慢性非癌性疼痛的治疗。

Treatment of chronic non-cancer pain.

机构信息

Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA 98195, USA.

出版信息

Lancet. 2011 Jun 25;377(9784):2226-35. doi: 10.1016/S0140-6736(11)60402-9.

Abstract

Chronic pain is a pervasive problem that affects the patient, their significant others, and society in many ways. The past decade has seen advances in our understanding of the mechanisms underlying pain and in the availability of technically advanced diagnostic procedures; however, the most notable therapeutic changes have not been the development of novel evidenced-based methods, but rather changing trends in applications and practices within the available clinical armamentarium. We provide a general overview of empirical evidence for the most commonly used interventions in the management of chronic non-cancer pain, including pharmacological, interventional, physical, psychological, rehabilitative, and alternative modalities. Overall, currently available treatments provide modest improvements in pain and minimum improvements in physical and emotional functioning. The quality of evidence is mediocre and has not improved substantially during the past decade. There is a crucial need for assessment of combination treatments, identification of indicators of treatment response, and assessment of the benefit of matching of treatments to patient characteristics.

摘要

慢性疼痛是一个普遍存在的问题,它以多种方式影响着患者、他们的重要他人和整个社会。在过去的十年中,我们对疼痛背后的机制以及技术先进的诊断程序的理解有了进步;然而,最显著的治疗变化并不是新的循证方法的发展,而是可用临床工具包中应用和实践的变化趋势。我们提供了关于慢性非癌性疼痛管理中最常用干预措施的经验证据的概述,包括药理学、介入、物理、心理、康复和替代方式。总的来说,目前可用的治疗方法在疼痛方面提供了适度的改善,在身体和情绪功能方面只有最小的改善。证据的质量一般,在过去十年中并没有实质性的提高。对于联合治疗的评估、治疗反应指标的确定以及将治疗与患者特征相匹配的益处的评估,都有着至关重要的需求。

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