对阿片类药物使用障碍患者在阿片类药物激动剂治疗中的疼痛的定量感官测试:一个范围审查
Debora Oliveira1, Gabriel P A Costa2, Rodrigo Fontenele1
1. Department of Behavioral Health, Staint. Elizabeth's Hospital, Washington, DC, United States.
Pain medicine (Malden, Mass.)
|September 24, 2025
概括
定量感官测试 (QST) 显示了在接受阿片类药物激动剂治疗 (OAT) 的阿片类药物使用障碍 (OUD) 患者的疼痛理解潜力. 研究结果表明,即使在戒断后,疼痛处理也发生了变化,突出显示了神经适应性变化.
科学领域:
- 疼痛研究 疼痛研究
- 神经科学是一个神经科学.
- 药物中毒药物 药物中毒药物
背景情况:
- 阿片类药物使用障碍 (OUD) 是一种复杂的疾病,通常与改变疼痛感知有关.
- 片激动剂治疗 (OAT) 是OUD管理的基石,但它对疼痛机制的影响需要进一步阐明.
- 定量感官测试 (QST) 提供了一种标准化的方法来评估感官处理和疼痛途径.
研究的目的:
- 系统地审查QST的应用,以评估OAT的OUD患者的疼痛反应和潜在机制.
- 为了确定常见的QST方法和与疼痛相关的结局,在OAT的OUD患者的研究中报告.
- 综合关于疼痛处理异常及其在这个人群中的持续性的发现.
主要方法:
- 根据PRISMA-ScR指南进行了全面的范围审查.
- 从创立到2025年3月,在五个主要数据库 (Ovid MEDLINE,Embase,APA PsycINFO,Cochrane Library,Web of Science) 进行了系统的文献搜索.
- 研究包括使用QST在接受OAT (甲,布普伦诺芬等) 的OUD成年人的原始研究. ),有或没有同时出现的慢性疼痛.
主要成果:
- 包括45项研究,主要使用具有有限标准化的横截面设计.
- 静态QST,特别是热刺激是最常见的,在60%的研究中,OUD患者与对照人群相比,冷痛耐受性降低.
- 有限的动态QST数据表明中心敏感化,疼痛异常经常持续尽管戒断,表明持久的神经适应性变化.
结论:
- 在接受OAT的患者中,QST有望改善对疼痛机制的临床理解.
- 标准化协议,纵向研究和对QST对治疗结果的预测价值的调查对于临床整合至关重要.
- 需要进一步的研究来完善QST方法,并提高其在OUD群体的疼痛管理中的效用.
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