Pain threshold variations in somatic wall tissues as a function of menstrual cycle, segmental site and tissue depth in non-dysmenorrheic women, dysmenorrheic women and men
Pain threshold variations in somatic wall tissues as a function of menstrual cycle, segmental site and tissue depth in non-dysmenorrheic women, dysmenorrheic women and men
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DOI：
10.1016/s0304-3959(97)03362-9
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发表时间：
1997-06-01
期刊：
影响因子：
7.4
通讯作者：
Vecchiet, L
中科院分区：
文献类型：
--
作者：
Giamberardino, MA;Berkley, KJ;Vecchiet, L
据报道，许多疾病的疼痛症状随着月经阶段的不同而不同。本研究调查了正常女性对皮肤、皮下和肌肉组织电刺激的痛阈值如何随月经阶段而变化，并将这些变化与痛经女性和健康男性在匹配的间隔时间进行比较。在一个月经周期的过程中，在四个部位测量三种组织的阈值四次。其中两个位于子宫内脏的腹部(腹部-腹直肌，左右)，两个位于子宫内脏的四肢(腿-股四头肌，手臂-三角肌)。从月经开始(第0天)计算，所研究的月经期为月经期(第2-6天)、排卵期(第12-16天)、黄体期(第17-22天)和经前期(第25-28天)。与月经相关的自发性疼痛是通过VAS量表上的日记估计来衡量的。无论刺激部位或刺激深度，黄体期阈值最高，皮肤阈值最低，肌肉/皮下组织阈值最低。痛经加重了月经期的影响。对于无痛经的女性，月经趋势仅在腹部肌肉和皮下组织显著，但对于痛经女性来说，腹部皮肤、四肢肌肉和皮下组织也有明显的月经趋势。痛经也会降低阈值，主要是肌肉，有时是皮下组织，但不会降低皮肤，左腹肌的痛觉过敏效应最大。腹部部位比四肢母猪更容易受到月经的影响。腹部的肌肉阈值，而不是皮肤或皮下阈值，明显低于四肢，尤其是痛经女性。腹肌痛觉过敏的程度与自发性月经痛的程度显著相关。在手臂和腿部的痛阈值方面，只有微小的性别差异，但男性一致拒绝在腹部部位进行测试，而女性则不是。这些结果表明，月经阶段、痛经状态、节段位置、组织深度和性别都对痛觉阈值有独特的交互作用，因此在进入个人判断刺激是否疼痛的漫长且仍在增长的生物因素列表中增加了更多项目。(C)1997年国际疼痛研究协会。
Pain symptoms of many disorders are reported to vary with menstrual stage.:This study investigated how pain thresholds to electrical stimulation of the skin, subcutis and muscle tissue varied with menstrual stage in normal women and compared these variations with those in women with dysmenorrhea and in healthy men at matched intervals. Thresholds of the three tissues were measured four times during the course of one menstrual cycle at four sites. Two of the sites were on the abdomen within the uterine viscerotome (abdomen-rectus abdominis, left and right) and two were outside it on the limbs (leg-quadriceps, arm-deltoid). Calculated from the beginning of menstruation (day 0), the menstrual phases studied were menstrual (days 2-6), periovulatory (days 12-16), luteal (days 17-22) and premenstrual (days 25-28). Spontaneous pain associated with menstruation was measured from diary estimates on a VAS scale. Whereas the highest thresholds always occurred in the luteal phase regardless of segmental site or stimulus depth, the lowest thresholds occurred in the periovulatory stage for skin, whereas those for muscle/subcutis occurred perimenstrually. Dysmenorrhea accentuated the impact of menstrual phase. For non-dysmenorrheic women menstrual trends were significant only in abdominal muscle and subcutis, but for dysmenorrheic women the trends were also significant in abdominal skin and in limb muscle and subcutis. Dysmenorrhea also lowered thresholds mainly in muscle and sometimes in subcutis, but never in skin, with the greatest hyperalgesic effects in left abdominis muscle. Abdominal sites were more vulnerable to menstrual influences than limb sires. Muscle thresholds, but not skin or subcutis thresholds, were significantly lower in abdomen than in limbs, particularly in dysmenorrheic women. The amount of abdominal muscle hyperalgesia correlated significantly with the amount of spontaneous menstrual pain. Only minor sex differences were observed for pain thresholds of the arm and leg, but there was a unanimous refusal by men, but not by women, to be tested at abdominal sites. These results indicate that menstrual phase, dysmenorrhea status, segmental site, tissue depth and sex all have unique interacting effects on pain thresholds, thus adding more items to the lengthy and still-growing list of biological factors that enter into an individual's judgment of whether or not a stimulus is painful. (C) 1997 International Association for the Study of Pain.