Zhonghua Yi Xue Za Zhi. 2023 Oct 24;103(39):3088-3102. doi: 10.3760/cma.j.cn112137-20230529-00876.
Non-opioid analgesics are one of the important clinical treatment drugs for chronic pain disorders, which mainly include non-steroidal anti-inflammatory analgesics, ion channel drugs, antidepressants, glucocorticoids, neurotrophic drugs, muscle relaxants, α adrenergic receptor agonists, bone metabolism regulating drugs, N-methyl-D-aspartate receptor antagonists and traditional Chinese patent medicines. The guidelines for the treatment of chronic pain disorders based on international classification of diseases (ICD)-11 with non-opioid analgesics have not been reported. This guideline was formulated under the leadership of expert group on Pain Disease Diagnosis and Treatment Special Ability Training Project of National Health Commission Capacity Building and Continuing Education Center (hereinafter referred to as the expert group). The expert group systematically searches and evaluates the effectiveness evidence related to the indications, contraindications, precautions, and other issues of non-opioid analgesics treatment for the seven major categories of chronic pain diseases in ICD-11. It also recommends non-opioid analgesic drug treatment for special chronic pain patients such as the elderly, women and children, as well as patients with liver and kidney dysfunction. This guide aims to provide reference for the application of non-opioid analgesics in the treatment of chronic pain disorders in different disciplines.
非阿片类镇痛药是慢性疼痛性疾病重要的临床治疗药物之一，主要包括非甾体类抗炎镇痛药、离子通道药物、抗抑郁药、糖皮质激素、神经营养药物、肌肉松弛剂、α肾上腺素能受体激动剂、骨代谢调节药物、N-甲基-D-天冬氨酸受体拮抗剂及中成药。基于国际疾病分类（ICD）-11采用非阿片类镇痛药治疗慢性疼痛性疾病的指南尚未见报道。本指南在国家卫生健康委能力建设和继续教育中心疼痛疾病诊疗专项能力培训项目专家组（以下简称专家组）的领导下制定。专家组系统检索并评价了ICD-11中7大类慢性疼痛疾病采用非阿片类镇痛药治疗的适应证、禁忌证、注意事项等有效性证据，同时针对老年、妇女、儿童及肝肾功能不全等特殊慢性疼痛患者推荐了非阿片类镇痛药物治疗方案。本指南旨在为不同学科应用非阿片类镇痛药治疗慢性疼痛性疾病提供参考。
