卒中后中枢性疼痛发病机制及非药物治疗研究进展  

Pathogenesis and nonpharmacological treatment of central post-stroke pain

作　　者：何璐羽 李维梅 杨乐医 王贺波 HE Lu-yu;LI Wei-mei;YANG Le-yi;WANG He-bo(School of Graduate,North China University of Science and Technology,Tangshan 063000,China;School of Graduate,Hebei Medical University,Shijiazhuang 050000,China;Department of Neurology,Hebei General Hospital,Shijiazhuang 050000,China;Key Laboratory of Brain Networks and Cognitive Disorders,Hebei Province,Shijiazhuang 050000,China)

机构地区：[1]华北理工大学研究生学院,唐山063000 [2]河北医科大学研究生学院,石家庄050000 [3]河北省人民医院神经内科,石家庄050000 [4]河北省脑网络与认知障碍疾病重点实验室,石家庄050000

出　　处：《中国疼痛医学杂志》2025年第4期277-282,共6页Chinese Journal of Pain Medicine

基　　金：河北省自然科学基金(H2020307041);中央引导地方科技发展资金项目(236Z7745G);河北省省级科技计划资助(242W7703Z)。

摘　　要：卒中后中枢性疼痛(central post-stroke pain,CPSP)是一种脑卒中后致残率、致死率较高的中枢性神经病理性疼痛综合征,以自发痛、痛觉过敏、痛觉超敏和感觉异常为主要临床表现。CPSP的发病机制尚未完全明确,当前主要认为由中枢去抑制化、中枢敏化以及离子通道异常假说等共同作用,且药物治疗效果也并不尽如人意。近年来,CPSP发病机制和非药物治疗的相关研究进展迅猛。本文就CPSP临床表现、诊断、发病机制及非药物治疗研究进展等方面进行阐述,尤其从疾病临床表现角度对发病机制进行分析,并简要概述了重复经颅磁刺激、经颅直流电刺激、脑深部电刺激、脊髓电刺激、脑机接口等相关非药物治疗,以提高临床医师对CPSP的认知。Central post-stroke pain(CPSP),a central neuropathic pain syndrome,occurs after a cerebrovascular accident and has a high rate of disability and death.CPSP is characterized by spontaneous pain,allodynia,hyper-algesia and paraesthesia.The underlying mechanisms of CPSP have not been well understood.Current evidence suggests that it is primarily attributed to the combined effects of central disinhibition theory,central sensitization,and abnormal ion channel function.Unfortunately,the effect of drug treatment is not satisfactory.In recent years,rapid progress has been made in the pathogenesis and nonpharmacological treatment of CPSP.This article reviews the clinical manifestations,diagnosis,especially the pathogenesis and nonpharmacological treatment of CPSP.In particular,the pathogenesis of CPSP is analyzed from the perspective of clinical manifestations of the disease and related non-drug therapy such as repetitive transcranial magnetic stimulation,transcranial direct electrical stimulation,deep brain simulation,spinal cord stimulation and brain-computer interface technology are briefly summarized,in order to improve clinicians'understanding of CPSP.

关 键 词：卒中后中枢性疼痛 神经病理性疼痛 卒中 非药物治疗 发病机制 

分 类 号：R743.3[医药卫生—神经病学与精神病学]