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人类癌症疼痛的缓解:酒精诱导的神经腺溶解与垂体电刺激

Relief of cancer pain in man: alcohol-induced neuroadenolysis vs. electrical stimulation of the pituitary gland.

作者信息

Yanagida H, Corssen G, Trouwborst A, Erdmann W

出版信息

Pain. 1984 Jun;19(2):133-41. doi: 10.1016/0304-3959(84)90833-9.

Abstract

To explore new methods for the control of intractable pain caused by advanced cancer, the analgesic effect of electrical stimulation of the pituitary gland was investigated in 25 patients. The results were compared with a control study and with the effects of alcohol-induced pituitary neuroadenolysis (NALP) in the same patients. The pain score (0: no pain at all, 4: extreme pain) in the control study was 3.88 +/- 0.33. After electrical stimulation of the pituitary gland it was 1.24 +/- 1.61; and after NALP it was 1.0 +/- 1.60. The pain scores after electrical stimulation and NALP were significantly lower (P less than 0.01) than those in the control study; but there was no significant difference when the two were compared with each other. The duration of pain relief following NALP (59.65 +/- 68.72 days) was significantly longer compared with that recorded following electrical stimulation (2.97 +/- 2.58 days). Autopsy examinations of 3 patients who expired from their malignancies revealed that the pain relief was unrelated to the degree of necrosis induced in the pituitary by alcohol. Naloxone administration did not inhibit the analgesic effect of either NALP or electrical stimulation. The advantages and disadvantages of electrical stimulation, the pain relief mechanism activated by this method, and potential clinical applications are also discussed.

摘要

为探索控制晚期癌症所致顽固性疼痛的新方法,对25例患者垂体电刺激的镇痛效果进行了研究。将结果与对照研究以及同一批患者酒精诱导垂体神经溶解术(NALP)的效果进行了比较。对照研究中的疼痛评分(0:完全无痛,4:剧痛)为3.88±0.33。垂体电刺激后为1.24±1.61;NALP后为1.0±1.60。电刺激和NALP后的疼痛评分显著低于对照研究(P<0.01);但二者相互比较时无显著差异。与电刺激后记录的疼痛缓解持续时间(2.97±2.58天)相比,NALP后的疼痛缓解持续时间(59.65±68.72天)显著更长。对3例死于恶性肿瘤的患者进行尸检发现,疼痛缓解与酒精诱导的垂体坏死程度无关。给予纳洛酮并未抑制NALP或电刺激的镇痛效果。还讨论了电刺激的优缺点、该方法激活的疼痛缓解机制以及潜在的临床应用。

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