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非药物性治疗疼痛性周围神经病:系统评价。

Non-Pharmacological Management of Painful Peripheral Neuropathies: A Systematic Review.

机构信息

Medical School, University of Cyprus, Nicosia, Cyprus.

Whipps Cross Hospital, Barts Health NHS Trust, London, UK.

出版信息

Adv Ther. 2020 Oct;37(10):4096-4106. doi: 10.1007/s12325-020-01462-3. Epub 2020 Aug 18.


DOI:10.1007/s12325-020-01462-3
PMID:32809209
Abstract

INTRODUCTION: Peripheral neuropathic pain (PNP) is defined as the neuropathic pain that arises either acutely or in the chronic phase of a lesion or disease affecting the peripheral nervous system. PNP is associated with a remarkable disease burden, and there is an increasing demand for new therapies to be used in isolation or combination with currently available treatments. The aim of this systematic review was to evaluate the current evidence, derived from randomized controlled trials (RCTs) that assess non-pharmacological interventions for the treatment of PNP. METHODS: After a systematic Medline search, we identified 18 papers eligible to be included. RESULTS: The currently best available evidence (level II of evidence) exist for painful diabetic peripheral neuropathy. In particular, spinal cord stimulation as adjuvant to conventional medical treatment can be effectively used for the management of patients with refractory pain. Similarly, adjuvant repetitive transcranial magnetic stimulation of the motor cortex is effective in reducing the overall pain intensity, whereas adjuvant static magnetic field therapy can lead to a significant decrease in exercise-induced pain. Weaker evidence (level III of evidence) exists for the use of acupuncture as a monotherapy and neurofeedback, either as an add-on or a monotherapy approach, for treatment of painful chemotherapy-induced peripheral neuropathy CONCLUSIONS: Future RCTs should be conducted to shed more light in the use of non-pharmacological approaches in patients with PNP.

摘要

简介:周围神经性疼痛(PNP)定义为影响外周神经系统的病变或疾病的急性或慢性阶段出现的神经性疼痛。PNP 与显著的疾病负担相关,对于新的治疗方法的需求不断增加,这些方法可以单独使用或与现有治疗方法联合使用。本系统评价的目的是评估源于评估治疗 PNP 的非药物干预的随机对照试验(RCT)的现有证据。 方法:经过系统的 Medline 搜索,我们确定了 18 篇符合纳入标准的论文。 结果:目前针对糖尿病性周围神经病理性疼痛的最佳证据(证据级别 II)。特别地,脊髓刺激作为常规医学治疗的辅助手段可以有效地用于治疗难治性疼痛的患者。同样,运动皮质重复经颅磁刺激的辅助治疗可有效降低整体疼痛强度,而静磁场治疗可显著减轻运动引起的疼痛。对于针刺作为单一疗法以及神经反馈,无论是作为附加或单一疗法,用于治疗化疗引起的周围神经病理性疼痛的证据较弱(证据级别 III)。 结论:未来应进行 RCT 以进一步阐明在 PNP 患者中使用非药物方法的效果。

相似文献

[1]
Non-Pharmacological Management of Painful Peripheral Neuropathies: A Systematic Review.

Adv Ther. 2020-10

[2]
Pharmacological Management of Painful Peripheral Neuropathies: A Systematic Review.

Pain Ther. 2021-6

[3]
Non-pharmacological interventions for chronic pain in people with spinal cord injury.

Cochrane Database Syst Rev. 2014-11-28

[4]
Repetitive Magnetic Stimulation for the Management of Peripheral Neuropathic Pain: A Systematic Review.

Adv Ther. 2020-1-27

[5]
Adjuvant physical exercise for the management of painful polyneuropathy.

Postgrad Med. 2022-6

[6]
Duloxetine for treating painful neuropathy, chronic pain or fibromyalgia.

Cochrane Database Syst Rev. 2014-1-3

[7]
Neuropathic pain--recent trends in management.

J Indian Med Assoc. 2001-12

[8]
Oxcarbazepine for neuropathic pain.

Cochrane Database Syst Rev. 2017-12-2

[9]
Effectiveness of repetitive trancranial or peripheral magnetic stimulation in neuropathic pain.

Disabil Rehabil. 2017-5

[10]
Pharmacological and non-pharmacological treatments for neuropathic pain: Systematic review and French recommendations.

Rev Neurol (Paris). 2020-4-7

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[1]
Lending a hand: supportive exercise therapy for cancer treatment-induced polyneuropathy of the upper extremity-VISCIPH A.

Support Care Cancer. 2025-7-22

[2]
Decoding pain chronification: mechanisms of the acute-to-chronic transition.

Front Mol Neurosci. 2025-6-26

[3]
A multimodal intervention of manual therapy, exercise, and psychological management for painful diabetic neuropathy: intervention development and feasibility trial protocol.

Pain Manag. 2025-7

[4]
The comparative evidence of efficacy of non-invasive brain and nerve stimulation in diabetic neuropathy: a systematic review and network meta-analysis.

J Neuroeng Rehabil. 2025-4-19

[5]
Nonpharmaceutical treatment of distal sensorimotor polyneuropathy in diabetic patients: an unblinded randomized clinical trial.

BMC Complement Med Ther. 2025-3-6

[6]
An Open-Label Comparative Study of the Impact of Two Types of Electrical Stimulation (Direct Current Neuromuscular Electrical Stimulation and Transcutaneous Electrical Stimulation) on Physical Therapy Treatment of Diabetic Peripheral Neuropathy.

J Diabetes Res. 2025-2-4

[7]
Comparison of the effect of separate and simultaneous application of Tecar therapy and low-level laser therapy on the neurological symptoms of type 2 diabetic patients with peripheral neuropathy of lower limbs.

Turk J Phys Med Rehabil. 2024-8-26

[8]
RNA Interference Unleashed: Current Perspective of Small Interfering RNA (siRNA) Therapeutics in the Treatment of Neuropathic Pain.

ACS Pharmacol Transl Sci. 2024-9-23

[9]
A Systematic Guideline by the ASPN Workgroup on the Evidence, Education, and Treatment Algorithm for Painful Diabetic Neuropathy: SWEET.

J Pain Res. 2024-4-13

[10]
Diabetic Neuropathic Pain: Directions for Exploring Treatments.

Biomedicines. 2024-3-6

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