肩痛患者疼痛之臨床評估

對於疼痛的感覺，因人而異，受多方因素的影響，包括疼痛的部位、程度以及病程，和個人主觀的認知：同時也受情感與情緒等原因所左右。為了了解病人對於疼痛主觀感受及客觀評估之間的關係，我們收集了23位肩部疼痛的病人，包括肌腱炎，旋轉肌群部分斷裂及旋轉肌群完全斷裂開刀後的各類疾病。病人每週接受三次治療並且至少追蹤二個月。我們在第一、二次治療，第一、二週第一、二月分別於治療前後對病人患側和健側作測試，包括以疼痛視似圖（pain visual analogue）讓他們對自己疼痛的程度作主觀的描述，另外測試者則以熱源，經皮電氣刺激器（TENS）和自製簡易壓力器評估病人治療前後的感覺靈敏度（sensitivity）痛閾（pain threshold）以及最大忍受程度（pain tolerance）。測試結果發現，患者之健側痛閾和疼痛忍受的程度較患側高，同時雖然主客觀之各項評估值未見明顯相關，但在治療進步後，它刺激及溫覺之痛閾和疼痛忍受程度普遍上升，感覺靈敏度與患健側治療或主觀進步無關。

關鍵字

無資料

並列摘要

The conscious perception of pain that is evoked by a noxious stimulus is a multidimensional process that involves both a subjective evaluation of the sensory aspects of the stimulus (intensity, duration, location) as well as an affective or emotional response to that stimulus. The purpose of this invesigation was to develop a simple, reproducible, systemic measurement to realize the relationship between subjective and objective evaluation. The protocal evaluation includes the following measurement of pain: (1) visual analogue pain scale (2) heat stimulation (3) TENS (4) pressure pain. Twenty-three subjects with shoulder pain due to rotator cuff tendonitis, rotator cuff partial tear or complete tear after operation were evaluated. Each patient received 3 times of treatment per week, and was followed up for at least 2 months. We investigated their sensitivity, pain threshold, and pain tolerance of sound sides and lesion sides before and after treatment at each time. The data revealed that pain threshold and pain tolerance were significantly higher on the sound side than on the lesion side. The pain tolerance of TENS and heat stimulation increased as patients felt much better after one month's treatment. There was no difference in sensitivity of therapeutic trial. The pressure pain was not predictive of change in objective pain score or subjective pain measurement in our study.

並列關鍵字

rotator cuff ； pain visual analogue ； TENS

國際替代計量

肩痛患者疼痛之臨床評估

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