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慢性疼痛综合征、机制及当前治疗方法。

Chronic pain syndromes, mechanisms, and current treatments.

作者信息

Sirianni Justin, Ibrahim Mohab, Patwardhan Amol

机构信息

Department of Anesthesiology, University of Arizona, Tucson, Arizona, USA.

Department of Anesthesiology, University of Arizona, Tucson, Arizona, USA.

出版信息

Prog Mol Biol Transl Sci. 2015;131:565-611. doi: 10.1016/bs.pmbts.2015.01.004. Epub 2015 Feb 9.

Abstract

Although acute pain is a physiological response warning the human body of possible harm, chronic pain can be a pathological state associated with various diseases or a disease in itself. In the United States alone, around one-third of the population has experienced a chronic pain condition and annual cost to the society is in the range of 500-600 billion dollars.(1) It should be noted that if at all this is a very modest estimate, it surpasses the costs associated with cancer, heart disease, and diabetes combined.(1) Unfortunately, despite these humongous costs, the treatment of chronic pain is inadequate.(1) Chronic pain affects individuals in a variety of forms, and below we highlight some of the most common chronic pain conditions seen in a pain clinic. Most of these disorders are difficult to treat and typically require multimodal therapy including pharmacotherapy, behavioral modification, and targeted interventions. We have summarized the scope of each disorder, clinical features, proposed mechanisms, and current therapies for them (Table 1).

摘要

虽然急性疼痛是一种向人体发出可能伤害警告的生理反应,但慢性疼痛可能是与各种疾病相关的病理状态,或者其本身就是一种疾病。仅在美国,就约有三分之一的人口经历过慢性疼痛状况,社会每年为此付出的成本在5000亿至6000亿美元之间。(1)应当指出的是,即便这是一个非常保守的估计,它也超过了癌症、心脏病和糖尿病的综合成本。(1)不幸的是,尽管成本巨大,慢性疼痛的治疗仍不充分。(1)慢性疼痛以多种形式影响个体,下面我们将重点介绍疼痛诊所中一些最常见的慢性疼痛状况。这些疾病大多难以治疗,通常需要多模式治疗,包括药物治疗、行为矫正和靶向干预。我们总结了每种疾病的范围、临床特征、推测机制和当前治疗方法(表1)。

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