Relationships of abdominal pain, reports to visceral and temperature pain sensitivity, conditioned pain modulation, and heart rate variability in irritable bowel syndrome
Relationships of abdominal pain, reports to visceral and temperature pain sensitivity, conditioned pain modulation, and heart rate variability in irritable bowel syndrome
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DOI：
10.1111/nmo.12812
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发表时间：
2016-07-01
影响因子：
3.5
通讯作者：
Heitkemper, M. M.
中科院分区：
文献类型：
--
作者：
Jarrett, M. E.;Han, C. J.;Heitkemper, M. M.
背景肠易激综合征（IBS）是一种异质性疾病，有许多病理生理机制似乎有助于症状慢性化。其中之一就是疼痛敏感性的改变。方法在社区招募18-45岁的妇女.在入选的患者中，56例患有IBS，36例为健康对照（HC）女性。参与者完成问卷调查，记录4周症状日记，并进行12小时霍尔特，以评估夜间心率变异性，包括高频功率（HF），低频功率（LF）和总功率（TP）。在卵泡中期，大约80%的女性完成了热疼痛敏感性测试，条件性疼痛调制和内脏疼痛敏感性使用水负荷症状激发（WLSP）测试。关键结果正如预期的那样，IBS组的每日腹痛显著高于HC组。肠型亚组之间无差异（IBS-腹泻[ IBS-D]、IBS-便秘+混合型[IBS-CM]）。IBS组和HC组之间的热疼痛敏感性没有差异，但IBS-CM组的热疼痛敏感性显著高于IBS-D组。在WLSP测试中，IBS组经历的症状困扰显著多于HC组，IBS-CM组高于IBS-D组。心率变异性指标在各组或IBS亚组之间没有差异。IBS组每日腹痛与LF、TP呈正相关。结论与推论尽管IBS患者的腹痛水平相似，但IBS-CM组对热测试和内脏测试程序表现出更高的敏感性。
Background Irritable bowel syndrome (IBS) is a heterogeneous condition with a number of pathophysiological mechanisms that appear to contribute to symptom chronicity. One of these is altered pain sensitivity. Methods Women between ages 18-45 were recruited the community. Of those enrolled, 56 had IBS and 36 were healthy control (HC) women. Participants completed questionnaires, kept a 4-week symptom diary and had a 12-h Holter placed to assess night-time heart rate variability including high frequency power (HF), low frequency power (LF), and total power (TP). At mid-follicular phase approximately 80% of women completed a thermal pain sensitivity test with conditioned pain modulation and visceral pain sensitivity using a water load symptom provocation (WLSP) test. Key Results As expected, daily abdominal pain was significantly higher in the IBS compared to HC group. There were no differences between the bowel pattern subgroups (IBS-diarrhea [ IBS-D], IBS-constipation plus mixed [IBS-CM]). Thermal pain sensitivity did not differ between the IBS and the HC groups, but was significantly higher in the IBS-CM group than the IBS-D group. In the WLSP test, the IBS group experienced significantly more symptom distress than HCs and the IBS-CM group was higher than the IBS-D group. Heart rate variability indicators did not differ between the groups or IBS subgroups. Daily abdominal pain was positively correlated with LF and TP in the IBS group. Conclusions & Inferences Despite similar levels of abdominal pain in IBS, the IBS-CM group demonstrated greater sensitivity to both thermal and visceral testing procedures.