만성 전신통증을 동반한 만성피로 환자에서 치료 전후 피로 증상과 관련된 요인
Fatigue Related Factors in Chronic Fatigue Patients with Chronic Widespread Pain after Treatment
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연구배경: 섬유근통증후군과 만성피로증후군 환자의 피로증상에 대한 기전은 아직 명확히 알려져 있지 않지만 최근 만성 통증이 만성피로 증상을 일으키는 주된 요인이라는 주장이 대두되고 있는데 본 연구에서는 만성피로와 관련된 주된 요인을 파악하고자 본 연구를 시행하였다. 방법: 일개 대학병원 일차의료기관을 방문한 환자들 중 만성적인 전신통증과 만성피로가 주 증상인 18세 이상의 환자들 중 섬유근통 증후군과 만성피로증후군(특발성 만성피로포함)으로 진단된 37명의 환자가 연구대상이었다. 연구는 4주 간의 증상 치료를 거쳐 시행되었으며 모든 대상들은 피로정도, 통증강도, 우울정도 및 불안정도를 치료전후로 파악하였다. 피로정도와 통증강도, 우울정도, 불안정도와의 상관성을 치료 전후로 분석하였고, 4주 후 피로정도의 호전과 관련된 통증강도, 우울정도, 불안정도의 변화와의 관련성을 파악하기 위한 회귀분석을 시행하였다. 결과: 치료 전 대상들의 피로정도는 통증강도, 우울정도, 불안정도와 모두 유의한 상관성이 있었다. 하지만, 치료 4주 후에는 통증강도만 피로정도와 유의한 상관성이 있었으나 우울정도나 불안정도는 상관성이 없었으며, 통증 강도의 변화만 피로정도의 호전과 통계적으로 유의하게 관련이 있었지만 우울정도나 불안정도의 호전은 관련이 없었다. 결론: 만성피로 및 만성적인 전신통증을 호소하는 환자들에서의 치료 후 피로증상의 호전은 통증강도의 호전과 연관이 있었지만, 우울 및 불안 등의 정서적 요인의 호전과는 연관성이 없었다.
Abstract
Background: The mechanism of fatigue in patients with fibromyalgia (FM) and CFS (CFS) has not been clarified, but recently there are opinions that chronic pain is a major factor causing chronic fatigue. We performed this study to identify major factors related to chronic fatigue. Methods: The subjects were 37 patients aged over 18 who visited the primary care institute of a university hospital, whose major symptoms were chronic widespread pain and chronic fatigue and who were given the diagnosis of FM or CFS. The research was carried out through four weeks of symptomatic treatment. The correlation of fatigue severity with the intensity of pain, depression level and anxiety level was analyzed, and regression analysis was conducted to examine the relation between improvement of fatigue after the four weeks’ treatment and changes in the intensity of pain, depression level and anxiety level. Results: After the four week treatment, only the intensity of pain was significantly correlatied with fatigue severity. In addition, only change in the intensity of pain was statistically significantly correlatied with the improvement of fatigue. Conclusion: In patients who complained of chronic fatigue and chronic widespread pain, the improvement of fatigue after treatment was related to the reduction of pain but not emotional factors such as depression and anxiety. (J Korean Acad Fam Med 2006;27:442-448)
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