阿片类药物诱导瘙痒的机制研究进展  

Research progress on mechanism of opioid-induced pruritus

作　　者：马芳 周培岚 苏瑞斌 MA Fang;ZHOU Pei-lan;SU Rui-bin(State Key Laboratory of Toxicology and Medican Countermeasures,Academy of Military Medical Sciences,Beijing 100850,China;College of Pharmacy,Nanjing University of Chinese Medicine,Nanjing 210046,China)

机构地区：[1]军事医学研究院,国家安全特需药品全国重点实验室,北京100850 [2]南京中医药大学药学院,江苏南京210046

出　　处：《中国药理学通报》2025年第1期29-34,共6页Chinese Pharmacological Bulletin

基　　金：国家自然科学基金资助项目(No 82273909)。

摘　　要：瘙痒是临床使用阿片类药物镇痛的患者普遍存在的严重不良反应之一。大量研究已经阐明阿片类药物的镇痛机制,但阿片类药物诱导瘙痒的机制尚不明确,瘙痒与镇痛之间的关系也模糊不清。目前的研究发现,阿片类药物作用于μ、κ及δ阿片受体后,直接或间接影响瘙痒关键受体——胃泌素释放肽受体的功能,进而影响瘙痒信息传递。神经介素B、神经肽Y、B型利钠肽等神经肽,以及其他受体如瞬时受体电位香草素1受体、N-甲基-D-天冬氨酸受体、5-羟色胺受体等,在吗啡诱导的瘙痒中也具有重要作用。 此外,阿片类药物所致瘙痒的预防和治疗也是围手术期吗啡镇痛的难点和热点之一。因此,明确瘙痒的具体发生机制,对寻找新的研究思路及预防和治疗阿片类药物诱导的瘙痒具有重要意义。Pruritus is one of the serious side effects in patients receiving opioid analgesia in clinic.A lot of studies have elucidated the analgesic mechanisms of opioids,but the mechanism of opioid-induced pruritus is still unclear,and the relationship between pruritus and analgesia is ambiguous.In the recent studies,after activation ofμ,κandδopioid receptors,opioids transmit itch information by interacting with the gastrin-releasing peptide receptor(GRPR)directly or indirectly.Neuropeptides such as neuromedin B(NMB),neuropeptide Y(NPY),B-type natriuretic peptide(BNP)and other receptors transient receptor potential vanilloids 1 receptor(TRPV1R),N-methyl-D-aspartate receptor(NMDAR)and 5-hydroxytryptamine(5-HT)receptor also play important roles in morphine-induced itching.In addition,the prevention and treatment of opioid-induced pruritus are still one of the difficulties and hot spots of perioperative morphine analgesia.Therefore,it is important to clarify the specific occurrence mechanism of pruritus to find new research ideas for the prevention and treatment of opioid-induced pruritus.

关 键 词：阿片类诱导的瘙痒 瘙痒与镇痛 瘙痒机制 阿片受体 胃泌素释放肽受体 瘙痒治疗 

分 类 号：R971.1[医药卫生—药品]