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疼痛的最新概念

Recent concepts of pain.

作者信息

Melzack R

出版信息

J Med. 1982;13(3):147-60.

PMID:6184428
Abstract

Recent evidence shows that pain is not simply a function of the amount of bodily damage alone, but is influenced by attention, anxiety, suggestion, and other psychological variables. The gate control theory proposes than pain signals from the body are modulated by other, concurrent somatic inputs as well as by descending influences from the brain. It is now known that some kinds of pain can be diminished or abolished by anesthetic blocks of trigger points or by intense stimulation of the same points. These effects appear to be mediated by brainstem mechanisms that exert a tonic inhibitory effect on pain signals. Studies of paraplegic patients further elucidate the multiple neural interactions that occur in eliciting and alleviating pain. An example of interacting therapies for cancer pain is the significant augmentation of the effectiveness of the Brompton mixture by a psychologically supportive hospital environment.

摘要

最近的证据表明,疼痛不仅仅是身体损伤程度的简单函数,还受到注意力、焦虑、暗示和其他心理变量的影响。闸门控制理论提出,来自身体的疼痛信号会受到其他同时发生的躯体输入以及大脑下行影响的调节。现在已知,某些类型的疼痛可以通过触发点的麻醉阻滞或对同一点的强烈刺激而减轻或消除。这些效应似乎是由对疼痛信号产生紧张性抑制作用的脑干机制介导的。对截瘫患者的研究进一步阐明了在引发和减轻疼痛过程中发生的多种神经相互作用。癌症疼痛相互作用疗法的一个例子是,心理支持性的医院环境显著增强了布朗普顿合剂的疗效。

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