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慢性疼痛管理中的阿片类药物渴望:退伍军人在疼痛康复中的结构方程模型
Irina A Strigo1,2, Tiffany Toor1, Andrea D Spadoni3,4,5
1Emotion and Pain Laboratory, San Francisco Veterans Affairs Health Care Center, San Francisco, CA 94121, United States.
Military medicine
|November 11, 2025
概括
嗜好阿片类药物没有预测慢性疼痛患者处方阿片类药物使用的变化. 治疗满意度与降低阿片类药物剂量有关,这表明疼痛管理与物质使用障碍有所不同.
科学领域:
- 疼痛管理 疼痛管理
- 成研究 研究成研究
- 临床心理学 临床心理学
背景情况:
- 渴望是滥用药物的已知因素,但其在治疗慢性疼痛的处方阿片类药物使用中的作用尚未得到充分研究.
- 现有的研究主要集中在物质使用障碍的个体上,在了解慢性疼痛群体方面存在差距.
- 这项研究解决了在使用处方阿片类药物治疗慢性疼痛的患者中阿片类药物渴望数据的稀缺性.
研究的目的:
- 调查治疗前阿片类药物渴望与慢性疼痛退伍军人阿片类药物使用的后续变化之间的关系.
- 检查与渴望,疼痛灾难化,抑郁,疼痛强度,阿片类药物摄入量,治疗目标和满意度有关的阿片类药物逐渐减少.
- 为了确定治疗前的阿片类药物渴望是否预测在强化疼痛康复治疗期间的阿片类药物剂量变化.
主要方法:
- 一项观察性研究涉及104名患有慢性疼痛的退伍军人,他们正在接受强化疼痛康复治疗.
- 结构方程建模 (SEM) 用于分析预测变量与阿片类药物剂量 (吗啡等效每日剂量) 变化之间的关系.
- 预测变量包括治疗前的阿片类药物渴望,疼痛灾难化,抑郁,疼痛强度,基线阿片类药物摄入量,治疗目标和满意度.
主要成果:
- 与假设相反,治疗前的阿片类药物渴望并没有显著预测治疗后处方阿片类药物使用的变化.
- 较高的治疗满意度与较大降低阿片类药物剂量有显著的关联.
- 治疗前的抑郁症与阿片类药物渴望有显著的积极关系.
结论:
- 片类药物渴望似乎不会预测在没有被诊断为药物使用障碍的慢性疼痛患者中持续使用处方阿片类药物.
- 研究结果表明,处方阿片类药物用于疼痛管理的使用可能与物质使用障碍有根本的不同.
- 建议使用纵向渴望评估进行进一步的研究,以验证这些研究结果在未经研究的慢性疼痛人群中得到验证.
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