“World analgesic day · Chinese analgesia week”: Discovering pain, recognizing pain and solving pain

On October 18, the theme release of world analgesic day and Chinese analgesic week and the opening ceremony of the joint conference of pain medicine week and pain specialist doctors of Chinese and Japanese hospitals were held in Beijing. More than 200 famous pain experts from more than 20 provinces in China attended the conference. At the meeting, Han Jisheng, academician of Chinese Academy of Sciences, released this year’s theme: “global year for prevention and treatment of low back pain”. < p > < p > at this conference, the China Japan Friendship Hospital was entrusted by the medical administration bureau of the National Health Commission to establish the national pain quality control center. Guo Yanhong, Commissioner of the medical administration of the National Health Commission and Zhou Jun, President of the China Japan Friendship Hospital, pointed out: the reason for pain quality control is to promote the standardization, standardization and homogenization of pain diagnosis and treatment services in China, narrow the gap of pain diagnosis and treatment quality between regions and different medical institutions, and better serve the patients with pain. < p > < p > subsequently, Professor Fan bifa, chairman of the conference and director of the national pain quality control center, talked about the development strategy of pain discipline in the future, and launched a series of cooperation projects to promote the development of pain discipline, such as the blue book of Chinese pain prevention and health promotion strategy, the common knowledge of Chinese experts in peripheral neuropathic pain diagnosis and treatment, and the excellent pain education project. < / P > < p > the Chinese pain health index, which was jointly sponsored by the national key clinical specialty pain specialist medical association and the chronic non communicable disease prevention and control center of China Center for Disease Control and prevention, was released for the first time at this conference. The index covers the epidemic level of disease, disease burden, diagnosis and treatment status and discipline construction, with a total of 16 indicators. < p > < p > the construction of pain health index in China provides a tool for the government to comprehensively understand the current situation of pain health in China, compare the severity of pain diseases, disease prevalence and control in different regions, monitor and evaluate the pain health management ability of Chinese people, and help improve the level of pain management. According to the report released on the same day, Beijing, Shanghai and Zhejiang rank among the top three in China. Han Jisheng, academician of Chinese Academy of Sciences, inscribed on site by Han Jisheng, academician of Chinese Academy of Sciences; fan bifa, chairman of pain medicine branch of Chinese Medical Association; Kong Lingzhi, chairman of health communication branch of Chinese Preventive Medicine Association; Zhang Daying, chairman of pain credit association of Chinese Medical Association; Wang Wen, chairman of soft tissue pain society of China Association for the promotion of research of Chinese medicine; and pain specialty of Chinese society of integrated traditional and Western medicine Xiong Donglin, chairman designate of the committee, Fu Zhijian, vice chairman of the pain branch of the Chinese Medical Association, and Liu Hui, vice president of the pain medicine branch of the Chinese Medical Association, jointly released the slogan of pain prevention and control of the “China health knowledge dissemination incentive plan” project – “find pain, recognize pain, solve pain”, and jointly appeal to the public to understand pain and correctly understand pain. When interpreting the slogan, Professor Zhang Daying, chairman designate of pain credit association of Chinese Medical Association and director of pain department of the First Affiliated Hospital of Nanchang University, pointed out that when dealing with pain, we often regard it as a symptom or an accessory of a certain disease. We expect it to subside with the recovery of the disease, and we will also be used to “forbearance will pass” when facing it. It is the basic right of patients to eliminate pain, and never tolerate pain. According to research, more than 70% of patients with pain “endure pain” do not seek medical treatment, only 28% of patients with the first pain within 1-10 days. Pain can be divided into acute pain and chronic pain. Acute pain is a short-term and sudden pain, often a symptom of many diseases, related to surgery, trauma, tissue injury or some disease status; chronic pain lasts for a long time, often is the continuation of acute pain. Osteoarthritis, neck pain, low back pain, headache and cancer pain are common chronic pain, which seriously affect the quality of life. Aging population, bad lifestyle and behavior habits, as well as chronic diseases are the factors causing the continuous increase of pain diseases. The pain should not be tolerated again and again. Once symptoms appear, active and effective treatment measures should be taken. Chronic pain should be treated as a disease. Pain can cause a series of pathophysiological changes, affect the emotional and mental health of patients, lead to sleep disorders, anxiety, irritability, and reduce the coordination degree of various treatments. Continuous pain stimulation can cause central sensitization. After central sensitization, the sensory threshold of neurons to pain stimulation is reduced, which increases the intensity and duration of pain, and also greatly increases the difficulty of pain treatment. If the postoperative pain control is not good, it will affect the rapid recovery. Especially after orthopedic joint surgery, patients are afraid of pain and refuse rehabilitation exercise, resulting in joint stiffness, muscle atrophy, thus affecting the operation effect. Pain patients, such as patients with osteoarthritis