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[疼痛与阿片类药物]

[Pain and opioids].

作者信息

Murányi Marianna, Radák Zsolt

机构信息

Semmelweis Egyetem Testnevelési és Sporttudományi Kar Budapest.

出版信息

Orv Hetil. 2008 Dec 14;149(50):2363-70. doi: 10.1556/OH.2008.28449.

Abstract

Noxious stimuli cause pain to protect the body from harmful situations and attract attention to pathophysiologic changes of the body. Specific receptors of pain (nociceptors) can be found all over our body. Pain initiates protecting mechanisms such as vegetative and motor reflexes, and emotional, behavioral changes. However, chronic pain is practically useless and leads to psychopathological changes. There are several ways to relieve pain including non-steroid anti-inflammatory agents, opioids, neurosurgical and non-invasive methods. Central and peripheral effects of opioids can be realized through opioid receptors of the central and the enteric nervous system. In the central nervous system, they can inhibit the perception of pain or change the emotional reactions. Opioids are indicated in postoperative pain, neuropathic pain and cancer. However, the use of opioids has severe side-effects such as breathing depression and the development of tolerance and dependence which do not make opioids optimal painkillers. There are several laboratories in Hungary and abroad working on the design of optimal pain relievers. Furthermore, the euphoric effects of opioids lead to abuse which makes the research important on the mechanisms of opioid addiction. Taken together, opioid research, the design of new compounds and the exploration of the mechanisms of opiate addiction are very important.

摘要

有害刺激引发疼痛以保护身体免受有害情况影响,并促使人们关注身体的病理生理变化。我们全身都能找到特定的疼痛感受器(伤害感受器)。疼痛会引发诸如自主神经和运动反射以及情绪、行为变化等保护机制。然而,慢性疼痛实际上并无益处,还会导致精神病理变化。缓解疼痛有多种方法,包括非甾体抗炎药、阿片类药物、神经外科手术和非侵入性方法。阿片类药物的中枢和外周作用可通过中枢神经系统和肠神经系统的阿片受体实现。在中枢神经系统中,它们可抑制疼痛感知或改变情绪反应。阿片类药物适用于术后疼痛、神经性疼痛和癌症疼痛。然而,使用阿片类药物会产生严重的副作用,如呼吸抑制以及耐受性和依赖性的形成,这使得阿片类药物并非最佳的止痛药。匈牙利国内外有多个实验室致力于设计最佳的止痛药物。此外,阿片类药物的欣快感会导致滥用,这使得对阿片类药物成瘾机制的研究变得很重要。综上所述,阿片类药物研究、新化合物的设计以及阿片成瘾机制的探索都非常重要。

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