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《最新(中德康復(fù)技術(shù)培訓(xùn)課件)25.06 康復(fù)技術(shù)培訓(xùn) 轉(zhuǎn)化醫(yī)學(xué)-藥學(xué)醫(yī)學(xué)精品資料.ppt》由會(huì)員上傳分享，免費(fèi)在線閱讀，更多相關(guān)內(nèi)容在教育資源-天天文庫(kù)。
1、最新(中德康復(fù)技術(shù)培訓(xùn)課件)25.06康復(fù)技術(shù)培訓(xùn)轉(zhuǎn)化醫(yī)學(xué)-藥學(xué)醫(yī)學(xué)精品資料Content?Chronicpainsyndromes:epidemiologyandcharacteristics慢性疼痛特征Mechanismsofpainchronification(Fibromyalgiaasmodelofchronicpain)疼痛的慢性損傷肌肉纖維疼痛?Neuroplasticity神經(jīng)重塑?Painmediators疼痛因子ConclusionandFutureDirection討論及未來(lái)展
2、望Chronicpain(characteristicsandepidemiology)Paininmusculoskeletalsystemisveryfrequentsymptom:肌肉骨骼系統(tǒng)疼痛為主?withtissuedamage:e.g.Osteoarthritis,discherniation實(shí)質(zhì)性損傷?without(specific)tissuedamage:jointdysfunction,irritationcausedbyoverstrain,musclehypertensi
3、onandothersManyofthesesyndromearenotverysevere(ordangerous)andselflimitingbutinsomecasestheycanbecomechronicTheimpactofmusculoskeletalpainonqualityoflife,andhealthexpensesisveryhighImportantquestion:howtoprevent(andtreat)chronicpainsyndromes無(wú)特殊性損傷關(guān)節(jié)功能喪
4、失其中一些并不危險(xiǎn)，并且有自身受限，但某些情況下會(huì)變成慢性重要問(wèn)題-如何預(yù)防并治療轉(zhuǎn)化成慢性疼痛MechanismsofpainchronificationMay,Pain2008;137:7–15DifferentlevelofplasticityinchronicpainNeuroplasticity:AlterationFunction功能Structure結(jié)構(gòu)Chemicalprofile化學(xué)指標(biāo)Centralsensitization(CoghillRC2005)中樞patientwith
5、chronicpain慢性疼痛normalsubject正常人Centralsensitization:functionalimagingGuedjetal.:JNuclMed2008;49:1798–1803May,2008May,2011.TheNeuroscientistChemicalprofile(painmediators)化學(xué)剖面（疼痛因子）Painmediators:BrainDerivedNeurotropicFactor,BDNF腦源性神經(jīng)營(yíng)養(yǎng)因子CorrelationofBDN
6、FandageinHealthyControlsandFMSpatientsPainmediators:BrainDerivedNeurotropicFactor,BDNFNugrahaetal.2013:NeurochemIntNugrahaetal.2012RheumatolIntPainmediators:BrainDerivedNeurotropicFactor,BDNF(ntotal=39;HADS-Dscore<8:n=21;8–10:n=10;>10:n=8;Dataareshowni
7、nmean±SEM;TheJocnkheere–Terpstratest:p<0.05)(ntotal=39;HADS-Ascore<8:n=9;8–10:n=12;>10:n=18;Dataareshowninmean±SEM;TheJocnkheere–Terpstratest:p>0.05).LevelofserumBDNFinFMSpatientsbasedondepressionscoregroupLevelofserumBDNFinFMSpatientsbasedonanxietysco
8、regroupCorrelation:R=0.434;p=0.006PainMediators:CD3+CD56+NKTCells:FMSanddepression%CD3+CD56+NKTCellsHADS-DScoreR=-0.297;p=0.03ANOVA:p=0.02Post-hoc:Bonferronitest:HADS-D<8and>10(p=0.018)CorrelationNugrahaetal.2013ClinExpRheumPainmediator
