Роль алекситимии в клинической картине хронической неспецифической тазовой боли у женщин

Abstract

The purpose was to evaluate the impact of alexithymia on the severity of clinical manifestations of chronic nonspecific pelvic pain (CNPP) in women. Material and methods. The study included 138 women with CNPP. All patients underwent a neurological examination, assessment of pain intensity using a visual analog scale (VAS), assessment of the level of alexithymia using the Russian version of the 20-item Toronto Alexithymia Scale (TAS). Pharmacotherapy of CNPP included the following sequential prescription: aceclofenac 100 mg, 2 times a day for 7 days, tolperisone 150 mg, 3 times a day for 2 weeks, escitalopram 5 mg, once a day for 2 months. Results. The patients were divided into 2 groups: group A (n = 101) — without alexithymia, group B (n = 37) — with alexithymia (average TAS score = 74 [65; 85]). A positive correlation was established between the level of alexithymia and the intensity of pain according to the VAS in patients of group B. According to the effectiveness of pharmacotherapy, patients of group A were divided into 3 subgroups A1, A2, A3. In subgroup A1, the intensity of pain decreased to 30 [20; 40] mm (p = 0.0032) after taking aceclofenac. In subgroup A2, pain decreased to 30 [10; 40] mm (p = 0.0042) after taking tolperisone. In the A3 subgroup, pain decreased 0 [0; 5] mm (p = 0.012) after taking escitalopram. In patients of group B, no effect of pharmacotherapy was noted. After the completion of pharmacotherapy, the patients were recommended kinesitherapy, after which the patients of group B experienced a decrease in pain to 40 [30; 45] mm (p = 0.00021), and a decrease in the level of alexithymia to 50 [45; 60] points (p = 0.0023 ). Conclusion. Patients with CNPP are low sensitive to traditional pharmacotherapy of pain, including drugs of peripheral and central action. Kinesitherapy has a positive effect, including stretching exercises and relaxation of skeletal muscles.