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  2. 慢性非癌症疼痛的非阿片类药物治疗
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  2. 慢性非癌症疼痛的非阿片类药物治疗

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慢性非癌症疼痛的非阿片类药物治疗

Randi Sokol1, Ellie Grossman2, Rebecca Bourgery2

  • 1Cambridge Health Alliance, Malden, Massachusetts.

American family physician
|August 20, 2025

在PubMed 上查看摘要

概括
此摘要是机器生成的。

慢性疼痛影响着数以百万计的人, 有效的治疗方法因疼痛类型而异,包括治疗骨关节炎的NSAID和治疗神经性疼痛和纤维肌痛的特定药物,而阿片类药物则是最后的手段.

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科学领域:

  • 治疗疼痛
  • 药理学
  • 康复工作

背景情况:

  • 慢性疼痛是一种普遍且使人衰弱的疾病,每5名美国成年人中就有1人受到影响.
  • 一个全面的,以患者为中心的生物心理社会方法对于有效的慢性疼痛管理至关重要.
  • 治疗策略必须针对疼痛类型,功能,生活质量,自我管理和精神健康相关疾病.

研究的目的:

  • 审查慢性疼痛目前的药物治疗和非药物治疗方案.
  • 为特定的慢性疼痛症提出基于证据的治疗建议.
  • 强调一个量身定制,多学科的疼痛管理方法的重要性.

主要方法:

  • 对治疗慢性疼痛的现有文献进行系统审查.
  • 对骨关节炎,慢性腰部疼痛,神经病痛和纤维肌痛的药理疗效分析.
  • 评估非药物干预和阿片类药物的作用.

主要成果:

  • 非类固醇抗炎药物 (NSAID) 可以显著缓解骨关节炎的疼痛.
  • 有限的证据支持SNRIs和 gabapentinoids用于骨关节炎;药物治疗对慢性腰部疼痛的益处很小.
  • 杜洛西丁, gabapentin, 普雷加巴林和局部素对神经病痛有效; 普雷加巴林,杜洛西丁和米尔纳西普兰对纤维肌痛有效.

结论:

  • 治疗慢性疼痛的选择应根据疼痛类型和患者因素进行个性化.
  • 药物治疗和非药物治疗的结合,以及自我管理,是改善功能和生活质量的关键.
  • 使用阿片类药物应保留在对其他治疗不耐药的情况下,经过仔细的风险益处评估.