Philosophy and efficacy of multidisciplinary approach to chronic pain management.
Philosophy and efficacy of multidisciplinary approach to chronic pain management.
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DOI：
10.1007/bf02480093
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发表时间：
1998-09-01
影响因子：
2.8
通讯作者：
Turk, Dennis C
中科院分区：
文献类型：
--
作者：
Okifuji, Akiko;Turk, Dennis C
流行病学研究表明，超过40%的普通人群经历持续性或复发性疼痛[1，2]。这些人中的许多人进行正常的生活活动，没有明显的中断;然而，有些人的生活由于持续的疼痛问题而受到严重影响。慢性疼痛的不良反应经常扩展到患者的家庭，影响家庭成员的健康[3 - 5]。慢性疼痛不仅对生活质量产生不利影响，而且还具有深远的社会经济影响，因为慢性疼痛通常与生产力的丧失以及医疗保健和福利的使用增加有关。在过去的三十年里，人们已经做出了大量的努力来确定慢性疼痛的病因，病理生理学和有效的治疗。然而，尽管在感觉生理学、解剖学和生物化学方面的知识取得了重大进展，并且开发了新的强效药物和其他创新的医疗和外科手术，但许多慢性疼痛患者仍然遭受持续的疼痛和严重的残疾。近年来，鉴于有限的医疗资源，治疗的成本效益变得越来越重要。因此，需要对其有效性的经验证据进行批判性评价。本文的主要目的是回顾多学科治疗慢性疼痛的疗效。美国有许多多学科疼痛中心（MPC），慢性疼痛患者由具有各种医疗保健背景的临床医生团队治疗。我们先来回顾一下
Epidemiological studies have indicated that over 40% of the general population experience persistent or recurrent pain [1, 2]. Many of these individuals carry on their normal life activities without significant interruption; however, there are some whose lives are substantially compromised due to persistent pain problems. Adverse effects of chronic pain are frequently extended to the patient's family, affecting the well-being of family members [3-5]. Not only does chronic pain adversely affect quality of life, but it also has profound socioeconomic implications because chronic pain is frequently associated with loss of productivity as well as increased use of health care and welfare benefits. Over the past three decades, intensive efforts have been made to identify the etiology, pathophysiology, and effective treatment of chronic pain. However, despite major advances in knowledge of sensory physiology, anatomy, and biochemistry and the development of new, potent medications and other innovative medical and surgical procedures, many chronic pain patients continue to suffer from unremitting pain and significant disability.In recent years, the cost-effectiveness of therapies has become increasingly relevant in light of the limited health care resources. Consequently, critical evaluations of the empirical evidence for its efficacy are desired. The primary purpose of this paper is to review the efficacy of multidisciplinary treatment of chronic pain. Many multidisciplinary pain centers (MPCs) are available in the United States where chronic pain patients are treated by teams of clinicians with various health care backgrounds. We will first review the basic