Levine J
Ann Intern Med. 1984 Feb;100(2):269-76. doi: 10.7326/0003-4819-100-2-269.
Recent advances have been made in research on the physiology of pain, especially that focusing on the primary afferent nociceptor and endogenous analgesia systems. These advances have shed new light on the mechanisms of action of some long-used methods of managing pain, have led to the development of several methods, and have suggested new lines of investigation that may lead to more rational treatment of pain. The earlier that we can intervene in the pain-transmission pathways, the more likely we are to produce adequate and lasting control of pain. The peripheral nervous system is an important target for this therapeutic approach. The elucidation of the central neural pathways, which contain endogenous opioids and mediate the analgesia elicited by opiates, has raised the possibility of more rational use of this class of analgesics. The rationale for the use of current therapies needs to be reexamined in light of these new findings, and both current and new methods need to be tested in controlled trials.
近年来，疼痛生理学研究取得了进展，特别是在对初级传入伤害感受器和内源性镇痛系统的研究方面。这些进展为一些长期使用的疼痛管理方法的作用机制提供了新的见解，促成了几种方法的开发，并提出了可能带来更合理疼痛治疗的新研究方向。我们越早干预疼痛传递途径，就越有可能实现对疼痛的充分且持久的控制。外周神经系统是这种治疗方法的重要靶点。对包含内源性阿片类物质并介导阿片类药物引起的镇痛作用的中枢神经通路的阐明，增加了更合理使用这类镇痛药的可能性。鉴于这些新发现，需要重新审视当前疗法的使用原理，并且当前和新方法都需要在对照试验中进行测试。
