Pain Survey in Rheumatology Outpatient Clinics in Taiwan

台灣風濕科門診疼痛調查

葉修誠(Xiu-Cheng Yeh) ； 黃光永(Kuang-Yun Huang) ； 羅淑芬(Shu-Fen Lo) ； 黃春明(Chun-Ming Huang) ； 鄭添財(Tien-Tsai Cheng) ； 陳信華(Hsin-Hua Chen) ； 林理信(Li-Hsin Lin) ； 林世昌(Shih-Chang Lin) ； 周昌德(Chung-Tei Chou)

《Formosan Journal of Rheumatology》 27卷2期 (2013/12) Pp. 59-66

https://doi.org/10.6313/FJR.2013.27(02).06

摘要

目的：於臺灣不同地區的八個醫療中心風濕科門診進行調查，以瞭解台灣人口疼痛之盛行率及特性。方法：在多個醫學中心的風濕科門診對患者進行調查。自2009年7月至9月，臺灣八個醫學中心參與並招募參加者。使用了經設計及驗證、載入到有觸控面板之電腦的調查問卷，由病人自己回答所有問題，再由醫生檢查。結果：自北、中和南地區的八個醫療中心招募總共8,549 病人。62%（共5,316人）的患者有疼痛，其中70%以上具中度至重度疼痛（VAS＞4）。64%的疼痛患者發現慢性疼痛的持續時間超過三個月。調查中最常見的疾病是類風濕性關節炎（RA，24.2%）、退化性關節炎（OA，11.2%）、紅斑性狼瘡（SLE，15.3%）、痛風（11.9%）、僵直性脊椎炎（AS，8.2%）和其他自身免疫性疾病（AID，12.6%）。在5,316位有疼痛的患者，以女性為主（64%）。疼痛量表（visual analogue scale, VAS）的整體平均為4.76。疼痛的盛行率隨年齡增長而增加。在臺灣，中部地區的疼痛盛行率最高（68%），但有著最低的平均疼痛量表值（4.5）。相較之下，南部地區發現有最高的平均疼痛量表值（5.33）。相對於紅斑性狼瘡或自身免疫性疾病，我們注意到在發炎性及非發炎性關節疾病（inflammatory and non-inflammatory joint diseases）和纖維肌痛症（fibromyalgia）明顯有嚴重的疼痛。結論：在疼痛的調查中，即使接受了疼痛的處置，62%的台灣人患者有慢性風濕性疼痛，其中大部分為中至重度疼痛。這可能是由於不適當或不足夠的治療。造成台灣不同地區的疼痛盛行率及嚴重度不同之原因仍未明，應需要進一步的研究。

關鍵字

疼痛 ； 盛行率 ； 風濕疾病 ； 台灣人 ； 疼痛量表

並列摘要

Objective: For this study, a pain survey was conducted in the rheumatology outpatient department (OPD) of eight medical centers in Taiwan to determine the prevalence and characteristics of pain in a Taiwanese rheumatology patient population. Methods: Multi-center pain survey was conducted among Taiwanese patients in rheumatology OPDs. Eight medical centers in Taiwan were enrolled from July to September in 2009 to recruit participants. Using a well-designed and validated pain survey questionnaire that was uploaded to touch-screen computers, all questions were answered by the patients themselves and checked by physicians. Results: In all, 8,549 patients were recruited from 8 medical centers in the northern, central and southern regions; 62% (5,316)) of patients had pain, and among them, more than 70% were suffering from moderate to severe pain (VAS ＞4). Chronic pain with duration of more than three months was found in 64% of the with-pain patients. The most common diseases in this pain survey were rheumatoid arthritis (RA, 24.2%), osteoarthritis (OA, 11.2%), systemic lupus erythematosus (SLE, 15.3%), gout (11.9%), ankylosing spondylitis (AS, 8.2%) and other autoimmune diseases (AID, 12.6%). Of the 5,316 patients with pain, females were predominant (64%). The overall average visual analogue scale (VAS) score was 4.76. The prevalence of pain was increased with age. In Taiwan, the highest pain prevalence (68%), but lowest average VAS (4.5), was observed in the central region. In contrast, the highest average VAS (5.33) was found in the southern region. Severe pain was significant in inflammatory and non-inflammatory joint diseases and in fibromyalgia syndrome, compared with SLE or AID. Conclusion: The pain survey revealed that 62% of Taiwanese patients had chronic rheumatic pain and most of them with moderate to severe pain had received pain management. The pain might have resulted from the inadequate or insufficient treatment. The reason for the differences in pain prevalence and severity in different areas of Taiwan remains unknown and further study is needed.

並列關鍵字

Pain ； prevalence ； rheumatic diseases ； Taiwanese ； VAS