Kitahata L M
Department of Anesthesiology, Yale University School of Medicine, New Haven, Connecticut.
Yale J Biol Med. 1993 Sep-Oct;66(5):437-42.
Pain has been a major concern of humankind since the ancient times, and it remains one of the most important subjects of all health care professionals. Despite the obvious overwhelming clinical importance, the major advances in its diagnosis and therapy have been made only recently. "How do the sensory apparatus of the body and system of signal transmission relate to pain of peripheral origin?" is the topic of discussion. To do this, it is important to understand what constitutes the total pain experience. It consists of: 1) signal transduction at the peripheral receptor site, 2) signal conduction along the peripheral nerve, 3) pain modulation at the level of the spinal cord, 4) pain perception at the supraspinal site, and 5) the associated sensations, emotional reactions, and effective state. The signal transmission related to pain may be modified by various analgesic agents. Specific analgesic agent has a specific site of action which may be at peripheral receptors, at peripheral nerves, at the level of the spinal cord, at supraspinal levels by activating descending inhibitory systems, or at more cephalad levels by reducing the affective component of pain.
自古以来，疼痛一直是人类主要关注的问题，并且它仍然是所有医疗保健专业人员最重要的课题之一。尽管其临床重要性显而易见，但直到最近才在疼痛的诊断和治疗方面取得了重大进展。“身体的感觉器官和信号传输系统如何与外周源性疼痛相关？”是讨论的主题。要做到这一点，了解构成整个疼痛体验的因素很重要。它包括：1）外周受体部位的信号转导，2）沿外周神经的信号传导，3）脊髓水平的疼痛调制，4）脊髓上部位的疼痛感知，以及5）相关的感觉、情绪反应和有效状态。与疼痛相关的信号传输可能会被各种镇痛剂改变。特定的镇痛剂有特定的作用部位，可能在外周受体、外周神经、脊髓水平、通过激活下行抑制系统在脊髓上水平，或通过减少疼痛的情感成分在更靠头端的水平。
