神经病理性疼痛症状问卷中文版及初步验证
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摘要
目的:本研究旨在对神经病理性疼痛症状问卷(neuropathic pain symptoms inventory, NPSI)进行中文版并验证。方法:将原版NPSI翻译后应用于140名神经病理疼痛病人,对量表进行信效度、反应性及因子分析。结果:量表10项条目中8项阳性率大于40%。完成平均耗时11.54±2.36分,两次量表总分与两次VAS相关系数分别为ρ=0.689、0.948 (P <0.01)。两次量表的差值与两次VAS评分的差值相关系数为ρ=0.793 (P <0.01)。所有条目组内相关系数在0.800以上。得出五个独立因子,所有条目都只与单一因子相关。病人总体印象变化评分和临床总体印象评分与两次量表总分差值相关系数分别为:ρ=0.764、0.793 (P <0.01)与各分项两次间变化中等程度相关。结论:中文版NPSI适用于以中文为母语的神经病理疼痛病人。
Objective: This study sought to translate NPSI to Chinese version and tentatively validate the CV-NPSI(Chinese Version-NPSI). Methods: The CV-NPSI had been applied to 140 patients with NP(neuropathic pain) after having been translated from original version. The CV-NPSI underwent face validity analysis, convergent analysis, test-retest reliability, factor analysis and analysis of sensitivity to changes. Results: Face validity: The average time to finish the CV-NPSI is 11.54±2.36 minutes. The percentage of patients who reported a score > 0 of 8 items in the 10 items is more than 40%. Convergent analysis: The Spearman correlation between the total score of the CV-NPSI and VAS of each time is 0.689 and 0.948(P < 0.01) respectively,and it is 0.793(P < 0.01) between the change in the CV-NPSI score and the change in the VAS. Test-retest reliability: The ICC(intraclass correlation coefficient) of patients are above 0.800. Factor analysis: Five independent factors which accounted for 72.918% of the total variance have been found. All the items were related to only one factor. Sensitivity to change: The p-GIC(Patient Global Impression of Change) and c-GIC(Patient Global Impression of Change) scores were strongly correlated(ρ = 0.764 and 0.793, P < 0.01, respectively) with the change in the CV-NPSI total score. The p-GIC was correlated with the change in subscore of the CV-NPSI moderately(ρ = 0.458, 0.364, 0.421, 0.420, 0.434, P < 0.01). Conclusions: The CV-NPSI translated and validated by this study applies appropriately to Chinese patients with NP. It is able to tentatively characterize subgroups of neuropathic pain patients and evaluate the change of pain and therapy.
Objective: This study sought to translate NPSI to Chinese version and tentatively validate the CV-NPSI(Chinese Version-NPSI). Methods: The CV-NPSI had been applied to 140 patients with NP(neuropathic pain) after having been translated from original version. The CV-NPSI underwent face validity analysis, convergent analysis, test-retest reliability, factor analysis and analysis of sensitivity to changes. Results: Face validity: The average time to finish the CV-NPSI is 11.54±2.36 minutes. The percentage of patients who reported a score > 0 of 8 items in the 10 items is more than 40%. Convergent analysis: The Spearman correlation between the total score of the CV-NPSI and VAS of each time is 0.689 and 0.948(P < 0.01) respectively,and it is 0.793(P < 0.01) between the change in the CV-NPSI score and the change in the VAS. Test-retest reliability: The ICC(intraclass correlation coefficient) of patients are above 0.800. Factor analysis: Five independent factors which accounted for 72.918% of the total variance have been found. All the items were related to only one factor. Sensitivity to change: The p-GIC(Patient Global Impression of Change) and c-GIC(Patient Global Impression of Change) scores were strongly correlated(ρ = 0.764 and 0.793, P < 0.01, respectively) with the change in the CV-NPSI total score. The p-GIC was correlated with the change in subscore of the CV-NPSI moderately(ρ = 0.458, 0.364, 0.421, 0.420, 0.434, P < 0.01). Conclusions: The CV-NPSI translated and validated by this study applies appropriately to Chinese patients with NP. It is able to tentatively characterize subgroups of neuropathic pain patients and evaluate the change of pain and therapy.
引文
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[6]Baron R, F?rster M, Binder A. Subgrouping of patients with neuropathic pain according to pain-related sensory abnormalities:a first step to a stratified treatment approach. Lancet Neurol, 2012, 11(11):999~1005.
[7]Gilron I, Baron R, Jensen T. Neuropathic pain:principles of diagnosis and treatment. Mayo Clin Proc, 2015,90(4):532~545.
[8]Bouhassira D, Attal N, Fermanian J, et al.Development andvalidationoftheNeuropathicPainSymptomInventory. Pain, 2004, 108(3):248~257.
[9]Reimer M, Helfert SM, Baron R. Phenotyping neuropathic pain patients:implications for individual therapy and clinical trials. Curr Opin Support Pa, 2014, 8(2):124.
[10]李君,冯艺,韩济生,等.三个中文版神经病理性疼痛诊断量表的制定与多中心验证.中国疼痛医学杂志, 2011, 17(9):549~553.
[11]JensenMP,JohnsonLE,GertzKJ, etal.Thewords patients use to describe chronic pain:Implications for measuringpainquality.Pain,2013,154(12):2722~2728.
[12]BouhassiraD, AttalN.Diagnosisandassessmentof neuropathic pain:the saga of clinical tools. Pain, 2011,152(3 Suppl):S74.
