Objectives This review and meta-analysis evaluated the impact of diagnostic criteria and clinical phenotypes on quantitative sensory testing (QST) outcomes in patients with complex regional pain syndrome (CRPS). Methods Eight databases were searched based on a previously published protocol. Forty studies comparing QST outcomes between CRPS-I versus II, warm versus cold CRPS, upper versus lower limb CRPS, males versus females, or using Budapest versus older IASP criteria were included. Results Studies investigating QST differences between CRPS-I versus II (n = 4), between males versus females (n = 2), and between upper and lower limb CRPS (n = 2) showed no significant differences. Four studies compared QST outcomes in warm versus cold CRPS, showing heat hyperalgesia in warm CRPS, with thermal and mechanical sensory loss in cold CRPS. Although CRPS diagnosed using the Budapest criteria (24 studies) versus 1994 IASP criteria (13 studies) showed similar sensory profiles, there was significant heterogeneity and low quality of evidence in the latter. Conclusion Based on the findings of this review, classifying CRPS according to presence or absence of nerve lesion into CRPS-I and II, location (upper or lower limb) or according to sex might not be clinically relevant as all appear to have comparable sensory profiles that might suggest similar underlying mechanisms. In contrast, warm versus cold phenotypes exhibited clear differences in their associated QST sensory profiles. To the extent that differences in underlying mechanisms might lead to differential treatment responsiveness, it appears unlikely that CRPS-I vs. II, CRPS location, or patient sex would prove useful in guiding clinical management.

中文翻译：

---

不同 CRPS 表型和诊断标准对定量感官测试结果的影响：系统评价和荟萃分析

目的 本综述和荟萃分析评估了诊断标准和临床表型对复杂区域疼痛综合征 (CRPS) 患者定量感觉测试 (QST) 结果的影响。方法 根据先前发布的方案检索八个数据库。纳入了四十项研究，比较 CRPS-I 与 II、热 CRPS 与冷 CRPS、上肢 CRPS 与下肢 CRPS、男性与女性、或使用布达佩斯与旧的 IASP 标准之间的 QST 结果。结果 研究 CRPS-I 与 II (n = 4)、男性与女性 (n = 2) 以及上肢和下肢 CRPS (n = 2) 之间 QST 差异的研究显示没有显着差异。四项研究比较了热 CRPS 与冷 CRPS 的 QST 结果，显示热 CRPS 中存在热痛觉过敏，而冷 CRPS 中存在热感觉和机械感觉丧失。尽管使用布达佩斯标准（24 项研究）与 1994 年 IASP 标准（13 项研究）诊断的 CRPS 显示出相似的感官特征，但后者存在显着的异质性和低质量的证据。结论 根据本综述的结果，根据是否存在神经病变、部位（上肢或下肢）或根据性别将 CRPS 分类为 CRPS-I 和 II，可能没有临床相关性，因为所有这些似乎都具有可比的感觉特征这可能表明类似的潜在机制。相比之下，温暖与寒冷的表型在相关的 QST 感官特征上表现出明显的差异。就潜在机制的差异可能导致不同的治疗反应而言，CRPS-I 与 II、CRPS 位置或患者性别似乎不太可能在指导临床管理中发挥作用。