Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, UK.
Curr Opin Anaesthesiol. 2023 Oct 1;36(5):595-601. doi: 10.1097/ACO.0000000000001305. Epub 2023 Aug 13.
This review looks to overview advances in endometriosis-associated pain, both in understanding the pain mechanisms involved and increasing treatment options with well designed clinical trials and meta-analyses.
Our understanding of endometriosis-associated pain has progressed from a purely nociceptive model to an awareness that both neuropathic and nociplastic mechanisms can be present for some people with endometriosis. Clinical trials and meta-analyses have demonstrated efficacy of surgical treatments and hormonal therapies. It is notable that currently, the basic science and clinical trials are not cross-fertilising.
Following growth in other areas of chronic pain, there have been significant advances in our understanding of endometriosis-associated pain. However, there remains lots to explore and we are currently a long way from our goal of timely personalized holistic multidisciplinary treatment for all sufferers of endometriosis-associated pain.
本篇综述旨在概述与子宫内膜异位症相关疼痛的研究进展,包括对相关疼痛机制的理解,以及通过精心设计的临床试验和荟萃分析来增加治疗选择。
我们对与子宫内膜异位症相关的疼痛的理解已经从纯粹的伤害感受模型发展到认识到一些子宫内膜异位症患者可能同时存在神经病理性和感觉性疼痛机制。临床试验和荟萃分析已经证明了手术治疗和激素治疗的有效性。值得注意的是,目前基础科学和临床试验并没有相互促进。
在慢性疼痛的其他领域取得进展后,我们对与子宫内膜异位症相关疼痛的理解也取得了重大进展。然而,仍有许多方面需要探索,我们离为所有与子宫内膜异位症相关疼痛患者提供及时、个性化、全面和多学科治疗的目标还有很长的路要走。