[13]Cruccu G, Sommer C, Anand P, et al.EFNS guidelines onneuropathicpainassessment:revised2009.EurJ Neurol, 2011, 152(1):14~27.
[14]SmithBH.NeuPSIGguidelinesonneuropathicpain assessment. Pain, 2011, 152(1):14~27.
[15]Pommier B, Créac'HC, Beauvieux V, et al. Robot-guided neuronavigated rTMS as an alternative therapy for central(neuropathic)pain:Clinical experience and longterm follow-up. Eur J Pain, 2016, 20(6):907~916.
[16]von Hehn CA, Baron R, Woolf CJ. Deconstructing the neuropathicpainphenotypetorevealneuralmechanisms. Neuron, 2012, 73(4):638.
[17]Amir R, Liu CJ, Devor M. Oscillatory mechanism in primary sensory neurones. Brain:A Journal of Neurology, 2002, 125(Pt 2):421.
[18]Demant DT, Lund K, Vollert J, et al.The effect of oxcarbazepine in peripheral neuropathic pain depends on painphenotype:arandomised,double-blind,placebo-controlledphenotype-stratifiedstudy.Pain,2014,155(11):2263~2273.
[19]Kalliom?ki J, Attal N, Jonzon B, et al.A randomized,double-blind, placebo-controlled trial of a chemokine receptor 2(CCR2)antagonist in posttraumatic neuralgia. Pain?, 2013, 154(5):761.
[20]Martinez V, Szekely B, Martin F, et al.The efficacy of a glial inhibitor, minocycline, for preventing persistent pain after lumbar discectomy:a randomized, double-blind,controlledstudy.Pain?,2013,154(8):1197~1203.
[2]Freeman R, Baron R, Bouhassira D, et al. Sensory profiles of patients with neuropathic pain based on the neuropathic pain symptoms and signs. Pain?, 2014, 155(2):367~376.
[3]Finnerup NB, Attal N, Haroutounian S, et al.Pharmacotherapyforneuropathicpaininadults:asystematic reviewandmeta-analysis.LancetNeurology,2015,14(2):162.
[4]MarchettiniP,WilhelmS,PettoH, etal.Arethere differentpredictorsofanalgesicresponsebetween antidepressantsandanticonvulsantsinpainful diabeticneuropathy.EurJPain,2016,20(3):472~482.
[5]HelfertS,ReimerM,H?perJ, etal.Individualized Pharmacological Treatment of Neuropathic Pain. Clin Pharmacol Ther, 2015, 97(2):135~142.
[6]Baron R, F?rster M, Binder A. Subgrouping of patients with neuropathic pain according to pain-related sensory abnormalities:a first step to a stratified treatment approach. Lancet Neurol, 2012, 11(11):999~1005.
[7]Gilron I, Baron R, Jensen T. Neuropathic pain:principles of diagnosis and treatment. Mayo Clin Proc, 2015,90(4):532~545.
[8]Bouhassira D, Attal N, Fermanian J, et al.Development andvalidationoftheNeuropathicPainSymptomInventory. Pain, 2004, 108(3):248~257.
[9]Reimer M, Helfert SM, Baron R. Phenotyping neuropathic pain patients:implications for individual therapy and clinical trials. Curr Opin Support Pa, 2014, 8(2):124.
[10]李君,冯艺,韩济生,等.三个中文版神经病理性疼痛诊断量表的制定与多中心验证.中国疼痛医学杂志, 2011, 17(9):549~553.
[11]JensenMP,JohnsonLE,GertzKJ, etal.Thewords patients use to describe chronic pain:Implications for measuringpainquality.Pain,2013,154(12):2722~2728.
[12]BouhassiraD, AttalN.Diagnosisandassessmentof neuropathic pain:the saga of clinical tools. Pain, 2011,152(3 Suppl):S74.
[13]Cruccu G, Sommer C, Anand P, et al.EFNS guidelines onneuropathicpainassessment:revised2009.EurJ Neurol, 2011, 152(1):14~27.
[14]SmithBH.NeuPSIGguidelinesonneuropathicpain assessment. Pain, 2011, 152(1):14~27.
[15]Pommier B, Créac'HC, Beauvieux V, et al. Robot-guided neuronavigated rTMS as an alternative therapy for central(neuropathic)pain:Clinical experience and longterm follow-up. Eur J Pain, 2016, 20(6):907~916.
[16]von Hehn CA, Baron R, Woolf CJ. Deconstructing the neuropathicpainphenotypetorevealneuralmechanisms. Neuron, 2012, 73(4):638.
[17]Amir R, Liu CJ, Devor M. Oscillatory mechanism in primary sensory neurones. Brain:A Journal of Neurology, 2002, 125(Pt 2):421.
[18]Demant DT, Lund K, Vollert J, et al.The effect of oxcarbazepine in peripheral neuropathic pain depends on painphenotype:arandomised,double-blind,placebo-controlledphenotype-stratifiedstudy.Pain,2014,155(11):2263~2273.
[19]Kalliom?ki J, Attal N, Jonzon B, et al.A randomized,double-blind, placebo-controlled trial of a chemokine receptor 2(CCR2)antagonist in posttraumatic neuralgia. Pain?, 2013, 154(5):761.
[20]Martinez V, Szekely B, Martin F, et al.The efficacy of a glial inhibitor, minocycline, for preventing persistent pain after lumbar discectomy:a randomized, double-blind,controlledstudy.Pain?,2013,154(8):1197~1203.