Gunawardena Dulan A, Stanley Edward, Issler-Fisher Andrea C
Concord Clinical School, University of Sydney, New South Wales, Australia.
Concord Repatriation General Hospital, Sydney, New South Wales, Australia.
J Burn Care Res. 2023 Sep 7;44(5):1182-1188. doi: 10.1093/jbcr/irad021.
Post-burn pruritus and neuropathic pain significantly affect the quality of life of affected individuals in several domains including psychosocial well-being, sleep and general impairment in activities of daily living. Whilst neural mediators involved in itch in the non-burns setting have been well investigated, there remains a lacuna of literature examining the pathophysiological and histological changes unique to burn-related pruritus and neuropathic pain. The aim of our study was to conduct a scoping review into the neural factors that contribute to burn-related pruritus and neuropathic pain. A scoping review was conducted to provide an overview of the available evidence. The PubMed, EMBASE and Medline databases were searched for publications. Data regarding neural mediators implicated, population demographics, total body surface area (TBSA) affected and sex was extracted. In total, 11 studies were included in this review with a total of 881 patients. The most frequently investigated neurotransmitter was the Substance P (SP) neuropeptide which appeared in 36% of studies (n = 4), followed by calcitonin gene-related peptide (CGRP) in 27% of studies (n = 3). Post-burn pruritus and neuropathic pain are symptomatic experiences that are predicated upon a heterogeneous group of underlying mechanisms. What is clear from the literature, however, is that itch and pain may occur secondary to the influence of both neuropeptides, such as SP, and other neural mediators including Transient receptor protein channels. Of the articles included for review, they were characterized by small sample sizes and large differences in statistical methodology and reporting.
烧伤后瘙痒和神经性疼痛在包括心理社会幸福感、睡眠和日常生活活动总体受损等多个领域显著影响受影响个体的生活质量。虽然在非烧伤情况下参与瘙痒的神经介质已得到充分研究，但对于烧伤相关瘙痒和神经性疼痛所特有的病理生理和组织学变化的文献研究仍存在空白。我们研究的目的是对导致烧伤相关瘙痒和神经性疼痛的神经因素进行范围综述。进行范围综述以提供现有证据的概述。在PubMed、EMBASE和Medline数据库中搜索出版物。提取有关所涉及的神经介质、人群统计学特征、受影响的体表面积（TBSA）和性别的数据。本综述共纳入11项研究，涉及881名患者。研究最频繁的神经递质是P物质（SP）神经肽，在36%的研究（n = 4）中出现，其次是降钙素基因相关肽（CGRP），在27%的研究（n = 3）中出现。烧伤后瘙痒和神经性疼痛是基于一组异质性潜在机制的症状体验。然而，从文献中可以明确的是，瘙痒和疼痛可能继发于神经肽（如SP）和其他神经介质（包括瞬时受体蛋白通道）的影响。在所纳入综述的文章中，其特点是样本量小，统计方法和报告存在很大差异。
