1.The Graduate School, Shanxi Medical University, Shanxi Province, Taiyuan 030001, China;
2.Department of Rheumatism and Immunity, the Second Hospital of Shanxi Medical University, Shanxi Province, Taiyuan 030001, China
Abstract：Rheumatoid arthritis (RA) is a chronic, systemic autoimmune disease characterized by symmetry and polyarthritis. “Pain” is the most common symptom of rheumatoid arthritis. Rheumatoid arthritis pain is caused by a variety of factors, in addition to inflammatory factors, non-inflammatory factors including central nervous system regulatory pathway abnormalities, damage to the surrounding joints, fibromyalgia and chronic generalized pain can cause pain, In addition, other factors including psychological factors such as sleep disorders, anxiety and depression, cognitive responses such as pain disaster and self-efficacy, positive and negative behavioral responses, diet and obesity, and comprehensive nursing care may also affect pain perception in RA patients. Patients and physicians must recognize that not all pain is inflammatory, and that non-inflammatory treatment strategies need to be considered in addition to antirheumatic medications.
[1] Denk F，Mcmahon SB，Tracey I. Pain vulnerability：a neurobiological perspective [J]. Nat Neurosci，2014，17（2）：192-200.
[2] Woolf CJ. Central sensitization：implications for the diagnosis and treatment of pain [J]. Pain，2011，152（3）：S2-S15.
[3] Koop SM，ten Klooster PM，Vonkeman HE，et al. Neuropathic-like pain features and cross-sectional associations in rheumatoid arthritis [J]. Arthritis Res Ther，2015，17（1）：237.
[4] Schaible HG，Ebersberger A，Natura G. Update on peripheral mechanisms of pain：beyond prostaglandins and cytokines [J]. Arthritis Res Ther，2011，13（2）：210.
[5] Walsh DA，McWilliams DF. Mechanisms，impact and management of pain in rheumatoid arthritis [J]. Nat Rev Rheumatol，2014，10（10）：581-592.
[6] 张美娟.膝关节生理解剖环境对膝关节生物力学特性的影响[J].中国组织工程研究，2012，16（26）：4903-4907.
[7] Walitt B，Nahin RL，Katz RS，et al. The prevalence and characteristics of fibromyalgia in the 2012 National Health Interview Survey [J]. PLoS One，2015，10（9）：e0138024.
[8] Joharatnam N，McWilliams DF，Wilson D，et al. A cross-sectional study of pain sensitivity，disease-activity assessment，mental health，and fibromyalgia status in rheumatoid arthritis [J]. Arthritis Res Ther，2015，17（1）：11.
[9] Lee YC，Frits ML，Iannaccone CK，et al. Subgrouping of patients with rheumatoid arthritis based on pain，fatigue，inflammation，and psychosocial factors [J]. Arthritis Rheumatol，2014，66（8）：2006-2014.
[10] Taylor-Gjevre RM，Gjevre JA，Nair B，et al. Components of sleep quality and sleep fragmentation in rheumatoid arthritis and osteoarthritis [J]. Musculoskeletal care，2011， 9（3）：152-159.
[11] Irwin MR，Olmstead R，Carrillo C，et al. Sleep loss exacerbates fatigue，depression，and pain in rheumatoid arthritis [J]. Sleep，2012，35（4）：537-543.
[12] Tang NK，Lereya ST，Boulton H，et al. Nonpharmacological treatments of insomnia for long-term painful conditions：a systematic review and meta-analysis of patient-reported outcomes in randomized controlled trials [J]. Sleep，2015，38（11）：1751-1764.
[13] Smith BW，Zautra AJ. The effects of anxiety and depression on weekly pain in women with arthritis [J]. Pain，2008，138（2）：354-361.
[14] Edwards RR，Cahalan C，Mensing G，et al. Pain，catastrophizing，and depression in the rheumatic diseases [J]. Nat Rev Rheumatol，2011，7（4）：216-224.
[15] Knittle KP，De Gucht V，Hurkmans EJ，et al. Effect of self-efficacy and physical activity goal achievement on arthritis pain and quality of life in patients with rheumatoid arthritis [J]. Arthrit Care Res，2011，63（11）：1613-1619.
[16] Edwards RR，Cahalan C，Calahan C，et al. Pain，catastrophizing，and depression in the rheumatic diseases [J]. Nat Rev Rheumatol，2011，7（4）：216-224.
[17] Englbrecht M，Gossec L，Delongis A，et al. The Impact of Coping Strategies on Mental and Physical Well-Being in Patients with Rheumatoid Arthritis [J]. Semin Arthritis Rheum，2012，41（4）：545-555.
[18] Deane KD，Demoruelle MK，Kelmenson LB，et al. Genetic and environmental risk factors for rheumatoid arthritis [J]. Best Pract Res Clin Rheumatol，2017，31（1）：3-18.
[19] Navarini L，Afeltra A，Gallo Afflitto G，et al. Polyunsaturated fatty acids：any role in rheumatoid arthritis? [J]. Lipids Health Dis，2017，16（1）：197.
[20] Lourdudoss C，Di Giuseppe D，Wolk A，et al. Dietary Intake of Polyunsaturated Fatty Acids and Pain in Spite of Inflammatory Control Among Methotrexate-Treated Early Rheumatoid Arthritis Patients [J]. Arthrit Care Res，2018， 70（2）：205-212.
[21] Simopoulos AP. An increase in the omega-6/omega-3 fatty acid ratio increases the risk for obesity [J]. Nutrients，2016，8（3）：128.
[22] Okifuji A，Hare BD. The association between chronic pain and obesity [J]. J Pain Res，2015，8：399-408.
[23] 秦亚兰.对类风湿关节炎患者关节疼痛的临床观察及护理[J].世界最新医学信息文摘，2018，18（67）：207-209.
[24] 蒋燕红，傅根莲，刘晓霞.类风湿关节炎护理研究进展[J].中华现代护理杂志，2018，24（9）：1112-1116.
2020, Vol. 17 
京公网安备 11010502046598号