Study On Quality Of Life And Its Relationship With Psychophysiological Factors In Chronic Pain Patients

Objective:(1) To investigate the pain characteristics, physiological and psychological symptoms, as well as life quality in non-organic chronic pain patients. (2) To analyze the influential factors of life quality and the interaction among these influential factors in non-organic chronic pain patients.Methods:139 non-organic chronic pain patients and 115 normal subjects were participated in the study. The pain characteristics, life quality, depression, anxiety, insomnia were evaluated respectively by using the Chinese version of Shout-Form McGill Pain Questionnaire (SF-MPQ), Shout-Form Quality of life Questionnaire (SF-12), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and Athens Insomnia Scale (AIS). Student's t test, analysis of variance, Pearson correlation analysis, multiple linear step wise regression analysis and path analysis were used in the data analysis.Results:(1) SF-MPQ total score was higher in the patient group than that in the control group (t=-12.962, P<0.001), both SF-MPQ sensory pain sub-score and emotional pain sub-score were also higher in patient group (P<0.001). In the patient group, there were 88(63%) at sever pain level or needed treatment,44(32%) at moderate pain level, and 7(5%) at mild pain level. Forthermore, the average number of pain location was 3, the pain duration was 12 hours per day and pain frequency was 6 times per week in the patient group. (2) SF-12 total score was lower in the patient group than that in the control group (t= 15.598, P<0.001). All eight SF-12 sub-scores, including physical functioning(PF), role-physical(RP), bodily pain(BP), general health(GH), vitality(VT), social functioning(SF), role-emotional (RE), and mental health(MH), were significantly lower in the patient group compared with the control group (P<0.05). SF-12 total scores significantly differed among the groups with different pain intensity (P<0.05) and different number of pain sites (P<0.05). (3) Compared to the control group, the patient group was more likely to be in depression [76(54.7%) versus19 (16.5%), respectively,x2= 39.131, P<0.001]. BDI total score was higher in the patient group than that in the control group (t=-8.999, P<0.001). (4) Compared to the control group, the patient group was more likely to be in anxiety [21(15.1%) versus 1(0.9%), respectively, x2=16.127, P<0.001]. BAI total score was higher in the patient group than that in the control group (t=-9.555, P<0.001). (5) Compared to the control group, the patient group was more likely to be insomnia [116 (83.5%) versus 24(20.9%), respectively, x2=99.640, P<0.01]. AIS total score was higher in the patient group than that in the control group (t=-15.928, P<0.001). (6) SF-MPQ total score, sensory pain sub-score, and emotional pain sub-score were positively correlated with BDI, BAI, AIS total scores in the patient group(P<0.001). (7) SF-12 total score, PF sub-score, BP sub-score, and GH sub-score were negatively correlated with SF-MPQ total score and SF-MPQ sensory pain sub-score, emotional pain sub-score, VAS sub-score, pain intensity sub-score, number of pain sites, BDI total score, BAI total score and AIS total score in the patient group(P<0.05). SF-12 RP sub-score was negatively correlated with SF-MPQ emotional pain sub-score, pain intensity sub-score, number of pain sites, BDI total score, BAI total score and AIS total score(P<0.05). SF-12 VT sub-score was negatively correlated with SF-MPQ total score and SF-MPQ sensory pain sub-score, emotional pain sub-score, VAS sub-score, number of pain sites, BDI total score, BAI total score and AIS total score(P<0.05). SF-12 SF sub-score was negatively correlated with SF-MPQ total score and SF-MPQ sensory pain sub-score, emotional pain sub-score, pain intensity sub-score, number of pain sites, BDI total score, BAI total score and AIS total score(P<0.05). SF-12 RE sub-score was negatively correlated with SF-MPQ total score and SF-MPQ sensory pain sub-score, emotional pain sub-score, number of pain sites, BDI total score, BAI total score and AIS total score(P<0.05). SF-12 MH sub-score was negatively correlated with SF-MPQ emotional pain sub-score, VAS sub-score, number of pain sites, BDI total score, BAI total score and AIS total score(P<0.05). (8) The multiple linear stepwise regression analysis model predicted a total of 50.2% (adjusted R2) of the variance of the SF-12 total score in the patient group. The independent variables that had a significant influence on SF-12 total score were BDI total score, AIS total score, SF-MPQ VAS sub-score, and number of pain sites, meanwhile, depression was the most obvious influential factor.Conclusion:(1)In the non-organic chronic pain group, there were over 50% patients suffered from serious pain, the average number of pain location was 3, pain duration was 12 hours per day, pain frequency was 6 times per week. (2)The depression, anxiety and insomnia of the non-organic chronic pain patients was significantly in higher level than that of the normal population. (3)The life quality of the non-organic chronic pain patients was significantly in lower level than that of the normal population. (4)The pain characteristics, including VAS and number of pain sites, as well as depression and anxiety significantly affected the life quality of the non-organic chronic pain patients. Depression was the most obvious influential factor. Objective:To detect serum interleukin-1 (IL-1) levels in the patient group and in the control group respectively, and analyze the relationship between serum IL-1 levels and pain, depression, anxiety, insomnia and life quality in the patient group.Methods:5 ml blood sample was taken from every participant, including 139 subjects in the patient group and 115 subjects in the control group. Then all the blood samples were centrifuged by 3000 rev/min speed for 15 minutes to separate the serum. The serum samples were preserved in -70℃refrigerator.60 serum samples from the patient group and 60 serum samples from the control group were selected randomly. The serum IL-1 levels were detected by enzyme-linked immunosorbent assay (ELISA).Results:(1)The serum IL-1 level of the patient group was higher than that of the control group (t=-12.149, P<0.001). (2) The serum IL-1 levels significantly differed among the groups with different pain intensity in the patient group (P<0.001). The serum IL-1 level of the slight pain group was lower than all the other groups respectively (P<0.05). The serum IL-1 level of mild pain group was lower than those of other groups (P<0.05), and the serum IL-1 level of the moderate pain group was lower than that of severe pain group (P<0.05). (3) The serum IL-1 level was positively correlated with SF-MPQ total score, BDI total score, BAI total score, AIS total score in the patient group (P<0.05). The serum IL-1 was negatively correlated with SF-12 total score and other seven sub-scores except VT sub-score in the patient group.Conclusion:(1)The serum IL-1 levels of the non-organic chronic pain patients were higher than that of the normal population. (2)The serum IL-1 levels were positive related to the chronic pain, depression, anxiety, insomnia but negative related to life quality.