慢性疼痛的病理生理学 慢性疼痛的病理生理学
Stanley Lyndon1,2,3
1Center for Brain/Mind Medicine, Brigham and Women's Hospital, Boston, MA, United States.
The Clinical journal of pain
|January 30, 2026
概括
慢性疼痛将保护性感知转化为不适应性状态. 本综述确定了持续缓解的机制和目标,强调慢性疼痛是系统疾病.
科学领域:
- 神经科学是一个神经科学.
- 免疫学 免疫学 免疫学
- 遗传学 遗传学是一种遗传学.
- 心理学 心理学 心理学
背景情况:
- 慢性疼痛影响了20%的人口,由于不适应的神经,免疫和心理变化而持续存在.
- 保护性痛感可以转化为慢性疼痛状态,需要对潜在机制有更深入的了解.
研究的目的:
- 巩固关于 nociception 转化为慢性疼痛的机制和临床证据.
- 确定治疗杆点,以实现持久的疼痛缓解.
主要方法:
- 按照SANRA的指导进行叙事审查,搜索多个数据库 (PubMed,Embase等). 和灰色文学.
- 包括对生物,免疫学,遗传学,表观遗传学或心理社会机制的研究以及针对机制的干预措施.
- 有资格研究的专题综合和方法质量评估.
主要成果:
- 慢性疼痛涉及一个多阶段的级联:周围,脊柱和脊柱上敏感化.
- 神经免疫对话,微生物组失调,性别差异和表观遗传学都会放大疼痛.
- 新兴疗法针对离子通道,质激活,细胞因子和微生物组进行精确的疼痛管理.
结论:
- 慢性疼痛是一种系统性疾病,需要综合,基于机制和以人为中心的护理.
- 了解生物支架解释了治疗失败,并指导疾病修饰止痛药的研究.
- 未来的研究应该专注于公平的交付模式和慢性疼痛管理的精确方法.
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