Harden Norman, Cohen Mitchell
Rehabilitation Institute of Chicago, Chicago, IL 60677, USA.
J Pain Symptom Manage. 2003 May;25(5 Suppl):S12-7. doi: 10.1016/s0885-3924(03)00065-4.
Neuropathic pain is a challenging condition to treat. It is heterogeneous in nature and largely resistant to treatment with commonly prescribed analgesics. Current management strategies fail to achieve adequate or satisfactory pain relief in a high proportion of patients. The four main reasons that treatments for neuropathic pain fail are: inadequate diagnosis and a lack of appreciation of the mechanisms involved; insufficient management of comorbid conditions; incorrect understanding or selection of treatment options; and the use of inappropriate outcomes measures. These unmet needs in the current management of neuropathic pain are reviewed in this article. The review focuses on the need for a methodical and mechanistic approach to diagnosis, and a flexible, interdisciplinary approach to treatment of neuropathic pain conditions, in order to improve pain relief and quality of life in patients with neuropathic pain.
神经性疼痛是一种难以治疗的病症。其本质具有异质性,并且对常用的处方镇痛药大多具有耐药性。当前的管理策略在很大一部分患者中未能实现充分或令人满意的疼痛缓解。神经性疼痛治疗失败的四个主要原因是:诊断不足以及对所涉及机制缺乏认识;对合并症的管理不足;对治疗选择的理解或选择不正确;以及使用不恰当的疗效指标。本文对当前神经性疼痛管理中这些未满足的需求进行了综述。该综述着重强调需要采用有条理的、基于机制的方法进行诊断,以及采用灵活的、跨学科的方法来治疗神经性疼痛病症,以改善神经性疼痛患者的疼痛缓解情况和生活质量。