影响类风湿关节炎疼痛的非炎性因素  

Non-inflammatory factors affecting rheumatoid arthritis pain

作　　者：何佳莉 王晓霞[2] 陈慧芳 刘丹[1] HE Jiali;WANG Xiaoxia;CHEN Huifang;LIU Dan(The Graduate School,Shanxi Medical University,Shanxi Province,Taiyuan030001,China;Department of Rheumatism and Immunity,the Second Hospital of Shanxi Medical University,Shanxi Province,Taiyuan030001,China)

机构地区：[1]山西医科大学研究生院,山西太原030001 [2]山西医科大学第二医院风湿免疫科,山西太原030001

出　　处：《中国医药导报》2020年第5期38-40,58,共4页China Medical Herald

基　　金：山西省科技攻关项目（20150313008-4）

摘　　要：类风湿关节炎(RA)是一种以对称性、多关节炎为主要表现的慢性、全身性自身免疫性疾病。“疼痛”是类风湿关节炎最常见的症状。引起类风湿关节炎疼痛的因素是多方面的,除了炎性因素外,非炎性因素包括中枢神经系统调节通路异常、周围关节的损伤、纤维肌痛及慢性广泛性疼痛等都会引起疼痛,此外,包括睡眠障碍、焦虑、抑郁等心理因素,疼痛灾难化及自我效能感等认知反应,积极及消极的行为反应,饮食与肥胖,综合性护理等其他因素也可能影响RA患者的疼痛感知。患者和医生必须认识到并不是所有的疼痛都是炎性的,治疗上除了抗风湿的药物外,还需要考虑非炎性治疗策略。Rheumatoid arthritis(RA)is a chronic,systemic autoimmune disease characterized by symmetry and polyarthritis.“Pain”is the most common symptom of rheumatoid arthritis.Rheumatoid arthritis pain is caused by a variety of factors,in addition to inflammatory factors,non-inflammatory factors including central nervous system regulatory pathway abnormalities,damage to the surrounding joints,fibromyalgia and chronic generalized pain can cause pain,In addition,other factors including psychological factors such as sleep disorders,anxiety and depression,cognitive responses such as pain disaster and self-efficacy,positive and negative behavioral responses,diet and obesity,and comprehensive nursing care may also affect pain perception in RA patients.Patients and physicians must recognize that not all pain is inflammatory,and that non-inflammatory treatment strategies need to be considered in addition to antirheumatic medications.

关 键 词：类风湿关节炎 疼痛 影响因素 纤维肌痛 焦虑 睡眠 

分 类 号：R593.22[医药卫生—内科学]