Yajima Yoshinori, Narita Minoru, Ozaki Masahiko, Niikura Keiichi, Suzuki Tsutomu
Dept. of Toxicology, Hoshi University School of Pharmacy and Pharmaceutical Sciences.
Gan To Kagaku Ryoho. 2005 Oct;32(10):1377-83.
According to the World Health Organization (WHO) guidelines for patients with moderate or severe pain, morphine has been used as a "gold standard" treatment for cancer pain. Recent clinical experiences have demonstrated that when morphine is used to control pain in cancer patients, psychological dependence is not a major concern. However, undue anxiety about psychological dependence on morphine in cancer patients has caused physicians and patients to use inadequate doses of opioids. In basic research, we reported that the morphine-induced rewarding effects can be dramatically suppressed under a neuropathic pain-like state induced by sciatic nerve ligation and an inflammatory pain-like state produced by intraplantar injection of formalin or carrageenan in rodents. The use of morphine for the treatment of pain is sometimes accompanied with side effects such as emesis, constipation and drowsiness. We show that the lower doses of morphine produce emesis, whereas antinociceptive doses of morphine show no emetic responses in ferrets. These findings provide further evidence that an adequate dose of morphine is useful and safe in a clinical setting.
根据世界卫生组织（WHO）针对中度或重度疼痛患者的指南，吗啡一直被用作癌症疼痛的“金标准”治疗药物。近期的临床经验表明，当使用吗啡来控制癌症患者的疼痛时，心理依赖并非主要问题。然而，对癌症患者吗啡心理依赖的过度担忧导致医生和患者使用阿片类药物的剂量不足。在基础研究中，我们报告称，在啮齿动物坐骨神经结扎诱导的神经性疼痛样状态以及足底注射福尔马林或角叉菜胶产生的炎性疼痛样状态下，吗啡诱导的奖赏效应可被显著抑制。使用吗啡治疗疼痛有时会伴有诸如呕吐、便秘和嗜睡等副作用。我们发现，较低剂量的吗啡会引起呕吐，而镇痛剂量的吗啡在雪貂中未表现出催吐反应。这些发现进一步证明，在临床环境中，适当剂量的吗啡是有用且安全的。
