辣椒素可诱发带状疱疹后神经痛患者的疼痛和痛觉过敏。

Capsaicin evoked pain and allodynia in post-herpetic neuralgia.

作者信息

Petersen Karin L, Fields Howard L, Brennum Jannick, Sandroni Paola, Rowbotham Michael C

机构信息

Department of Neurology, UCSF Pain Clinical Research Center, University of California, San Francisco, CA, USA Department of Anesthesia, UCSF Pain Clinical Research Center, University of California, San Francisco, CA, USA Department of Physiology, UCSF Pain Clinical Research Center, University of California, San Francisco, CA, USA Laboratory of Pain Physiology, Department of Anesthesia, Herlev Hospital, Herlev, Denmark Department of Neurosurgery, Rigshospitalet, Denmark Mayo Clinic, Rochester, MN, USA.

出版信息

Pain. 2000 Nov;88(2):125-133. doi: 10.1016/S0304-3959(00)00311-0.

DOI:10.1016/S0304-3959(00)00311-0

PMID:11050367

Abstract

The hypothesis that the pain and allodynia associated with post-herpetic neuralgia (PHN) is maintained by a combination of input from preserved primary afferent nociceptors and sensitization of central pain transmitting neurons was examined in 17 subjects with PHN. Pain, allodynia, thermal sensory function, cutaneous innervation, and response to controlled application of 0.075% capsaicin were measured. Compared to mirror-image skin, applying capsaicin on a 9 cm(2) area of PHN skin significantly increased overall PHN pain and allodynia in 11 of 17 subjects. These 'capsaicin responders' were characterized by higher average daily pain, higher allodynia ratings, and relatively preserved sensory function at baseline compared to the non-responders. In three of the 'capsaicin responders' the area of allodynia expanded into previously non-allodynic and non-painful skin that had normal sensory function and cutaneous innervation. These observations support the hypothesis that allodynia in some PHN patients is a form of chronic secondary hyperalgesia maintained by input from intact and possibly 'irritable' primary afferent nociceptors to a sensitized CNS.

摘要

在17名带状疱疹后神经痛（PHN）患者中，研究了以下假设：与PHN相关的疼痛和痛觉过敏是由保留的初级传入伤害感受器的输入与中枢性疼痛传递神经元的敏化共同维持的。测量了疼痛、痛觉过敏、热感觉功能、皮肤神经支配以及对0.075%辣椒素控制性应用的反应。与镜像皮肤相比，在17名受试者中的11名患者的9平方厘米PHN皮肤区域涂抹辣椒素，显著增加了总体PHN疼痛和痛觉过敏。与无反应者相比，这些“辣椒素反应者”的特征是平均每日疼痛更高、痛觉过敏评分更高，且基线时感觉功能相对保留。在三名“辣椒素反应者”中，痛觉过敏区域扩展到先前无痛觉过敏和无痛的皮肤，这些皮肤具有正常的感觉功能和皮肤神经支配。这些观察结果支持了以下假设：一些PHN患者的痛觉过敏是一种慢性继发性痛觉过敏，由完整且可能“易激惹”的初级传入伤害感受器向敏化的中枢神经系统输入维持。