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中风后中枢性疼痛现代治疗方法的进展:一项叙述性综述

Advancements in Modern Treatment Approaches for Central Post-Stroke Pain: A Narrative Review.

作者信息

Asadauskas Auste, Stieger Andrea, Luedi Markus M, Andereggen Lukas

机构信息

Department of Neurosurgery, Cantonal Hospital of Aarau, 5001 Aarau, Switzerland.

Faculty of Medicine, University of Bern, 3012 Bern, Switzerland.

出版信息

J Clin Med. 2024 Sep 11;13(18):5377. doi: 10.3390/jcm13185377.

Abstract

PURPOSE OF REVIEW

Central post-stroke pain (CPSP) poses a multifaceted challenge in medical practice, necessitating a thorough and multidisciplinary approach for its diagnosis and treatment. This review examines current methods for addressing CPSP, highlighting both pharmacological and non-pharmacological therapies. It covers the mechanisms and clinical effectiveness of these treatments in managing CPSP and emphasizes the importance of personalized treatment plans, given the varied causes of CPSP.

RECENT FINDINGS

Recent advancements have illuminated diverse treatment modalities for CPSP. Pharmacotherapy spans from conventional analgesics to anticonvulsants and antidepressants, tailored to mitigate the neuropathic characteristics of CPSP. Non-pharmacological interventions, including physical therapy and psychological strategies, are pivotal in managing CPSP's chronic nature. For cases resistant to standard treatments, advanced interventions such as nerve blocks and surgical procedures like deep brain stimulation (DBS) or motor cortex stimulation (MCS) are considered. Additionally, innovative technologies such as neuromodulation techniques and personalized medicine are emerging as promising avenues to enhance therapeutic outcomes and improve quality of life for individuals grappling with CPSP.

SUMMARY

Modern approaches in managing CPSP require an interdisciplinary and patient-centric approach. Customizing treatment plans to address the specific etiology and symptoms of CPSP is crucial. Pharmacotherapy remains fundamental, encompassing medications such as anticonvulsants and antidepressants tailored to manage neuropathic pain. Integrating non-pharmacological interventions is crucial for providing comprehensive care. Additionally, investigating innovative technologies and personalized medicine presents promising opportunities to enhance treatment results and elevate the quality of life for those suffering from CPSP. Ultimately, an integrated approach that acknowledges the multifaceted nature of CPSP is essential for effective management and patient well-being.

摘要

综述目的

中风后中枢性疼痛(CPSP)在医学实践中构成了多方面的挑战,需要采用全面且多学科的方法进行诊断和治疗。本综述探讨了当前应对CPSP的方法,重点介绍了药物治疗和非药物治疗。它涵盖了这些治疗方法在管理CPSP方面的机制和临床效果,并强调了个性化治疗方案的重要性,因为CPSP的病因各不相同。

最新发现

最近的进展揭示了CPSP的多种治疗方式。药物治疗范围从传统镇痛药到抗惊厥药和抗抑郁药,旨在减轻CPSP的神经病理性特征。非药物干预,包括物理治疗和心理策略,对于管理CPSP的慢性性质至关重要。对于对标准治疗有抵抗的病例,可考虑采用神经阻滞等先进干预措施以及深部脑刺激(DBS)或运动皮层刺激(MCS)等手术程序。此外,神经调节技术和个性化医疗等创新技术正成为有前景的途径,以提高治疗效果并改善患有CPSP的个体的生活质量。

总结

现代管理CPSP的方法需要跨学科且以患者为中心的方法。根据CPSP的具体病因和症状定制治疗方案至关重要。药物治疗仍然是基础,包括用于管理神经性疼痛的抗惊厥药和抗抑郁药等药物。整合非药物干预对于提供全面护理至关重要。此外,研究创新技术和个性化医疗为提高治疗效果和改善CPSP患者的生活质量提供了有前景的机会。最终,认识到CPSP多方面性质的综合方法对于有效管理和患者福祉至关重要。

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