综合心理干预对脊髓损伤后神经病理性疼痛的疗效

摘要

目的:探讨综合心理干预对脊髓损伤后神经病理性疼痛病人焦虑、抑郁情绪以及疼痛强度的影响.方法:选取脊髓损伤并伴有神经病理性疼痛的住院病人72例,随机分为干预组和对照组各36例.两组病人入院后均实施常规康复治疗,干预组在此基础上,实施综合心理干预.在治疗前及治疗3个月后采用焦虑自评量表(self-rating anxiety scale,SAS)和抑郁自评量表(self-rating depression scale,SDS)评价病人情绪状况,疼痛视觉模拟评分(visual analogue scale,VAS)评价病人疼痛强度.结果:最终干预组34例、对照组33例完成随访.两组病人治疗前SAS、SDS、VAS评分均无统计学差异(P>0.05).治疗后干预组SAS、SDS评分显著低于治疗前,差异有统计学意义(P<0.01),对照组病人SAS、SDS评分均无显著性改善(P>0.05).两组VAS评分同治疗前比较无显著性改善(P>0.05).结论:综合心理干预虽然不能减轻脊髓损伤后神经病理性疼痛病人的疼痛强度,但可以显著改善其焦虑抑郁的负性情绪,对于该病的治疗具有重要作用.%Objective:This study was performed to investigate the effects of comprehensive psychological intervention on anxiety, depression and pain in patients with neuropathic pain after spinal cord injury. Methods:A total of 72 patients with spinal cord injury and neuropathic pain were enrolled. The patients were randomly allocated to the interventional group (n=36) and the control group (n=36). Patients in the interventional group received comprehensive psychological intervention and routing nursing care. Patients in the control group received routing nursing care. The patients were evaluated before treatment and 3 months after treatment using self-rating anxiety scale (SAS), self-rating depression scale (SDS) for mood, and visual analogue scale (VAS) for pain intensity.Results:A total of 67 patients (34 in the interventional group, 33 in the control group) completed the trial. At the baseline, there were no differences in SAS, SDS and VAS in two groups (P> 0.05). After treatment, the level of anxiety and depression in the interventional group decreased significantly compared with baseline value (P< 0.01). There were no significant differences in the change of anxiety and depression in the control group (P> 0.05). No improvement was found for pain intensity in neither group (P> 0.05).Conclusions: Comprehensive psychological intervention may not reduce pain intensity, but it can help patients with spinal cord injury and neuropathic pain relieve anxiety and depression. It can be a valuable complement in the treatment of neuropathic pain after spinal cord injury.