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[神经性疼痛:病理生理学、评估与治疗]

[Neuropathic pain: pathophysiology, assessment, and therapy].

作者信息

Sommer C

机构信息

Neurologische Klinik, Universitätsklinikum Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Deutschland,

出版信息

Schmerz. 2013 Dec;27(6):619-32; quiz 633-4. doi: 10.1007/s00482-013-1344-8.

Abstract

Neuropathic pain is caused by lesions in the somatosensory system. Characteristic but not exclusive features are spontaneous burning pain, electrifying and shooting pain, hyperalgesia, and allodynia. The basic concept of the pathophysiology of neuropathic pain is the combination of peripheral and central sensitization. Knowledge on the molecular mechanisms has grown exponentially in recent years. The problem lies in identifying the individual mechanisms and in determining a comprehensive concept. Progress has also been made in assessment, e.g., methods for detecting dysfunction of nociceptors have significantly improved. In addition, there are many more therapeutic options available than 15 years ago. The drugs available include antidepressants, anticonvulsants, opioids, and topical medications. Data from controlled trials and recommendations from guidelines are available.

摘要

神经病理性疼痛由体感系统的损伤引起。其特征性但并非唯一的症状包括自发性灼痛、电击样和刺痛、痛觉过敏和感觉异常。神经病理性疼痛病理生理学的基本概念是外周和中枢敏化的结合。近年来,关于分子机制的知识呈指数级增长。问题在于识别个体机制并确定一个全面的概念。在评估方面也取得了进展,例如,检测伤害感受器功能障碍的方法有了显著改进。此外,与15年前相比,有更多的治疗选择。可用药物包括抗抑郁药、抗惊厥药、阿片类药物和局部用药。有来自对照试验的数据和指南的建议。

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