The Pharmacologic Approach in Differential Diagnosis of Chronic Pain
The Pharmacologic Approach in Differential Diagnosis of Chronic Pain
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慢性疼痛鉴别诊断的药理学方法
DOI：
10.1097/00007632-197909000-00010
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发表时间：
1979
期刊：
影响因子：
3
通讯作者：
J. Gregg
中科院分区：
文献类型：
--
作者：
J. Ghia;G. Duncan;T. Toomey;W. Mao;J. Gregg
在一个多学科的疼痛门诊环境中，通过使用差别脊柱阻滞（DSB）对100例腰部以下原因不明的慢性疼痛进行了评价。经典的DSB方法，改进为更好地控制心理变量，被认为是一种安全有效的手段，区分各种疼痛机制。我们发现，在所有接受测试的患者中，55%的患者有中枢性或心因性疼痛，30%的患者有交感神经介导的疼痛，相比之下，15%的患者有躯体疼痛。对这些患者的长期随访证实了这一印象。这些结果证实了心理变量的重要性，表明在慢性疼痛患者中，有必要结合常规使用精细诊断DSB程序，使用基于行为的治疗。
Chronic pain of unknown cause below waist level was evaluated in 100 patients by using the Differential Spinal Block (DSB) in a multidisciplinary pain clinic setting. The classic DSB approach, refined for better control of psychologic variables, was found to be a safe and effective means of differentiating various pain mechanisms. We found that, of all patients tested, 55% had pain of central or psychogenic origin and 30% had sympathetically mediated pain, as compared with 15% who had somatic pain. A long-term follow-up of these patients confirmed this impression. These results substantiated the importance of psychologic variables, indicating the necessity for use of behavioral-based therapies in conjunction with the routine use of the refined diagnostic DSB procedure in patients with chronic pain.