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ノシプラスティック疼痛:一般的な疼痛状態の理解に向けて
Mary-Ann Fitzcharles1, Steven P Cohen2, Daniel J Clauw3
1Department of Rheumatology and Alan Edwards Pain Management Unit, McGill University, Montreal, QC, Canada.
Lancet (London, England)
|June 1, 2021
まとめ
ノシプラスティック疼痛は,ノシセプティブおよび神経疾患性疼痛とは異なる,新たに定義された疼痛カテゴリーである. ノシプラスティックな痛みを認識することは 治療に異なる反応をするので 効果的な治療に不可欠です
科学分野:
- 痛みに関する研究
- 神経科学
- 臨床疼痛管理
背景:
- ノシプラスティック疼痛は,ノシセプティブ (組織損傷) と神経疾患 (神経損傷) の異なる疼痛カテゴリーです.
- その根本的なメカニズムは 拡張された中枢神経系 (CNS) 処理と痛みの調節の変化です
- 症状には,組織損傷を上回る広範な痛みと,疲労や気分障害のような中枢神経関連の問題があります.
研究 の 目的:
- ノシプラスティック痛みを他の痛みのカテゴリと区別する.
- ノシプラスティック疼痛の認識が 適切な治療戦略に重要であることを強調する.
主な方法:
- 機械的な理解に基づく概念的定義と差別化.
- 臨床症状分析について
- 治療反応の比較
主要な成果:
- ノシプラスティック疼痛は,識別可能な損傷と中枢神経系に由来する症状に不釣り合いな痛みによって特徴付けられます.
- 独立して (例えば,線維筋痛) または他の痛みタイプ (例えば,慢性腰痛) と一緒に起こることがあります.
- 抗炎症薬やオピオイドのような 外部治療に対する反応が低下しています
結論:
- ノシプラスティックな痛みは 3つ目の痛みのカテゴリーです
- 正確な診断は治療決定を導くために不可欠です.
- 治療アプローチは,痛感性または神経疾患の痛みとは異なる必要があります.
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