Department of Anesthesiology, Vanderbilt University School of Medicine, Nashville, Tennessee 37212, USA.
Anesthesiology. 2010 Sep;113(3):713-25. doi: 10.1097/ALN.0b013e3181e3db38.
Complex regional pain syndrome (CRPS) is a neuropathic pain disorder with significant autonomic features. Few treatments have proven effective, in part, because of a historically poor understanding of the mechanisms underlying the disorder. CRPS research largely conducted during the past decade has substantially increased knowledge regarding its pathophysiologic mechanisms, indicating that they are multifactorial. Both peripheral and central nervous system mechanisms are involved. These include peripheral and central sensitization, inflammation, altered sympathetic and catecholaminergic function, altered somatosensory representation in the brain, genetic factors, and psychophysiologic interactions. Relative contributions of the mechanisms underlying CRPS may differ across patients and even within a patient over time, particularly in the transition from "warm CRPS" (acute) to "cold CRPS" (chronic). Enhanced knowledge regarding the pathophysiology of CRPS increases the possibility of eventually achieving the goal of mechanism-based CRPS diagnosis and treatment.
复杂性区域疼痛综合征（CRPS）是一种伴有显著自主特征的神经性疼痛障碍。为数不多的治疗方法已被证明是有效的，部分原因是由于历史上对该疾病发病机制的了解不佳。过去十年中进行的 CRPS 研究大大增加了对其病理生理机制的了解，表明其具有多因素性。外周和中枢神经系统机制都参与其中。这些机制包括外周和中枢敏感化、炎症、交感神经和儿茶酚胺能功能改变、大脑中感觉代表的改变、遗传因素和心理生理相互作用。CRPS 发病机制的相对贡献可能因患者而异，甚至在同一患者随时间的推移而变化，特别是在从“温热型 CRPS”（急性）到“冷型 CRPS”（慢性）的转变过程中。对 CRPS 病理生理学的深入了解增加了最终实现基于机制的 CRPS 诊断和治疗目标的可能性。
