Ohata M, Shimoyama N, Shimoyama M
Division of Pain and Palliative Medicine, National Cancer Center Hospital.
Nihon Rinsho. 2001 Sep;59(9):1775-80.
Cancer pain is usually treated by 1) pharmacotherapy, 2) nerve block, 3) radiation therapy, 4) cognitive therapy and 5) alternative medicine. Among these methods, pharmacotherapy is the simplest way to relieve cancer pain without special equipment or special settings. WHO cancer treatment guideline shows morphine is effective to most cancer pain. However, 10-20% of the patients' pain is refractory to morphine. A majority of such refractory pain is due to nerve injury caused by cancer itself or by treatment. Recently, many biological processes involved in the mechanism of neuropathic pain have been elucidated. Pharmacological treatment aimed at blocking such processes should produce specific effects on the pain. Such mechanism-based pharmacotherapy is the most effective way to treat difficult pain.
1)药物治疗,2)神经阻滞,3)放射治疗,4)认知治疗和5)替代医学。在这些方法中,药物治疗是缓解癌症疼痛最简单的方法,无需特殊设备或特殊环境。世界卫生组织癌症治疗指南表明,吗啡对大多数癌症疼痛有效。然而,10%-20%的患者疼痛对吗啡无效。大多数此类难治性疼痛是由癌症本身或治疗引起的神经损伤所致。最近,许多参与神经性疼痛机制的生物学过程已被阐明。旨在阻断这些过程的药物治疗应对疼痛产生特定效果。这种基于机制的药物治疗是治疗难治性疼痛最有效的方法。