and rheumatoid arthritis, whose daily activities and functional exercises are affected by pain, will increase the risk of osteoporosis and muscle atrophy, resulting in a vicious circle. Pain can be the accompanying symptoms of some diseases, such as headache and childbirth pain secondary to hypertension, and also can be diseases pain diseases, such as primary trigeminal neuralgia, postherpetic neuralgia, chronic low back pain, etc. Acute pain is the symptom of some diseases, while chronic pain is a disease state. Acute pain is mainly symptomatic treatment on the basis of the treatment of etiology, while chronic pain not only needs symptomatic treatment, but also needs comprehensive treatment for the etiology and pathogenesis of pain. For acute pain, it is often the signal of body injury or pathological changes, so it is necessary to go to the hospital for treatment in time. For example, abdominal pain caused by acute appendicitis can not be delayed, otherwise it may lead to abdominal infection, sepsis and other serious consequences. For chronic pain, it will worsen, facilitate and generalize, resulting in malignant circulation, thus further affecting sleep, quality of life and psychology. “Blocking therapy” refers to the injection of local or small amount of hormone drugs into pain points, joint capsule and other tissues. Local can play a role in rapid analgesia, a small amount of local hormone can play a strong anti-inflammatory effect, play a role in eliminating inflammatory edema, promoting the absorption of inflammatory exudation, relieving muscle spasm, improving the metabolism of pathological tissues, so the blocking therapy can not only relieve temporary pain, but also treat the disease. Although long-term, repeated and high-dose corticosteroids may cause adverse reactions such as dependence, osteoporosis and osteonecrosis of the femoral head, blocking therapy is an effective treatment method because of the small dose of hormone used each time. < p > < p > 3. The “Application of glucocorticoid in minimally invasive interventional treatment of pain – consensus of Chinese experts” published in 2017 indicates that in the treatment of epidural space and selective nerve root block, the use of medium and long-term glucocorticoids shall not exceed 3 times within 6 months, and the short-term effect shall not exceed 5 times; intra articular injection of glucocorticoid shall be conducted once every 3 months, and the longest continuous 2 years. People often say that “addiction” may be caused by disease dependence, because of physical or disease reasons, patients really need long-term use of analgesic drugs, such as rheumatoid arthritis patients need to take long-term hormone. “Addiction” in medicine refers to mental dependence and addiction, which means that people have a desire to use drugs periodically or continuously, and produce compulsive medication behavior in order to obtain satisfaction or avoid discomfort. Opiates are the most common addictive drugs that the common people are afraid of. Drug addicts are easy to get addicted to, but addiction to pain patients is relatively rare. The pain is obviously improved after taking analgesics, and it will recur as soon as the drug is stopped. This situation is often due to the disease itself, such as some patients with degenerative arthritis or chronic low back pain, and the pain will recur. No matter what kind of analgesics they are, they should be used under the guidance of doctors. Doctors will choose treatment drugs according to the primary disease, combined diseases, medication history and so on. The commonly used analgesics in clinic include nonsteroidal anti-inflammatory drugs, opioid analgesics, anticonvulsants, antidepressants and so on. The mechanism of action and adverse reactions of different drugs are different, so they can not be generalized. Non steroidal anti-inflammatory drugs do have gastrointestinal side effects, such as epigastric pain, nausea, dyspepsia, etc. in severe cases, gastroduodenal erosion, ulcer and life-threatening gastrointestinal perforation and bleeding may occur. Patients with corresponding high-risk factors should use non steroidal anti-inflammatory and analgesic drugs cautiously. If the patient needs to take NSAIDs for a long time, pay attention to the monitoring of blood routine and occult blood in stool. If there is discomfort, inform the doctor in time. The adverse reactions of analgesic drugs are not only related to drug characteristics, but also related to personal constitution, dosage, duration of use, and whether there are risk factors for adverse drug reactions. Therefore, when selecting analgesic drugs, we should communicate with doctors about the patient’s normal health status, whether there is any history of adverse reactions of analgesic drugs in the past, and the accompanying diseases and taking With the drugs, doctors will choose the appropriate treatment drugs according to the patient’s situation, so as to minimize the incidence of adverse reactions. At present, some analgesic drugs also carry out genetic testing to predict the risk of adverse reactions of patients taking drugs, so as to reduce the occurrence of adverse reactions. Most of acute pain can be completely relieved after the removal of pathogenic factors. However, chronic pain can not be cured due to its complex etiology, which requires long-term treatment, such as diabetes, essential hypertension and other chronic diseases. The purpose of chronic pain treatment is often symptomatic treatment, relieve pain, improve mood, improve the quality of life. It is not scientific to try to “cure” chronic pain through one or several treatments, which needs to be treated correctly. < / P > < p > many patients go to the hospital when they can’t bear the pain, and even suffer pain for a long time without proper treatment. Experts and others at the meeting jointly appealed to the public to find out the pain early, correctly understand the pain, and solve the pain as soon as possible, so as to improve the quality of life.