Chinese General Practice ›› 2023, Vol. 26 ›› Issue (14): 1766-1774.DOI: 10.12114/j.issn.1007-9572.2022.0788

Special Issue: 神经退行性病变最新文章合辑 帕金森最新文章合辑 脑健康最新研究合辑

• Evidence-based Medicine • Previous Articles     Next Articles

Factors Affecting Pain in Patients with Parkinson's Disease: a Systematic Review

  

  1. School of Nursing, Nanjing University of Traditional Chinese Medicine, Nanjing 210023, China
  • Received:2022-05-06 Revised:2022-12-02 Published:2023-05-15 Online:2022-12-29
  • Contact: XU Guihua

帕金森病患者疼痛影响因素的系统评价

  

  1. 210023 江苏省南京市,南京中医药大学护理学院
  • 通讯作者: 徐桂华
  • 作者简介:
    作者贡献:章雨桐、徐桂华进行文章的构思与设计,结果的分析与解释;章雨桐、王秋琴负责数据收集与整理;章雨桐、徐语晨、翁恒、梁咏琪、汪露露进行统计学处理;章雨桐进行论文撰写;王庆进行论文修订;王秋琴、王庆负责文章的质量控制及审校;徐桂华对文章整体负责,监督管理。
  • 基金资助:
    江苏省自然科学面上项目-基于NF-κB信号通路探讨铜砭刮痧治疗帕金森病的机制研究(19KJB360014); 江苏省研究生实践创新计划项目-铜砭刮痧干预帕金森病患者运动症状的临床疗效研究(SJCX22_0812)

Abstract:

Background

Pain is a common non-motor symptom in patients with Parkinson's disease (PD) , which has a serious impact on patients' quality of life. Current scholars have explored the factors influencing the occurrence of pain in patients with PD, but there is some variability in the findings.

Objective

To evaluate the influencing factors of pain in PD patients.

Methods

We searched the CNKI, Wanfang Data, VIP, SinoMed, Web of Science, PubMed, Medline, Embase and Cochrane Library databases for studies on factors influencing pain in patients with PD from database establishment to April 12, 2022. Two researchers independently conducted literature screening and relevant information extraction. We used the Agency for Healthcare Research and Quality (AHRQ) Scale and the Newcastle-Ottawa Scale (NOS) to evaluate the risk of bias in cross-sectional studies and case-control studies, respectively. We performed a descriptive analysis of all influencing factors of pain, and implemented a meta-analysis of these influencing factors using RevMan 5.3.

Results

Sixteen studies were finally included, with a total sample size of 2 855 cases, and 24 influencing factors of pain identified. There were two protective factors and 22 risk factors in descriptive analysis. The meta-analysis showed that, female〔OR=3.73, 95%CI (1.75, 7.96) , P=0.000 7〕, long duration of PD〔OR=1.35, 95%CI (1.15, 1.60) , P=0.000 3〕, depressed mood 〔OR=1.14, 95%CI (1.07, 1.22) , P<0.000 01〕, high UPDRS Ⅲ score〔OR=1.07, 95%CI (1.03, 1.11) , P=0.000 2〕, advanced Hoehn-Yahr stages〔OR=2.28, 95%CI (1.28, 4.04) , P=0.005〕, and high NMSS score〔OR=1.68, 95%CI (1.46, 1.93) , P<0.000 01〕 were risk factors for pain in PD patients. The GRADE analysis showed that the quality of evidence for the effects of gender and NMSS score on pain was moderate, and that for the effects of duration of PD, depressed mood and UPDRSⅢ score on pain was low, and that for the effect of Hoehn-Yahr stage on pain was very low.

Conclusion

Female, long duration of PD, depressed mood, motor impairment, advanced Hoehn-Yahr stages and other severe non-motor symptoms (sleep disturbance, fatigue) are risk factors for pain in PD patients, which need to be further validated by high-quality, large-sample studies in the future.

Key words: Parkinson disease, Pain, Non-motor symptoms, Root cause analysis, Cross-sectional studies, Case-control studies, Systematic review

摘要:

背景

疼痛是帕金森病(PD)患者常见的非运动症状之一,且对患者生活质量造成严重影响,目前学者对PD患者发生疼痛的影响因素进行了探讨,但研究结果存在差异。

目的

系统评价PD患者疼痛的影响因素。

方法

计算机检索中国知网、万方数据知识服务平台、维普网、中国生物医学文献服务系统(SinoMed)、Web of Science、PubMed、Medline、Embase、Cochrane Library数据库有关PD患者疼痛影响因素的研究,检索时间为建库至2022-04-12。由2名研究者独立筛选文献,并提取相关资料。采用美国卫生保健质量研究机构(AHRQ)编制量表和纽卡斯尔-渥太华量表(NOS)分别对横断面研究和病例对照研究进行偏倚风险评价。对所有涉及的影响因素进行描述性分析,并采用RevMan 5.3软件对PD患者疼痛的影响因素进行Meta分析。

结果

共纳入16项研究,总样本量为2 855例,共涉及24种影响因素。描述性分析结果可知有2项保护因素和22项危险因素;Meta分析结果可知:女性〔OR=3.73,95%CI(1.75,7.96),P=0.000 7〕、病程长〔OR=1.35,95%CI(1.15,1.60),P=0.000 3〕、抑郁情绪〔OR=1.14,95%CI(1.07,1.22),P<0.000 01〕、统一帕金森病评定量表(UPDRS)Ⅲ评分高〔OR=1.07,95%CI(1.03,1.11),P=0.000 2〕、Hoehn-Yahr分级高〔OR=2.28,95%CI(1.28,4.04),P=0.005〕、非运动症状评价量表(NMSS)评分高〔OR=1.68,95%CI(1.46,1.93),P<0.000 01〕是PD患者发生疼痛的危险因素。GRADE分级结果显示性别、NMSS评分是中等质量证据,病程、抑郁情绪、UPDRSⅢ评分是低质量证据,Hoehn-Yahr分级是极低质量证据。

结论

女性、病程长、抑郁情绪、运动障碍、Hoehn-Yahr分级高以及其他非运动症状(睡眠障碍、疲劳)程度重是PD患者疼痛的危险因素,未来需要更大样本、高质量研究进一步验证。

关键词: 帕金森病, 疼痛, 非运动症状, 影响因素分析, 横断面研究, 病例对照研究, 系统评价