Hautkappe M, Roizen M F, Toledano A, Roth S, Jeffries J A, Ostermeier A M
Department of Anesthesia and Critical Care, the University of Chicago, Illinois 60637, USA.
Clin J Pain. 1998 Jun;14(2):97-106. doi: 10.1097/00002508-199806000-00003.
Topical capsaicin is known to be a safe and effective pain management adjunct for rheumatoid arthritis, osteoarthritis, neuralgias, and diabetic neuropathy. However, studies and case reports in the literature have indicated that other conditions may also benefit from capsaicin: painful or itching cutaneous disorders from operations, injuries, or tumors; neural dysfunction; or inflammation of the airways and urinary tract.
To determine the effectiveness of capsaicin for painful cutaneous disorders and neural dysfunction, the authors analyzed data from 33 reports (MEDLINE search of 1966-96) on the efficacy of capsaicin. Outcome measures consisted of the response rate and degree of pain relief. Results from placebo-controlled trials were pooled when possible; effect of treatment was estimated by the method of DerSimonian and Laird.
Pain relief for postmastectomy syndrome and cluster headache was greater with capsaicin than with placebo; also, psoriasis and pruritus responded better to capsaicin. Uncontrolled studies and case reports have indicated that pain or dysfunction was less at the end of capsaicin therapy for neck pain, loin pain/hematuria syndrome, oral mucositis, rhinopathy, reflex sympathetic dystrophy syndrome, detrusor hyperreflexia, and cutaneous pain due to tumor of the skin.
Capsaicin is effective for psoriasis, pruritus, and cluster headache; it is often helpful for the itching and pain of postmastectomy pain syndrome, oral mucositis, cutaneous allergy, loin pain/hematuria syndrome, neck pain, amputation stump pain, and skin tumor; and it may be beneficial for neural dysfunction (detrusor hyperreflexia, reflex sympathetic dystrophy, and rhinopathy). A universal problem for many of the studies analyzed was the absence of a "burning placebo" such as camphor.
局部使用辣椒素是类风湿性关节炎、骨关节炎、神经痛和糖尿病性神经病变安全有效的疼痛管理辅助药物。然而，文献中的研究和病例报告表明，其他病症也可能从辣椒素中获益：手术、损伤或肿瘤引起的疼痛或瘙痒性皮肤疾病；神经功能障碍；或气道和尿道炎症。
为确定辣椒素对疼痛性皮肤疾病和神经功能障碍的有效性，作者分析了33篇关于辣椒素疗效的报告（1966 - 1996年MEDLINE检索）中的数据。结局指标包括缓解率和疼痛减轻程度。尽可能汇总安慰剂对照试验的结果；采用DerSimonian和Laird方法估计治疗效果。
辣椒素治疗乳房切除术后综合征和丛集性头痛的疼痛缓解效果优于安慰剂；此外，银屑病和瘙痒症对辣椒素反应更好。非对照研究和病例报告表明，辣椒素治疗结束时，颈部疼痛、腰背痛/血尿综合征、口腔黏膜炎、鼻病、反射性交感神经营养不良综合征、逼尿肌反射亢进以及皮肤肿瘤引起的皮肤疼痛的疼痛或功能障碍减轻。
辣椒素对银屑病、瘙痒症和丛集性头痛有效；对乳房切除术后疼痛综合征、口腔黏膜炎、皮肤过敏、腰背痛/血尿综合征、颈部疼痛、截肢残端疼痛和皮肤肿瘤的瘙痒和疼痛通常有帮助；对神经功能障碍（逼尿肌反射亢进、反射性交感神经营养不良和鼻病）可能有益。所分析的许多研究的一个普遍问题是缺乏诸如樟脑之类的“灼烧安慰剂”。
