomenon that causes patients to perceive more pain and broader discomfort. However, the bio psychosocial factors associated with the phenomenon of perception continue to explore and further the current knowledge on CS in patients with chronic musculoskeletal pain. The main purpose of this study was to determine the extent of associative relationship between central nervous system sensitization and bio psychosocial measures in patients with chronic musculoskeletal pain. Settings and Design: An observational cross-sectional study was carried out in a tertiary care hospital’s outpatient unit. Methods and Materials: Two hundred patients with chronic musculoskeletal pain were included in the present cross-sectional study. They completed questionnaires such as Central sensitisation inventory (CSI), Tampa Scale of Kinesiophobia (TSK), Pain Catastrophizing index (PCI), Insomnia Severity Index (ISI), Widespread Pain Index (WPI), Symptom Severity Score (SS), Kessler Psychological Distress Scale (K10 SCORE) and Fatigue Severity Scale (FSS). Results: The bio psychosocial factors showed mild to moderate correlation with CSI score ,FSS (r=0.432); TSK (r=0.432); K10 score (r=0.450);PCI score (r=0.465); Total (WPI+SS) score (r=0.467) and ISI score(r=0.249).These bio psychosocial factors in a statistically significant hierarchical regression model showed 37.9 % variance on CSI score (F- 31.39;P< 0.001) where kinesiophobia and Insomnia did not satisfy the model fit. Conclusion: Even the CS showed a significant association with bio psychosocial factors, it kept kinesiophobia and Insomnia out in its variance contribution.
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