慢性疼痛的综合管理

承认慢性疼痛本身就是一种诊断(ICD-11中已经引入慢性原发性疼痛),可以帮助临床医师和患者从寻找诊断的心态转向讨论长期管理策略[5]。部分慢性疼原因不成比例，常规CT或MRI检查能获得的诊断信息有限[11]。诊断性治疗(区域阻滞治疗)是一种可用于部分诊断不明的慢性疼痛的诊断方法。2018年世界卫生组织发布的ICD-11中第一次提出了慢性疼痛系统诊断分类[8],有助于收集全面的流行病学数据，区分慢性术用于慢性疼痛诊断，有助于提高慢性疼痛的诊断2多维度评估疼痛Baker面部表情疼痛评分量表等单维度疼痛评估量表仅能对疼痛强度进行评估，疼社会因素。慢性疼痛存在感觉、情绪、认知和行为4个维度，推荐疼痛进行评估。简化的McGill疼痛问卷表2(Shot-formMcgillPainQuestionnaire ,SF-MPQ2)能够对疼痛性质、疼痛强1.7基因(使用dCas9蛋白实现对NaV1.7的非永久性基因抑制或使用ZFP锌指蛋白进行表rtheStudyofPaindefinitionofpain:concepts,challenges,andcompromises[J].Pain,2020,161(9):1976-1982.DOI:10.1097/j.pain.0000000000001939[2]TreedeRD,RiefWfDiseases(ICD11)[J].Pain,2019,16杂志，2016,18(4):481-486.DOI:10.3760/cma.j.issn.1008-1372.2016.04.001.[4]CohenSP,VaseL,HootenWM.Chronicpain:anupdateontices,andnewadvances[J].Lancet,2021,397(10289):2082-2097.DOI:10.10140-6736(21)00393-7.[5]KangY,TrewernL,JackmanJ,etal.Chronicis[J].BMJ,2023,381:e076036.[6]ElliottAM,SmithBH,HannafordPChecommunity:resultsofa4-yearfollow-upstudy[J].Pain,2002,99(1-2):29307.DOI:10.1016/s0304-3959(02)00138-0.[7]ChenB,LiL,DonovanC,etal.PrevalenceandcharbodypaininChina:anationalstudy[J].Springer/yzygj/ylyxjg/202301/eb45824e37384816be86fa8e6b3ftofchronicpain[J].Diagnostics(Basel),2023,13(24):3689.DOI:10.3390/diag[11]MaoJ.Challengesofmanagingchronicpain[J].BMJ,2017,356:j741.[12]LatypovTH,SoMC,HungPScfacialpainderivedby9.DOI:10.1038/s41598-023-logy[J].NatRevCancer.2018,18(8):500-510.DOI:10.1038/s41568-018-0016-5.[15]DworkinRH,TurkDC,RevickiDA,enofanexpandedandrevisedversionoftheShort-formMcGillPainQuestionnaire(SF-MPQ-2)[J].Pain,2009,144(1-2):35-42.DOI:10.1016/j.pain.2009.02.007.[16]CookKF,KallenMA,BuckenmaierC3rd,etal.Evaluationofandresponseburdenofpatientself-reportmeasuresofthePainAssessmeeningToolandOutcomesRegistry(PASTOR)[J].MilMed,2011.DOI:10.7205/MILMED-D[17]NijsJ,MairesseO,Neurobiology,assessment,andtreatmentinphysicaltherapistpraer,2018,98(5):325-335.DOI:10.1093/ptj/pzy020.23(2):e273-e283.DOI:10.1016/j.bja.2019[19]LancetT.Rethinkingchronicpain[J].La[20]VardehD,MannionRJ,WoolfCJ.Towardamechanism-bandiagnosis[J].JPain,2016,17(9):Suppl-T50.T69DOI:10.1016/j.jpain.2016.0[21]ThemelisK,TangN.Themanagementofchronicpain:re-centringperson-centredcare[J].JClinMed,2023,12(22):6957.DOI:10.3390/jcm12226957.杂志，2023,103(39):3083-3087.DOI:10.3760/l12137-20230704-01135AcadDermatol,2007,57(Suppl6):S136-S142.DOI:10.1016/j[24]GlareP,AubreyKR,Myrsurgery[J].Lancet,2019,393(10180):1537-1546.DOI:10.1016/S0140-6736(19)3[25]GatchelRJ,Reubenionofpainanditsimpact:reportoftheworkgrouponthePreventionofAcuteandChronicPainoftheFederalPainResearchSt837-851.DOI:10.1016/j.jpain.2018.02.015.[26]BadiolaIJ.Canchronicpainbeprevented?[J[27]FrictonJ.Theneedroom"ofhealthcare[J].GlobAdvHealthMed,2015,4(1):6-7.DOI:10.7453/g[28]GewandterJS,DworkinRH,Turkforchronicpainpreventionclinicaltrials:IMMPACTrecommendep,2021,6(1):e895.DOI:10.1097/PR9.0000000000000895.[29]GomezK,SantiagoU,NelsonTS,etCaV2.2N-typecalciumchannelforch23,120(47):e2305215120.DOI:10.1073/pnas.2305215120.[30]WangY,QinD,GuoZ,etal.ResearchprogressonthepotentilgesicBU08028[J].EurJPharmacol,2022,914:174678.DOI:10.1016/j.ejphar.20[31]MorenoAM,AlemánF,CatroliGF,etedinsiturepressionofNaV1.7inmice[J].SciTr