分散注意力对健康人群试验性疼痛的影响

摘要

目的：采用点探测认知任务研究分散注意力对健康人群试验性疼痛的影响。方法20名健康大学生接受200 mm Hg持续压力诱发试验性疼痛，在单纯加压疼痛试验与分心条件下的疼痛试验中，VRS量表评定与改良MPQ（MPQ-SF）评定被试者的疼痛强度、疼痛不适度。结果分心条件下，图片[（3．1±1．3）、（3．0±1．2）]与字词[（3．3±1．4）、（3．4±1．5）]点探测试验中的疼痛强度与不适度显著低于单纯加压时[（4．1±1．8）、（4．0±1．8）]，差异均有统计学意义[（ F（2，8）＝21．424，P＜0．001；F（2，8）＝17．962，P＜0．001）]，且图片点探测任务中第4～8分钟时疼痛强度降低尤为明显，差异有统计学意义（ P＜0．05）。疼痛不适度的降低主要表现在第1、2分钟，图片[（2．3±0．7）、（2．5±0．8）]与字词[（2．4±0．8）、（2．9±0．9）]点探测任务中的不适度明显低于单纯加压[（3．7±1．3）、（4．0±1．4）]，差异有统计学意义（P＜0．05）。图片点探测试验对不适度的分心止痛效果（3．0±1．2）优于字词点探测试验（3．4 ±1．5），差异有统计学意义（P＜0．05）。通过MPQ-SF的现时疼痛强度指数（PPI）结果发现，单纯加压的PPI值（5．0±1．6）高于图片点探测任务的PPI值（3．5 ±1．4），差异有统计学意义（F＝5．097，P＜0．05）。结论分散注意力的方法降低了健康人群试验性疼痛的强度与不适度。%Objective To investigate the effects of distraction on tourniquet pain in healthy subjects .Methods Tourniquet pain was induced by the tourniquet at continuous pressure of 200 mm Hg for 10 min .20 healthy college students were asked to perform two distraction tasks during the pressure ,one of which is pictorial dot-probe task with three kinds of emotional pictures ,the other is word dot-probe task with five kinds of pain-related words ,and a control task ,in which no distraction task was performed .The pain intensity ,pain distress were recorded by Visual Rating Scale(VRS)and Modified McGill Pain Questionnaire short-form(MPQ-SF) . Results Compared with the control task[(4 .1 ± 1 .8) ,(4 .0 ± 1 .8)] ,the pain intensity and distress were significant lower in picture [(3 .1 ± 1 .3) ,(3 .0 ± 1 .2)]and word[(3 .3 ± 1 .4) ,(3 .4 ± 1 .5)] distraction tasks[(F(2 ,8)=21 .424 ,P<0 .001;F(2 ,8)=17 .962 ,P<0 .001)] .The pain distress in word distraction task (3 .4 ± 1 .5) was higher than that in the pictorial distraction task (3 .0 ± 1 .2) (P<0 .05) .Meanwhile ,for the last four minutes ,the pain intensity was significant lower in pictorial distraction task compared with the control task(P<0 .05) .And at the beginning of the experiment ,the pain distress was significant lower in pictorial[(2 .3 ± 0 .7) , (2 .5 ± 0 .8)]and word[(2 .4 ± 0 .8) ,(2 .9 ± 0 .9)] distraction task compared with the control task [(3 .7 ± 1 .3) ,(4 .0 ± 1 .4)](P<0 .05) .Compared with the control task (5 .0 ± 1 .6) ,the present pain index (PPI) was significant lower in the pictorial distraction task(3 .5 ± 1 .4)(F=5 .097 ,P<0 .05) .Conclusion The tourniquet pain was attenuated by distraction of cognitive tasks in pain in-tensity and pain distress .