Eisenberg Elon, Geller Rimma, Brill Silviu
Rambam Medical Center and Israel Institute of Technology, Pain Relief Unit, Haifa Pain Research Group, Haifa, Israel.
Expert Rev Neurother. 2007 May;7(5):521-31. doi: 10.1586/14737175.7.5.521.
Complex regional pain syndrome is a painful disorder of unclear etiology, typically involving the distal part of one limb, represented by spontaneous and evoked pain as well as autonomic, motor and trophic abnormalities. It can be incapacitating and severely affect function and quality of life. Although full-blown complex regional pain syndrome can be diagnosed easily, less fulminate forms of the syndrome often remain undiagnosed. Controlled trials have demonstrated that a short course of oral corticosteroids, intranasal or intramuscular calcitonin, intravenous bisphosphonates, free-radical scavengers, gabapentin, regional intravenous sympathetic blocks with bretylium and spinal cord stimulation or physical therapy and occupational therapy can be efficacious for complex regional pain syndrome. Nonetheless, the management of this syndrome is difficult because currently available drugs and technologies do not provide adequate pain relief for a considerable percentage of sufferers. The present review focuses primarily on the pharmacotherapy of complex regional pain syndrome and describes briefly the epidemiology, pathogenesis and clinical manifestations of the syndrome.
复杂性区域疼痛综合征是一种病因不明的疼痛性疾病，通常累及一侧肢体的远端，表现为自发痛和诱发性疼痛以及自主神经、运动和营养异常。它可能使人丧失能力，并严重影响功能和生活质量。虽然典型的复杂性区域疼痛综合征容易诊断，但该综合征的较轻型往往仍未被诊断出来。对照试验表明，短期口服皮质类固醇、鼻内或肌肉注射降钙素、静脉注射双膦酸盐、自由基清除剂、加巴喷丁、用溴苄铵进行区域静脉交感神经阻滞、脊髓刺激或物理治疗及职业治疗对复杂性区域疼痛综合征可能有效。尽管如此，该综合征的治疗仍很困难，因为目前可用的药物和技术并不能为相当一部分患者提供充分的疼痛缓解。本综述主要关注复杂性区域疼痛综合征的药物治疗，并简要描述该综合征的流行病学、发病机制和临床表现。
