Joshi S K, Gebhart G F
Department of Pharmacology, The University of Iowa College of Medicine, 2-302 Bowen Science Building, Iowa City, IA 52242, USA.
Curr Rev Pain. 2000;4(6):499-506. doi: 10.1007/s11916-000-0074-7.
Visceral pain, although different from somatic pain in several important features, is not as widely researched and consequently our knowledge of neurophysiologic mechanisms as well as clinical management of visceral pain states remains unsatisfactory. Several recent studies have employed different visceral pain animal models to provide insight into the peripheral and central nervous system mechanisms underlying pain originating from the urinary bladder, ureter, and gastrointestinal tract. The effects of opioid and nonopioid drugs in these models have also been evaluated and are reviewed in this article. The importance of anatomic pathways relaying pain sensation in the central nervous system, particularly the newly described dorsal column pathway, is also discussed. In human subjects, new techniques like positron emission tomography are now being used to better understand visceral pain perception. Such findings deriving from basic animal research and human studies summarized in the present overview lead to a better understanding of visceral pain states and may be helpful in developing better treatment strategies to combat visceral pain states in the clinical setting.
内脏痛虽然在几个重要特征上与躯体痛不同,但对其研究并不广泛,因此我们对内脏痛状态的神经生理机制以及临床管理的了解仍不尽人意。最近的几项研究采用了不同的内脏痛动物模型,以深入了解源自膀胱、输尿管和胃肠道的疼痛的外周和中枢神经系统机制。本文还评估并综述了阿片类药物和非阿片类药物在这些模型中的作用。还讨论了在中枢神经系统中传递痛觉的解剖学途径的重要性,特别是新描述的背柱途径。在人类受试者中,正电子发射断层扫描等新技术现在正被用于更好地理解内脏痛觉。本综述中总结的来自基础动物研究和人体研究的这些发现,有助于更好地理解内脏痛状态,并可能有助于制定更好的治疗策略,以对抗临床环境中的内脏痛状态。