Srinivasan Malathy, Torres Joseph E, McGeary Donald, Nagpal Ameet S
Department of Physical Medicine and Rehabilitation, Sidney Kimmel Medical College at Thomas Jefferson University.
UT Health San Antonio, Department of Anesthesiology.
Curr Phys Med Rehabil Rep. 2020 Sep;8(3):240-248. doi: 10.1007/s40141-020-00264-6. Epub 2020 May 23.
I.To provide an overview of the current complementary and alternative (CAM) treatment options for women with chronic pelvic pain (CPP).
II.Recent studies on chronic pain at cellular, molecular and network level and their interaction with the immune system has unfolded several mechanisms for pain making it promising to explore the alternative paradigm to manage the incredibly complex chronic pelvic pain condition where multifactorial etiology often limits successful outcomes.
III.The multifactorial nature and complexity in establishing the underlying diagnosis in CPP limits predictable response to traditional medical and interventional options. Complementary and alternative options have been studied to improve outcomes. Incorporation of exercise-based CAM, pelvic floor physical therapy, acupuncture and cognitive behavioral therapy are suggested to show promising results but well powered randomized studies are needed to draw conclusions on their efficacy. Evidence for non-opioid alternatives such as oral cannabinoids are preliminary and may emerge to be safe and effective.
I. 概述目前针对慢性盆腔疼痛(CPP)女性的补充和替代(CAM)治疗选择。
II. 近期在细胞、分子和网络水平上对慢性疼痛及其与免疫系统相互作用的研究揭示了多种疼痛机制,这使得探索替代模式来管理极其复杂的慢性盆腔疼痛状况成为可能,因为多因素病因常常限制了成功的治疗结果。
III. CPP潜在诊断的多因素性质和复杂性限制了对传统医学和介入治疗选择的可预测反应。补充和替代治疗选择已被研究以改善治疗结果。建议将基于运动的补充和替代医学、盆底物理治疗、针灸和认知行为疗法纳入其中,这些方法显示出有前景的结果,但需要有充分样本量的随机研究来得出关于其疗效的结论。非阿片类替代药物(如口服大麻素)的证据是初步的,可能会证明其安全有效。