多学科专家关于在疼痛管理中使用自然疗法草药的循证观点。
Evidence-Based Opinions from Multidisciplinary Experts on Use of Naturopathic Herbal Remedies in Pain Management.
作者信息
Mobasheri Ali, Spring-Charles Aliyyaa, Gamaleri Francesco Carlo, McSwan Joyce, Garg Manohar, Sethi Vidhu Sood
机构信息
Research Unit of Health Sciences and Technology, Physics and Technology, University of Oulu, Oulu, Finland.
Department of Regenerative Medicine, State Research Institute Centre for Innovative Medicine, Vilnius, Lithuania.
出版信息
J Pain Res. 2024 Feb 8;17:599-608. doi: 10.2147/JPR.S432090. eCollection 2024.
BACKGROUND
Pharmacological approaches to acute and chronic pain management, including non-steroidal anti-inflammatory drugs (NSAIDs) and opioids, are respectively associated with adverse reactions (such as gastrointestinal, cardiovascular, and renal effects) that might limit their use in patients with comorbidities and controversy related to inappropriate use. Naturopathic remedies might offer patients alternative and integrative treatments with minimal side effects.
OBJECTIVE
To explore the regional variation in the acceptance and use of naturopathic remedies in pain management.
METHODS
Two expert panel discussions were held by GlaxoSmithKline Consumer Healthcare (now Haleon Pte. Ltd.) over 9 and 12 hours in 2020 and 2021, respectively, and attended by multidisciplinary experts in naturopathy, Ayurvedic medicine, community pharmacy, physiotherapy, clinical pharmacy, Western medicine, academics, and naturopathic pain relief. Experts shared and discussed their experiences of naturopathic treatments and relevant clinical evidence related to different types of pain (including joint and muscle pain, migraine, sleeplessness due to pain, and general pain) and examined barriers to providing support to patients.
RESULTS
Experts agreed on the potential for curcumin (2020, 71.4% [5/7]; 2021, 91.7% [11/12]) and fish oil (2020, 100% [7/7]) for management of osteoarthritic joint pain although these are not uniformly recommended in osteoarthritis treatment guidelines. In treatment of migraines, coenzyme Q10 and magnesium were favored by experts (2021, 90.9% [10/11] and 63.6% [7/11], respectively).
CONCLUSION
The need was emphasized for more and higher quality clinical studies to support naturopathic remedies, which might not be reflected in the latest treatment guidelines. The expert panel also highlighted missed opportunities for physicians and pharmacists to recommend effective naturopathic treatments.
背景
急性和慢性疼痛管理的药理学方法，包括非甾体抗炎药（NSAIDs）和阿片类药物，分别与不良反应（如胃肠道、心血管和肾脏影响）相关，这些不良反应可能会限制它们在合并症患者中的使用，以及与不当使用相关的争议。自然疗法可能为患者提供副作用最小的替代和综合治疗。
目的
探讨自然疗法在疼痛管理中的接受度和使用的地区差异。
方法
葛兰素史克消费者保健公司（现为Haleon私人有限公司）分别在2020年和2021年举行了两次专家小组讨论，时长分别为9小时和12小时，自然疗法、阿育吠陀医学、社区药房、物理治疗、临床药学、西医、学术界和自然疗法疼痛缓解方面的多学科专家参加了讨论。专家们分享并讨论了他们的自然疗法治疗经验以及与不同类型疼痛（包括关节和肌肉疼痛、偏头痛、疼痛引起的失眠和全身疼痛）相关的临床证据，并研究了为患者提供支持的障碍。
结果
专家们一致认为姜黄素（2020年，71.4%[5/7]；2021年，91.7%[11/12]）和鱼油（2020年，100%[7/7]）对骨关节炎关节疼痛的管理有潜力，尽管骨关节炎治疗指南中并未一致推荐这些。在偏头痛治疗中，辅酶Q10和镁受到专家青睐（2021年，分别为90.9%[10/11]和63.6%[7/11]）。
结论
强调需要更多高质量的临床研究来支持自然疗法，这可能未在最新治疗指南中得到体现。专家小组还强调了医生和药剂师推荐有效自然疗法时错失的机会。
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