Sawynok Jana
Department of Pharmacology, Dalhousie University, 5850 College Street, Halifax, Nova Scotia, Canada.
Curr Pharm Des. 2005;11(23):2995-3004. doi: 10.2174/1381612054865019.
Neuropathic pain can be difficult to treat clinically, as current therapies involve partial effectiveness and significant adverse effects. Following the development of preclinical models for neuropathic pain, significant advances have been made in understanding the neurobiology of neuropathic pain. This includes an appreciation of the molecular entities involved in initiation of pain, the role of particular afferents (small and large diameter, injured and uninjured), and the contribution of inflammation. Currently, topical formulations of capsaicin (cream) and lidocaine (patch) are available for treating neuropathic pain in humans. Preclinical studies provide evidence that peripheral applications of opioids, alpha-adrenergic agents, and antidepressants also may be beneficial in neuropathic pain, and some clinical reports provide support for topical applications of such agents. An appreciation of the ability of drug application, to sites remote from the site of injury, to alleviate aspects of neuropathic pain will provide a significant impetus for the further development of novel topical analgesics for this condition.
神经性疼痛在临床上可能难以治疗，因为目前的治疗方法效果有限且有显著的副作用。随着神经性疼痛临床前模型的发展，在理解神经性疼痛的神经生物学方面取得了重大进展。这包括对疼痛起始过程中涉及的分子实体、特定传入神经（小直径和大直径、受损和未受损）的作用以及炎症的作用的认识。目前，辣椒素（乳膏）和利多卡因（贴片）的局部制剂可用于治疗人类的神经性疼痛。临床前研究表明，外周应用阿片类药物、α-肾上腺素能药物和抗抑郁药也可能对神经性疼痛有益，一些临床报告也支持此类药物的局部应用。认识到在远离损伤部位的地方应用药物缓解神经性疼痛的某些方面的能力，将为进一步开发针对这种情况的新型局部镇痛药提供重要动力。
