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用于神经性疼痛管理的周围神经刺激:一项叙述性综述。

Peripheral Nerve Stimulation for Neuropathic Pain Management: A Narrative Review.

作者信息

Mao Zhangyan, Lv Jing, Sun Yan, Shen Jiwei, Gao Yafen, Sun Shujun, Yang Dong

机构信息

Department of Pain, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1277, Jiefang Avenue, Wuhan, 430022, China.

Institute of Anesthesia and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.

出版信息

Pain Ther. 2024 Dec;13(6):1387-1406. doi: 10.1007/s40122-024-00659-6. Epub 2024 Sep 28.

Abstract

This narrative review examines the therapeutic efficacy of peripheral nerve stimulation (PNS) in the treatment of neuropathic pain (NP), a type of pain arising from lesions or diseases of the somatosensory system with a global prevalence ranging from 6.90% to 10.00%. Traditional pharmacological interventions often fall short for many persons, highlighting the need for alternative treatments such as PNS, which has demonstrated significant promise with minimal side effects. The review summarizes the effectiveness of PNS in various NP conditions, including trigeminal neuralgia and postherpetic neuralgia, and underscores the need for further research to refine treatment approaches. The mechanism of PNS is discussed, involving the activation of non-nociceptive Aβ fibers and modulation of neurotransmitters, and offering pain relief through both peripheral and central pathways. Despite the proven efficacy of PNS, challenges remain, including the need for randomized controlled trials and the optimization of stimulation parameters. The review concludes that PNS is a promising treatment modality for NP, warranting additional high-quality trials to solidify its role in clinical practice.

摘要

本叙述性综述探讨了周围神经刺激(PNS)在治疗神经性疼痛(NP)中的疗效。神经性疼痛是一种由躯体感觉系统的损伤或疾病引起的疼痛,全球患病率在6.90%至10.00%之间。传统的药物干预对许多人来说往往效果不佳,这凸显了对PNS等替代治疗方法的需求,PNS已显示出显著的前景且副作用最小。该综述总结了PNS在各种NP病症(包括三叉神经痛和带状疱疹后神经痛)中的有效性,并强调需要进一步研究以完善治疗方法。文中讨论了PNS的机制,包括非伤害性Aβ纤维的激活和神经递质的调节,并通过外周和中枢途径缓解疼痛。尽管PNS的疗效已得到证实,但挑战依然存在,包括需要进行随机对照试验以及优化刺激参数。该综述得出结论,PNS是一种有前景的NP治疗方式,需要更多高质量试验来巩固其在临床实践中的作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d62/11543982/05b14d4dd33a/40122_2024_659_Fig1_HTML.jpg

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