2024 年第 2 期 第 19 卷

带状疱疹后遗神经痛患者疼痛灾难化的现状和影响因素分析

Analysis of the current status and influencing factors of pain catastrophizing in patients with postherpetic neuralgia

作者：张文文张喜维何明伟孙海燕庞金磊

英文作者：Zhang Wenwen Zhang Xiwei He Mingwei Sun Haiyan Pang Jinlei

单位：首都医科大学附属北京安贞医院疼痛科，北京100029

英文单位：Department of Pain Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

关键词：带状疱疹；后遗神经痛；疼痛灾难化；影响因素

英文关键词：Herpeszoster;Postherpeticneuralgia;Paincatastrophizing;Influencingfactors

• 摘要：

• 目的  探究带状疱疹后遗神经痛(PHN)患者疼痛灾难化（PC）的现状和影响因素。方法  选取2019年3月至2022年3月于首都医科大学附属北京安贞医院就诊的PHN患者为研究对象，通过调查问卷收集PHN患者的一般资料、疼痛灾难化量表（PCS）得分、住院期间治疗措施、广泛性焦虑障碍量表（GAD-7）和抑郁筛查量表（PHQ-9）得分。采用单因素和多因素分析方法探究PCS得分的影响因素。结果  最终纳入303例PHN患者的调查数据，PCS得分为（30±10）分，其中有65例患者的PCS得分≥38分，占21.5%；164例（54.1%）患者的PHQ-9得分≥5分；176例（58.1%）患者的GAD-7得分≥5分。单因素分析结果显示，年龄≥60岁、未接受椎旁神经阻滞和止痛药物治疗、GAD-7和PHQ-9得分≥5分患者PCS得分更高（均P＜0.05）。多元线性回归分析结果显示，椎旁神经阻滞和止痛药物治疗、PHQ-9得分和GAD-7得分是PHN患者PCS得分的独立影响因素（均P＜0.05）。结论  PHN患者中出现PC的比例较高，超过一半的患者存在不同程度的焦虑和抑郁。此外，椎旁神经阻滞治疗可能是减轻PC的有效方法之一。同时，抑郁和焦虑的严重程度也需要被重视，因为它们可能与PC的发生和严重程度密切相关。

• Objective  To investigate the current status of pain catastrophizing (PC) and its influencing factors in patients with postherpetic neuralgia (PHN). Methods  PHN patients admitted to Beijing Anzhen Hospital, Capital Medical University from March 2019 to March 2022 were selected as the study subjects. General information of the PHN patients, Pain Catastrophizing Scale (PCS) scores, treatment measures during hospitalization, Generalized Anxiety Disorder 7-item scale (GAD-7) scores, and Patient Health Questionnaire-9 (PHQ-9) scores were collected through a questionnaire survey. Univariate and multivariate analyses were conducted to explore the main factors influencing PCS scores. Results  A total of 303 PHN patients were included in the survey. The average PCS score was (30±10), and 65 patients had PCS scores ≥38, accounting for 21.5%. PHQ-9 scores ≥ 5 were observed in 164 patients (54.1%), and GAD-7 scores ≥5 were observed in 176 patients (58.1%). Univariate analysis showed that patients aged ≥60 years, those who did not receive paravertebral nerve block treatment, pain medication treatment, and those with GAD-7 and PHQ-9 scores ≥5 had higher PCS scores(all P＜0.05). Multivariate linear regression analysis revealed that paravertebral nerve block treatment, pain medication treatment, PHQ-9 scores, and GAD-7 scores were independent influencing factors of PCS scores in PHN patients(all P＜0.05). Conclusions    The prevalence of PC is high in PHN patients, with more than half of the patients experiencing varying degrees of anxiety and depression. Furthermore, paravertebral nerve block treatment may be an effective method for alleviating pain catastrophizing. The severity of depression and anxiety should also be given attention, as they may be closely related to the occurrence and severity of pain catastrophizing.