PainVision用于带状疱疹后神经痛疼痛评估的临床观察

CLINICAL APPLICATION OF PAINVISION ON POSTHERPETIC NEURALGIA

摘要:

目的：评价PainVision用于带状疱疹后神经痛(postherpetic neuralgia,PHN)疼痛评估的可靠性。方法：选择40位T3-T12节段的PHN患者和40位健康志愿者为研究对象,对PHN患者常规进行药物及脉冲射频治疗,分析PHN患者治疗前后由PainVision所测定的疼痛程度(pain degree,PD)与同步评估的数字疼痛强度量表(numerical rating scale,NRS)、睡眠自评量表(Self-Rating Scale of Sleep,SRSS)、医院焦虑抑郁量表(Hospital Anxiety and Depression Scale,HADS)及简式的Mcgill疼痛问卷表(short form Mcgill pain questionnaire,SF-MPQ)的相关关系,并对PHN患者和健康受试者进行最小感知电流值(current perception threshold,CPT)的测定,了解PHN患者左前臂尺侧(L侧)、疱疹分布最痛点(P侧)及最痛点镜像侧(M侧)CPT值的变化。结果：在治疗前后PD与NRS,SRSS,SF-MPQ均具有较强的相关关系,相关系数γ均大于0.5,P＜0.0001,和入院时相比,在治疗后PD与HADS的相关关系要更强一些(γ=0.680,P＜0.0001)；PHN患者在P侧及M侧的CPT值均大于健康受试者,差异具有统计学意义(P＜0.0001),并且在PHN患者中P侧CPT值要显著高于M侧,差异具有统计学意义(P＜0.0001)。结论：PainVision可定量评估患者的感知功能及疼痛程度,并且与睡眠状况、焦虑抑郁情绪等存在正相关关系,值得在临床推广应用。

Abstract:

Objective:To evaluate the reliability of PainVision for assessment of postherpetic neuralgia(PHN).Methods:Forty patients diagnosed with T3-T12 torso PHN and 40 age-matched healthy volunteers were included in the trial.40 PHN patients were treated with pulsed radiofrequency combined with pharmacological therapy,we discussed the correlation of the pain degree(PD) that was aseessed by PainVision and numerical rating scale(NRS), Self-Rating Scale of Sleep(SRSS), Hospital Anxiety and Depression Scale(HADS),short form Mcgill pain questionnaire(SF-MPQ) at admission and posttreatment.We estimated the differences of current perception threshold(CPT) that were tested by PainVision in PHN subjects and healthy volunteers on the left forearm of ulnar side(L side),the most painful area of distribution of PHN(P site) and mirror-image site(M site). Result:PD and NRS,SRSS,HADS and SF-MPQ were highly correlated (γ＞0.5,P＜0.0001). Compared with admission,PD had an stronger correlation with HADS(γ=0.680,P＜0.0001). healthy volunteers showed significantly lower CPT compared to PHN on P site and M site(P＜0.0001).CPT of P site in PHN subjects was significantly higher on M site.Conclusion: PainVision device was a application for the evaluation of perception function and pain degree.PainVision had an excellence correlation with sleep situation and anxiety or depression,and is worthy of being widely applied in clinic.