摘要
目的:分析中枢性疼痛治疗和预后研究状况及其与发病假说间关系。资料来源:应用计算机检索Medline数据库2000-01/2004-12与中枢性疼痛治疗及其预后相关的文章,检索词为“centralpain”,限定检索语言为英文。同时检索万方数据库与中枢性疼痛治疗及其预后相关的文章,检索词为“中枢性疼痛,治疗,预后”。资料选择:对资料进行初审,选择与中枢性疼痛治疗、预后有关的文章,排除综述类文章及未提供类文章。资料提炼:共收集到45篇与中枢性疼痛有关的文章,排除综述类文章8篇,去除未提供的文章10篇,共入选文章27篇,通过阅读及全文对内容进行分类整理。资料综合:硬膜外皮质刺激治疗中枢性疼痛是近年功能神经外科领域的一个新的手段,约50%的患者可以从中受益。药物治疗可以减轻疼痛,但不能完全缓解,三环抗抑郁药如去甲阿米替林或抗惊厥药可能有用,降低应激水平好象可以减轻疼痛。以上治疗经验验证了中枢性疼痛的病灶学说及中枢神经元异常兴奋的假说。中枢性疼痛患者伴有的其他感觉异常及部分患者的缓解为中枢性疼痛机制研究提供了新的线索。结论:皮质、脊髓刺激及药物治疗对中枢性疼痛均有一定疗效。目前的研究及发现均在不断地验证中枢性疼痛的定位假说及中枢神经元的异常兴奋假说。
OBJECTIVE:To analyze treatment and prognosis of central pain and their relatio nship with the hypothesis in central pain. DATA SOURCES:Literatures about treatment and prognosis of central pain from Ja nuary 2000 to December 2004 were computersearched in Medline,with the key word s of “central pain' and the language was limited to English.Meanwhile,the same literatures as above was also computersearched in Wanfang Database with the ke y words “central pain,treatment,prognosis' and language was limited to Chinese. STUDY SELECTION:The literatures related to treatment and prognosis of central pain were selected by the primary trial,however review and literatures without a bstract were eliminated. DATA EXTRACTION:Totally 45 literatures were found about central pain in Medlin e database and Wanfang database,amongst which 27 literatures were admitted and t he other 18 excluded for no abstracts in 10 nor review in 8.The included literat ures were classified according to their content by reading the abstracts and ful l texts. DATA SYNTHESIS:Extradural cortical stimulation for neurogenic pain was a recen t addition to the field of functional neurosurgery.About 50%of patients with ce ntral pain drew benefit in the long run.Pain medications often provided some red uction of pain,but not complete relief of pain.Tricyclic antidepressants such as nortriptyline and anticonvulsants could be useful.Lowering stress levels appear ed to reduce pain.The above therapeutic experience verified focal theory of cent ral pain and hypothesis in central neuronal hyperexcitability.Other paresthesia of patients with central pain and relief of partial central pain patients provid ed new means for studying on the mechanism of central pain. CONCLUSION:Cortical and spinal cord stimulation and pain medications are effec tive for central pain.The results of studies validate the focal nature of centra l pain and hypothesis of neuronal hyperexcitability step by step.
出处
《中国临床康复》
CSCD
北大核心
2005年第14期172-173,共2页
Chinese Journal of Clinical Rehabilitation
