神经病理性疼痛的机制分类与治疗策略  

Pathophysiological mechanisms and therapeutic options of neuropathic pain

作　　者：陈雪梅[1] 许今[1] 王祥瑞[1] 

机构地区：[1]上海交通大学医学院附属仁济医院麻醉科,200127

出　　处：《国际麻醉学与复苏杂志》2013年第12期1128-1133,1138,共7页International Journal of Anesthesiology and Resuscitation

摘　　要：背景神经病理性疼痛（neumpathic pain，NP）是由于躯体感觉系统受损或病变而导致的顽固性疼痛，是严重影响患者生活质量的疾病。目的综述NP的发病机制、诊断与治疗的最新进展。内容从伤害感受器的敏感性增加、传入神经的异常电活动及中枢失抑制、脊髓背角变化促进伤害性感觉、交感系统对于伤害性感觉的维持和中枢重构5个方面阐述NP的发病机制，简介诊断方法，并从药物与非药物治疗的角度介绍现有的治疗方法。趋向根据发病机制的不同进行分类并采取相应的治疗措施将成为未来NP的防治方向，为患者提供更有效和精准的治疗策略。Background Being an intractable and chronic syndrome that may arise from injury to somatosensory system, neuropathic pain （NP） seriously affects the life quality of patients. Objective This review presents recent progress in the pathophysiological mechanisms, diagnosis and therapeutic options for NP. Content Five aspects of maladaptive changes in the peripheral, central and autonomic nervous system are focused to illustrate the pathophysiological mechanisms： sensitization of nocieeptors, abnormal ectopic excitability of affected neurons and disinhibition of nociception in the spinal inhibitory network, pronociceptive facilitation of the spinal dorsal horn, sympathetically maintained pain, as well as central nervous systerm reorganization processes. Recent progress of diagnosis, pharmacologic treatment and nonpharmacologic treatment of NP are also discussed. Trend A better understanding of pathophysiological mechanisms of NP will leads to a more effective and specific mechanism-based treatment approach.

关 键 词：神经痛 病理生理学 诊断 治疗学 

分 类 号：R741[医药卫生—神经病学与精神病学]