Northern Anesthesia & Pain Medicine, 10928 Eagle River Rd. #240, Eagle River, AK 99577, USA.
Loma Linda University School of Medicine, 11175 Campus St., Loma Linda, CA 92350, USA.
Pain Manag. 2022 Sep;12(6):699-709. doi: 10.2217/pmt-2021-0122. Epub 2022 Mar 15.
To evaluate the use of low-dose naltrexone (LDN) as a broad-spectrum analgesic. Retrospective cohort study from a single pain management practice using data from 2014 to 2020. Thirty-six patients using LDN for ≥2 months were matched to 42 controls. Pain scores were assessed at initial visit and at most recent/final documented visit using a 10-point scale. Cases reported significantly greater pain reduction (-37.8%) than controls (-4.3%; p < 0.001). Whole sample multivariate modeling predicts 33% pain reduction with LDN, with number needed to treat (for 50% pain reduction) of 3.2. Patients with neuropathic pain appeared to benefit even more than those with 'nociceptive'/inflammatory pain. LDN is effective in a variety of chronic pain states, likely mediated by TLR-4 antagonism.
评估低剂量纳曲酮（LDN）作为一种广谱镇痛药的效果。采用单中心疼痛管理实践的回顾性队列研究，数据来源于 2014 年至 2020 年。36 例患者使用 LDN 治疗≥2 个月，与 42 例对照患者匹配。采用 10 分制在初始就诊和最近/最终记录就诊时评估疼痛评分。病例组报告的疼痛缓解率显著高于对照组（-37.8%比-4.3%；p<0.001）。全样本多变量模型预测 LDN 可使疼痛缓解 33%，治疗缓解 50%的患者所需人数（NNT）为 3.2。神经病理性疼痛患者的获益似乎比“伤害感受性/炎症性”疼痛患者更大。LDN 在多种慢性疼痛状态中有效，可能通过 TLR-4 拮抗作用介导。
