Complex Regional Pain Syndrome: What's in a Name?
Complex Regional Pain Syndrome: What's in a Name?
复制标题
DOI：
10.1016/j.jpain.2010.06.001
复制
发表时间：
2011-01-01
期刊：
影响因子：
4
通讯作者：
Coderre, Terence J.
中科院分区：
文献类型：
--
作者：
Coderre, Terence J.
在20世纪40年代的两年内，两名波士顿医生发表了关于现在被称为复杂区域疼痛综合征（CRPS）的综合征的根本性质的截然不同的观点。埃文斯在1946年至1947年的几篇论文中提出，“交感神经反射使患肢保持疼痛和营养不良。1947年，Fovenstein提出动脉血管痉挛是这种疼痛综合征的关键病因。埃文斯的假说为这种综合征建立了60年的命名法，他的术语“反射性交感神经营养不良”在同一时期指导了临床治疗和研究活动。Focal提出的命名法没有得到承认，实际上对该领域没有任何影响。最近的证据表明，埃文斯对该领域的贡献实际上可能导致临床医生和研究人员误入歧途所有这些年。这篇关于CRPS的焦点文章将最近的观察结果与这两个早期的理论进行了比较，并提出了一个问题-如果我们从一开始就采用Focal的命名法会怎么样？视角：本文讨论了两个对立的历史观点的病因是什么现在被称为CRPS，以及他们如何影响命名，研究和临床治疗在随后的几十年。这篇焦点文章可以帮助研究人员和临床医生认识到综合征名称的重要性，以及它们如何无意中误导研究和治疗。(C)2011年美国疼痛协会American Pain Society
Within a 2-year period in the 1940s, 2 Boston physicians published dramatically opposing views on the underlying nature of a syndrome now known as complex regional pain syndrome (CRPS). Evans suggested, in several papers in 1946-1947, 'that sympathetic reflexes maintain pain and dystrophy in affected limbs. Foisie, in 1947, suggested arterial vasospasms were key in the etiology of this pain syndrome. Evans' hypothesis established the nomenclature for this syndrome for 60 years, and his term, "reflex sympathetic dystrophy," guided clinical treatment and research activities over the same period. Foisie's proposed nomenclature was unrecognized, and had virtually no impact on the field. Recent evidence suggests that Evans' contribution to the field may have in fact led clinicians and researchers astray all those years. This focus article on CRPS compares recent observations with these 2 earlier theories and asks the question-what if we had adopted Foisie's nomenclature from the beginning?Perspective: This article discusses 2 opposing historical views on the etiology of what is now known as CRPS, and how they affected nomenclature, research, and clinical therapy in subsequent decades. This focus article may help researchers and clinicians realize the importance of syndrome names, and how they may inadvertently misdirect research and treatment. (C) 2011 by the American Pain Society