Effects of treatment of peripheral pain generators in fibromyalgia patients
Effects of treatment of peripheral pain generators in fibromyalgia patients
复制标题
DOI：
10.1016/j.ejpain.2010.09.002
复制
发表时间：
2011-01-01
影响因子：
3.6
通讯作者：
Giamberardino, Maria Adele
中科院分区：
文献类型：
--
作者：
Affaitati, Giannapia;Costantini, Raffaele;Giamberardino, Maria Adele
纤维肌痛综合征（FS）经常与局部疼痛疾病共同发生。患有（1）FS +触发点肌筋膜疼痛综合征（n = 68）或（2）FS +关节疼痛（n = 56）的女性患者接受肌筋膜/关节症状[疼痛发作的次数/强度，触发/关节部位的压痛阈值、扑热息痛摄入量]和FS症状[疼痛强度、压痛点的压痛阈值、非疼痛部位皮肤、皮下组织和肌肉的压痛和电痛阈值]。两种方案的患者被随机分配到两组[（1）组各34名;（2）组各28名]，在第1天和第4天接受活性或安慰剂局部TrP或联合治疗[注射/水电泳]。在第4天和第8天重复评估。治疗后，在活性药物治疗组（而非安慰剂治疗组）中：肌筋膜/关节发作的次数和强度以及对乙酰氨基酚消耗量减少，触发/关节压力阈值增加（p < 0.001）;在压痛点和非疼痛部位，FS疼痛强度降低，所有阈值进行性升高在第8天，所有安慰剂治疗的患者都要求积极的局部治疗（第8天和第11天），而只有3名患者在积极治疗下。在3周的随访中，未接受进一步治疗的患者的FS疼痛仍然低于基础疼痛，而接受积极治疗的患者从第8天开始疼痛减轻（p < 0.0001）。局部肌肉/关节疼痛对FS有显著影响，可能是通过外周输入增加中枢敏感性;建议对纤维肌痛进行系统识别和治疗。(C)2010年，国际疼痛分会研究协会欧洲联合会。由爱思唯尔有限公司出版。保留所有权利。
Fibromyalgia syndrome (FS) frequently co-occurs with regional pain disorders. This study evaluated how these disorders contribute to FS, by assessing effects of local active vs placebo treatment of muscle/joint pain sources on FS symptoms.Female patients with (1) FS + myofascial pain syndromes from trigger points (n = 68), or (2) FS + joint pain (n = 56) underwent evaluation of myofascial/joint symptoms [number/intensity of pain episodes, pressure pain thresholds at trigger/joint site, paracetamol consumption] and FS symptoms [pain intensity, pressure pain thresholds at tender points, pressure and electrical pain thresholds in skin, subcutis and muscle in a non-painful site]. Patients of both protocols were randomly assigned to two groups [34 each for (1); 28 each for (2)] to receive active or placebo local TrP or joint treatment [injection/hydroelectrophoresis] on days 1 and 4. Evaluations were repeated on days 4 and 8.After therapy, in active - but not placebo-treated groups: number and intensity of myofascial/joint episodes and paracetamol consumption decreased and pressure thresholds at trigger/joint increased (p < 0.001); FS pain intensity decreased and all thresholds increased progressively in tender points and the non-painful site (p < 0.0001).At day 8, all placebo-treated patients requested active local therapy (days 8 and 11) vs only three patients under active treatment. At a 3-week follow-up, FS pain was still lower than basis in patients not undergoing further therapy and had decreased in those undergoing active therapy from day 8 (p < 0.0001).Localized muscle/joint pains impact significantly on FS, probably through increased central sensitization by the peripheral input; their systematic identification and treatment are recommended in fibromyalgia. (C) 2010 European Federation of International Association for the Study of Pain Chapters. Published by Elsevier Ltd. All rights reserved.