わが国における慢性疼痛および神経障害性疼痛に関する大規模実態調査

A Large-scale Survey on Chronic Pain and Neuropathic Pain in Japan

　背景：「疼痛」は，患者のみならず健康な人に対してもQOLを大きく損なうことが知られているにも関わらず，わが国では「疼痛」に関する大規模調査は少なく，疼痛患者の実態および治療に対する認識も十分ではない．また近年，慢性疼痛の中でも非ステロイド性抗炎症薬(NSAIDs)に反応性が低い疼痛として注目されている神経障害性疼痛については，患者のみならず医師の間においても，その認知度は低い．

　対象と方法：20～69歳の男女20,000名をスクリーニング対象とし，慢性疼痛の定義を満たした3,365名の慢性疼痛患者を対象に，慢性疼痛と神経障害性疼痛の実態，既存治療に対する満足度などについて，インターネットによる大規模調査を実施した．

　結果：慢性疼痛患者は20～69歳人口の26.4％，そのうち神経障害性疼痛の疑いのある患者は24.1％(20～69歳人口の6.4％)を占め，慢性疼痛患者の4人に1人は神経障害性疼痛の疑いがあることがわかった．また，慢性疼痛患者のうち医療機関での治療経験者の72.4％が治療を中止しており，その多くが満足な治療効果が得られないことを理由に挙げていた．

　まとめ：疼痛を遷延化させないためには，適切な早期診断・早期治療が求められる．

　Background：It is widely known that "pain" can significantly reduce the quality of life (QOL) of patients as well as healthy people.　Nevertheless, hardly any large-scale surveys of "pain" have been conducted in Japan, and patients who have pain and their treatment are insufficiently understood.　Neuropathic pain is a type of chronic pain that has recently been found to be resistant to non-steroidal anti-inflammatory drugs (NSAIDs), and it is poorly recognized by both patients and physicians.

　Methods：We screened 20,000 men and women 20 to 69 years of age in our large-scale web-based surey to identify patients with chronic pain, and the 3365 patients who met the definition of chronic pain were then surveyed in regard to chronic pain, neuropathic pain, and their satisfaction with existing treatments.

　Outcome：The prevalence of chronic pain among the subjects of the survey was 26.4%, and 24.1% of them, or approximately one in four of the patients with chronic pain, were suspected of having neuropathic pain (6.4% of the subjects as a whole).　Medical treatment was discontinued by 72.4% of the subjects with chronic pain who had sought treatment, mostly because of dissatisfaction with its effects.

　Conclusion：Proper early diagnosis and treatment are needed to prevent chronic pain.