Spagna Annachiara, Attal Nadine
CETD, Ambroise Pare Hospital, APHP, 92100 Boulogne-Billancourt, France.
CETD, Ambroise Pare Hospital, APHP, 92100 Boulogne-Billancourt, France; Inserm U987, UVSQ-Paris-Saclay University, Ambroise Pare Hospital, APHP, 92100 Boulogne-Billancourt, France.
Presse Med. 2024 Jun;53(2):104233. doi: 10.1016/j.lpm.2024.104233. Epub 2024 Apr 16.
Neuropathic pain poses a significant challenge due to its complex mechanisms, necessitating specific treatments. In recent decades, significant progress has been made in the clinical research of neuropathic pain, marking a shift from empirical strategies to evidence-based medicine in its management. This review outlines both pharmacological and non-pharmacological interventions. Antidepressants (tricyclic and serotonin-noradrenaline reuptake inhibitors), antiepileptics (gabapentin, pregabalin), and topical agents constitute the main pharmacological treatments. These approaches target peripheral or central mechanisms associated with neuropathic pain. Noninvasive neurostimulation, including transcutaneous electrical nerve stimulation (TENS) and repetitive transcranial magnetic stimulation (rTMS), provides non-pharmacological alternatives. However, challenges persist in effectively targeting existing medications and developing drugs that act on novel targets, necessitating innovative therapeutic strategies.
神经性疼痛因其复杂的机制而构成重大挑战，需要特定的治疗方法。近几十年来，神经性疼痛的临床研究取得了显著进展，标志着其管理从经验性策略向循证医学的转变。本综述概述了药物和非药物干预措施。抗抑郁药（三环类和5-羟色胺-去甲肾上腺素再摄取抑制剂）、抗癫痫药（加巴喷丁、普瑞巴林）和局部用药构成了主要的药物治疗方法。这些方法针对与神经性疼痛相关的外周或中枢机制。非侵入性神经刺激，包括经皮电刺激神经疗法（TENS）和重复经颅磁刺激（rTMS），提供了非药物替代方案。然而，在有效靶向现有药物和开发作用于新靶点的药物方面仍然存在挑战，因此需要创新的治疗策略。
