腰椎间盘突出症患者手部疼痛敏感性与手术前后患者功能、疼痛、健康状况的关系  

The relationship between hand pain sensitivity and the function, pain and health status before and after operation in patients with lumbar intervertebral disc herniation

作　　者：林思薪 曾巧[1] 陈炳泉[1] LIN Sixin;ZENG Qiao;CHEN Bingquan(The Second Department of Bone Injury,Panyu Hospital of Chinese Medicine,Guangdong Province,Guangzhou511400,China)

机构地区：[1]广州市番禺区中医院骨伤二科

出　　处：《中国医药导报》2019年第24期91-94,共4页China Medical Herald

基　　金：广东省中医药局科研项目(20171200)

摘　　要：目的探讨腰椎间盘突出症患者手部疼痛敏感性与手术前后患者功能、疼痛、健康状况的关系。方法选取2016年2月~2018年10月广州市番禺区中医院收治的腰椎间盘突出症患者87例为研究对象,定量感觉检查(QST)用于检测患者手部疼痛敏感性,包括热痛觉阀值(HPT)、冷痛觉阀值(CPT)、压力痛阀值(PPT)。术前及术后3个月采用Oswestry功能障碍指数(ODI)、视觉模拟评分(VAS)、医院焦虑抑郁量表(HADS)、欧洲五维健康量表(EQ-5D)(包括EQ-5D、EQ-VAS)、自我效能量表(SES)评价患者功能、疼痛、健康状况。结果腰椎间盘突出症患者术后ODI、腰部强度VAS、腿部强度VAS、HADS均低于术前(均P<0.05),而EQ-5D、EQ-VAS、SES则高于术前(P<0.05)。腰椎间盘突出症患者手部HPT与手术前后功能、疼痛、健康状况均无显著相关性(P>0.05)。腰椎间盘突出症患者手部CPT与手术前后功能及术后疼痛呈正相关,与SES呈显著负相关(P<0.05),而与术前疼痛、健康状况及术后HADS、EQ-5D、EQ-VAS均无相关性(P>0.05)。腰椎间盘突出症患者手部PPT与术前ODI、HADS、术后ODI呈显著负相关(P<0.05),而与手术前后SES呈正相关(P<0.05)。结论手部疼痛敏感性中的CPT、PPT与术后较高的疼痛程度以及较低的自我效能和功能存在一定相关性。Objective To investigate the relationship between hand pain sensitivity and function,pain and health status before and after operation in patients with lumbar intervertebral disc herniation.Methods Eight-seven patients with lumbar intervertebral disc herniation who were admitted to Panyu Hospital of Chinese Medicine in Guangzhou from February 2016 to October 2018 were prospectively selected for the study.Quantitative sensory test(QST)was used to detect the hand pain sensitivity,including heat pain threshold(HPT),cold pain threshold(CPT)and pressure pain threshold(PPT).Oswestry dysfunction index(ODI),visual analogue scale(VAS),hospital anxiety and depression scale(HADS),European five-dimensional health scale(EQ-5D)(including EQ-5D,EQ-VAS),self-efficacy scale(SES)was used to evaluate patients'function,pain and health status before and 3 months after operation.Results The ODI,waist pain intensity VAS,leg pain intensity VAS,HADS anxiety scale and HADS depression scale of patients with lumbar intervertebral disc herniation after operation were lower than those before operation(P<0.05),while EQ-5D,EQ-VAS and SES were higher than those before operation(P<0.05).There was no significant correlation between hand HPT and function,pain,health status before and after operation in patients with lumbar intervertebral disc herniation(P>0.05).CPT in hand of patients with lumbar intervertebral disc herniation was positively correlated with pre-and post-operative function and pain,and negatively correlated with SES(P<0.05),however,there was no correlation with preoperative pain,health status,postoperative HADS,EQ-5D and EQ-VAS(P>0.05).PPT in hands of patients with lumbar intervertebral disc herniation was negatively correlated with preoperative ODI,HADS anxiety scale,HADS depression scale and post-operative ODI(P<0.05),but positively correlated with pre-and post-operative SES(P<0.05).Conclusion CPT and PPT in hand pain sensitivity are correlated with higher postoperative pain degree and lower self-efficacy and function.

关 键 词：腰椎间盘突出症 疼痛敏感性 功能 疼痛 健康状况 

分 类 号：R681[医药卫生—骨科学]