类风湿关节炎病人疼痛管理的最佳证据总结  

Best evidence summary for pain management in patients with rheumatoid arthritis

作　　者：吴丽萍 肖丽娜 赖菡青 郭璇 周迅 WU Liping;XIAO Lina;LAI Hanqing;GUO Xuan;ZHOU Xun(School of Nursing,Guizhou University of Traditional Chinese Medicine,Guizhou 550025 China)

机构地区：[1]贵州中医药大学护理学院,550025 [2]贵州中医药大学第二附属医院,550001

出　　处：《全科护理》2025年第6期1127-1133,共7页Chinese General Practice Nursing

摘　　要：目的:评价和总结类风湿关节炎病人疼痛管理的相关证据,为临床类风湿关节炎病人疼痛护理干预提供循证依据。方法:系统检索国内外指南网、中英文数据库及相关网站中关于类风湿关节炎疼痛管理的相关证据,文献类型包括临床决策、指南、证据总结、专家共识和系统评价。检索时限为建库至2023年11月16日,由2名研究者独立进行文献质量评价、证据提取及级别评定。结果:纳入17篇文献,包括6篇指南、1篇临床决策、1篇专家意见和9篇系统评价。从疼痛评估、治疗原则和选择、药物治疗、中医治疗、物理治疗、职业疗法、运动干预、辅助器具使用、饮食与体重管理、自我管理与教育、心理治疗11个类别进行整合,汇总出31条最佳证据。结论:类风湿关节炎病人疼痛管理的相关证据,可为临床医护人员制订疼痛管理干预方案提供循证依据,医护人员可结合临床情景,为病人提供针对性、科学化的疼痛管理指导。Objective:To evaluate and summarize the evidence related to pain management in patients with rheumatoid arthritis(RA)and provide an evidence⁃based foundation for clinical pain nursing interventions.Methods:Systematic searches were conducted in domestic and international guideline websites,Chinese and English databases,and relevant websites for evidence on RA pain management.Literature types included clinical decision⁃making documents,guidelines,evidence summaries,expert consensuses,and systematic reviews.The search period covered from database inception to November 16,2023.Two researchers independently performed literature quality evaluation,evidence extraction,and evidence grading.Results:A total of seventeen articles were included,comprising 6 guidelines,1 clinical decision⁃making document,1 expert opinion,and 9 systematic reviews.The evidence was synthesized across 11 categories,pain assessment,treatment principles and options,pharmacotherapy,traditional Chinese medicine(TCM)therapy,physical therapy,occupational therapy,exercise interventions,assistive device utilization,diet and weight management,self⁃management and education,and psychological therapy.A total of 31 best evidence statements were summarized.Conclusions:The synthesized evidence on pain management in RA patients offers an evidence⁃based foundation for healthcare professionals to develop tailored intervention protocols.Clinicians can integrate this evidence with clinical contexts to provide patients with targeted and scientifically grounded pain management guidance.

关 键 词：类风湿关节炎 疼痛管理 证据总结 循证护理 

分 类 号：R473.5[医药卫生—护理学]