自主神经功能监测在躯体症状障碍患者临床评估中的研究进展

Progress in Autonomic Nervous System Monitoring for Clinical Assessment of Somatic Symptom Disorders

摘要:

躯体症状障碍（somatic symptom disorders, SSD）与慢性疼痛高度重叠，疼痛是SSD患者最常见的躯体症状之一，疼痛科医师在SSD的高效评估和准确诊断上面临着重大挑战。常用量表评估难以充分解释和处理这些问题，临床需要客观、可靠的方法来改善以疼痛为表现的SSD患者的评估。新近研究提示自主神经功能改变在SSD发生与维持中扮演着重要角色。心率变异性、交感神经皮肤反应及红外热成像皮温检测等自主神经功能监测指标，为SSD临床评估带来了新方向。本文旨在系统综述主流自主神经功能监测技术在 SSD评估中的最新研究进展，并对这些方法的优点、局限性进行深入剖析，以期为临床实践提供新的视角和方法。

Abstract:

There is a complex interrelationship between SSD and chronic pain, while pain is a common complaint among SSD patients. The situation poses substantial challenges for pain specialists in efficiently evaluating and accurately diagnosing SSD. Traditional assessment tools often fall short in adequately explaining and addressing these issues, and there is a clinical need for objective and reliable methods to improve the evaluation of SSD patients presenting with pain. Recent studies have shown that autonomic nervous system function alterations are crucial in the onset and maintenance of SSD. Biomarkers reflecting autonomic nervous system status, such as heart rate variability, sympathetic skin response, and abnormal skin temperature distribution patterns, have introduced new directions for the clinical assessment of SSD. This article aims to systematically review the latest research progress of mainstream autonomous nervous system function monitoring techniques in SSD evaluation. We also delve into the advantages and limitations of each method to provide new perspectives and strategies for clinical practice.