Svendsen Kristina B, Andersen Steen, Arnason Sigurdur, Arnér Staffan, Breivik Harald, Heiskanen Tarja, Kalso Eija, Kongsgaard Ulf E, Sjogren Per, Strang Peter, Bach Flemming W, Jensen Troels S
Danish Pain Research Center, University Hospital of Aarhus, Noerrebrogade 44, Building 1A, 8000 Aarhus, Denmark.
Eur J Pain. 2005 Apr;9(2):195-206. doi: 10.1016/j.ejpain.2004.06.001.
Breakthrough pain or transient worsening of pain in patients with an ongoing steady pain is a well known feature in cancer pain patients, but it is also seen in non-malignant pain conditions with involvement of nerves, muscles, bones or viscera. Continuous and intermittent pain seems to be a general feature of these different pain conditions, and this raises the possibility of one or several common mechanisms underlying breakthrough pain in malignant and non-malignant disorders. Although the mechanisms of spontaneous ongoing pain and intermittent flares of pain (BTP) may be difficult to separate, we suggest that peripheral and/or central sensitization (hyperexcitability) may play a major role in many causes of BTP. Mechanical stimuli (e.g. micro-fractures) changes in chemical environments and release of tumour growth factors may initiate sensitization both peripherally and centrally. It is suggested that sensitization could be the common denominator of BTP in malignant and non-malignant pain.
在持续稳定疼痛的患者中，突发疼痛或疼痛短暂加剧是癌症疼痛患者的一个众所周知的特征，但在涉及神经、肌肉、骨骼或内脏的非恶性疼痛情况中也可见到。持续性和间歇性疼痛似乎是这些不同疼痛情况的一个普遍特征，这就增加了恶性和非恶性疾病中突发疼痛存在一种或几种共同机制的可能性。尽管自发持续性疼痛和间歇性疼痛发作（突发疼痛）的机制可能难以区分，但我们认为外周和/或中枢敏化（过度兴奋）可能在许多突发疼痛的病因中起主要作用。机械刺激（如微骨折）、化学环境变化和肿瘤生长因子的释放可能在外周和中枢引发敏化。有人提出，敏化可能是恶性和非恶性疼痛中突发疼痛的共同特征。
