Mackey Sean, Feinberg Steven
Stanford University, 780 Welch Road #208, Palo Alto, CA 94304, USA.
Curr Pain Headache Rep. 2007 Feb;11(1):38-43. doi: 10.1007/s11916-007-0020-z.
Complex regional pain syndrome (CRPS) remains a challenging condition to diagnose and treat. There are few large-scale, randomized trials of pharmacologic agents, and most published studies are small, uncontrolled, or presented only in abstract form at meetings. The most commonly used agents, such as anticonvulsants, antidepressants, and opiates, have been found to be useful for other neuropathic pain conditions in large-scale trials but have not been adequately studied in CRPS. Systemic steroids delivered by multiple routes continue to be used, with some good evidence for short-term administration. N-methyl-D-aspartate antagonists have recently gained in popularity, without evidence from well-controlled trials. Bisphosphonates have been well studied and offer promise. In addition, there has been interest in thalidomide; however, we are still awaiting well-controlled trials. This article presents an overview of the available data regarding pharmacologic therapies for CRPS. These agents should be used in conjunction with a comprehensive interdisciplinary approach aimed at functional restoration and improved quality of life.
复杂性区域疼痛综合征（CRPS）的诊断和治疗仍然是一项具有挑战性的工作。关于药物治疗的大规模随机试验很少，大多数已发表的研究规模较小、未设对照，或仅在会议上以摘要形式呈现。在大规模试验中，已发现最常用的药物，如抗惊厥药、抗抑郁药和阿片类药物，对其他神经性疼痛有效，但在CRPS中尚未得到充分研究。通过多种途径给药的全身性类固醇仍在使用，有一些证据支持短期使用。N-甲基-D-天冬氨酸拮抗剂最近越来越受欢迎，但缺乏来自对照良好试验的证据。双膦酸盐已得到充分研究并展现出前景。此外，沙利度胺也引起了人们的兴趣；然而，我们仍在等待对照良好的试验结果。本文概述了有关CRPS药物治疗的现有数据。这些药物应与旨在功能恢复和提高生活质量的综合多学科方法联合使用。
