Beydoun Ahmad, Backonja Misha-Miroslav
Department of Neurology, University of Michigan Medical School, Ann Arbor, MI 48109, USA.
J Pain Symptom Manage. 2003 May;25(5 Suppl):S18-30. doi: 10.1016/s0885-3924(03)00066-6.
Current treatment options in neuropathic pain include antidepressants, antiepileptics, antiarrhythmics, and analgesics. However, stratification of treatments based on their original therapeutic class is inadequate, as drugs belonging to a particular class may have distinct antineuralgic modes of action. It is therefore useful to review the mechanisms of action of these drugs and determine which of these mechanisms is most likely responsible for the drugs' efficacy in the symptomatic treatment of neuropathic pain. Switching from the traditional therapeutic class stratification to one based on putative antineuralgic mechanisms of action will allow more rational selection of therapies, and aid evaluation of the additive or synergistic effects of drugs when used in combination.
目前用于治疗神经性疼痛的方法包括使用抗抑郁药、抗癫痫药、抗心律失常药和镇痛药。然而，根据药物原来的治疗类别进行分层是不够的，因为属于某一特定类别的药物可能具有不同的抗神经痛作用模式。因此，回顾这些药物的作用机制并确定这些机制中哪一种最有可能是药物对神经性疼痛进行症状治疗时产生疗效的原因是很有必要的。从传统的治疗类别分层转向基于假定抗神经痛作用机制的分层，将有助于更合理地选择治疗方法，并有助于评估药物联合使用时的相加或协同作用。
