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TMHMA:NOHEYTIKH

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2005

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- - .............................7 1- ........................................9 2- .....12

............................................................................12 .....................................................13 ............................................15 ..................................................................16 .............................18 (GATE CONTROL

THEORY)..........................................................................................19

3- ........................................21

....................................................................22 ......26

4- ......................31 ...............................................................32 ...........................................................33

3

5- ...34

.........................................................35 ..........................................................................39 ...................................................................42 ...............................................................44 ............................................................................46 ....................................................................48

6 - ................................49

...........................................................49 .........................................................68 .............................................................78

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, , , , . , . V, VII, IX, X. , , C .

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P ( ) (CGRP) (VIP) (CCK) T

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(GATE CONTROL THEORY)

Metzack Wall 1965. . . , , , - - . , , - C, . , , . , , . , . , , , C, . ,

21

.

Gate Control Theory of Wall and Melzack

1. (P) (S) (L) .

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4. , (L) (I), , ().

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(Visual Analog scale), , 10cm, .

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(Brief Pain Inventory) , , , , , . , , . (Pain Diary)

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. .

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. o Likert ( ). , . , .

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, , . . , , . , , , . , . , , 45-55 , . . , 70% , , . , , , . , . , 4 7 :

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1. 2. 3. 4. 5. 6. 7. , :

,

Panayi , ,

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, ) .

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, . , , . . , . , , , , , . . 50 , . , . , , . , . , , , . , . , . . . 50-60%

42

, . . , . . , , , . . , , . , , , , , .

43

: ) , , (NSAIDs) , ) (SADOA), . NSAIDs, , . NSAIDs , . NSAIDs , . NSAIDs . NSAIDs, 2, , . , , . . , .

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, . , , , , . . , , , , , , . , , . , , , .

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1)

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() (Dolobid) (rilisate) (Disalcid)

(SAIDs)

, . . NSAIDs : . NSAIDs :

(Feldene) (Voltaren) (Ponstel) (Meclomen) (Tolectin) (Indocin) (Motrin, Nuprin) (Nalfon) (Naprosyn) (Orudis)

NSAIDs , naphthylalkanones , .

56

NSAIDs ( ) . SAIDs -, , , . -.

1) 2) 3) 4) , ,

( ), , , .

5) 6) ,

1) 2) 3) 4)

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1) 2) 3) , 4) 5) 6)

1)

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2) 3)

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: (Anafranil) (Sinequan) (Wellbutrin) (Prozac) (Marplan) (Tofranil) N (Vivactil) (Surmontil)

60

(Parnate)

, , . , (Tegretol), (Klonopin), (Depakote) (Dilantin).

1) . . .

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1. .

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.

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.

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65

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(Lioresal)

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85

Patberg et al. 1985; Sibley 1985; Affleck et al. 1987; Guedj and Weinberger 1990), ( Laborde et al. 1986), ( Anderson et al. 1965), (Weinbrecth and Simon 1989), (Kranzl 1977), (Menges 1983) (Persinger 1980). . , . Rentschler et al (1929), Kellgren et al (1953), Hollander and Veostros (1963), Lowrence and Molgneux (1968), Harris (1984), Patberg et al (1985), Dequeker and Wuestenrand (1985), Guedj and Weinberger (1990) and Arbet at al (1994). , . (Sibley 1985; Latman 1981; Van de Laar et al 1991). Hollander (1961), , , , . . 70 (Shutty et al (1992), 87% , 77% . , , , . .. 558 (Robert N.Jamison, Karen

86

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(Rasker et al 1986, Hollander and Yeostros 1963, Harris 1984). , , , , . , , , , . , . , . , , ,

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, , , 1995 2. ,

, , .1995

Studio Press, , , 1998

4. - ,

1997

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-