Claessens Anouk A E, Vriend Linda, Ovadja Zachri N, Harmsen Martin C, van Dongen Joris A, Coert J Henk
Department of Plastic, Reconstructive and Hand Surgery, Medisch Centrum Leeuwarden, 8934 AD Leeuwarden, The Netherlands.
Department of Plastic, Reconstructive and Hand Surgery, University Medical Center Utrecht (UMC Utrecht), 3584 CX Utrecht, The Netherlands.
Bioengineering (Basel). 2024 Sep 30;11(10):992. doi: 10.3390/bioengineering11100992.
Neuropathic pain results from a defect in the somatosensory nervous system caused by a diversity of etiologies. The effect of current treat-ment with analgesics and surgery is limited. Studies report the therapeutic use of adipose tissue-derived components to treat neuropathic pain as a new treatment modality.
The aim of this systematic review was to investigate the therapeutic clinical efficacy of adipose tissue-derived components on neuro-pathic pain.
PubMed, Medline, Cochrane and Embase databases were searched until August 2023. Clinical studies assessing neuropathic pain after autologous fat grafting or the therapeutic use of adipose tissue-derived com-ponents were included. The outcomes of interest were neuropathic pain and quality of life.
In total, 433 studies were identified, of which 109 dupli-cates were removed, 324 abstracts were screened and 314 articles were excluded. In total, ten studies were included for comparison. Fat grafting and cellular stromal vascular fraction were used as treatments. Fat grafting indications were post-mastectomy pain syndrome, neuromas, post-herpetic neuropathy, neuro-pathic scar pain and trigeminal neuropathic pain. In seven studies, neuropathic pain levels decreased, and overall, quality of life did not improve.
The therapeutic efficacy of adipose tissue-derived components in the treatment of neuropathic pain remains unclear due to the few performed clinical trials with small sample sizes for various indications. Larger and properly designed (randomized) controlled trials are required.
神经性疼痛是由多种病因导致的躯体感觉神经系统缺陷引起的。目前镇痛药和手术治疗的效果有限。研究报道了使用脂肪组织衍生成分治疗神经性疼痛作为一种新的治疗方式。
本系统评价的目的是研究脂肪组织衍生成分治疗神经性疼痛的临床疗效。
检索了截至2023年8月的PubMed、Medline、Cochrane和Embase数据库。纳入评估自体脂肪移植后或脂肪组织衍生成分治疗后神经性疼痛的临床研究。感兴趣的结局指标是神经性疼痛和生活质量。
共识别出433项研究，其中去除109项重复研究，筛选324篇摘要，排除314篇文章。总共纳入10项研究进行比较。使用脂肪移植和细胞基质血管成分作为治疗方法。脂肪移植的适应证包括乳房切除术后疼痛综合征、神经瘤、带状疱疹后神经痛、神经性瘢痕疼痛和三叉神经神经性疼痛。在7项研究中，神经性疼痛水平降低，但总体而言，生活质量并未改善。
由于针对各种适应证进行的临床试验较少且样本量小，脂肪组织衍生成分治疗神经性疼痛的疗效仍不明确。需要开展更大规模且设计合理（随机）的对照试验。
